November 5, 2013

Prediabetes Requires Lifestyle Changes

By Julie Suchanek, MBA, MT (ASCP)
Metropolitan Medical Laboratory, PLC

Prediabetes – a Cause for Concern

Prediabetes can lead to diabetes, and the incidence of diabetes has been increasing for decades. If CDC predictions are accurate, as many as one in three American adults, or 45-50 million, may have diabetes in the year 2050 if present trends continue. According to Dr. Kevin McKinney, director of the adult clinical endocrinology unit at the University of Texas Medical Center in Galveston, “There is no way that the medical community could keep up
with that.”

According to the American Diabetes Association (ADA), 35 percent of U.S. adults 20 years and older have prediabetes, as do 50 percent of those aged 65 years or older. Yet, only 7.3 percent of Americans with prediabetes have been told they have it.

What is Prediabetes?

Prediabetes occurs when a person has a blood glucose or Hemoglobin A1c level higher than normal, but not high enough for a diagnosis of diabetes. He or she is at a higher risk for developing type 2 diabetes and other serious health problems including heart disease and stroke. Without lifestyle changes to improve health, 15-30 percent of people with prediabetes will develop type 2 diabetes within five years – and most will develop type 2 diabetes within 10 years.

Prediabetes usually occurs in people who already have insulin resistance. With insulin resistance, glucose builds up in the blood instead of being absorbed by the cells. In prediabetes, beta cells in the pancreas can no longer produce enough insulin to overcome insulin resistance, causing blood glucose levels to rise above the normal range.

The exact causes of insulin resistance are not completely understood. However, scientists believe that excess weight and physical inactivity are major contributors. Other causes may include genetics, ethnicity, certain diseases, hormones, steroid use, some medications, older age, sleep problems (especially sleep apnea), and cigarette smoking.

Diabetics can suffer from diverse complications that seriously erode their quality of life, such as:

• heart disease and stroke
• hypertension
• high cholesterol
• blindness or eye problems
• kidney disease
• nervous system disease
• amputations
• dental disease
• complications of pregnancy

Cost of Diabetes

Diabetics have health care costs 2.3 times higher than what they would have had in the absence of diabetes. Also:
• 1 in 10 health care dollars is spent treating diabetes and its complications
• in 5 health care dollars is spent caring for people with diabetes

Symptoms
Insulin resistance and prediabetes often have no symptoms. Classic symptoms for type 2 diabetes are increased thirst, frequent urination, fatigue, and blurred vision.

Testing

The ADA recommends that prediabetes testing is considered in adults who have any of these risk factors: overweight or obese; physically inactive; have a parent or sibling with diabetes; family background that is African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, or Pacific Islander; women who have given birth to a baby weighing more than 9 pounds and/or who have had gestational diabetes; high blood pressure (140/90 mmHg and above); HDL cholesterol below 35 mg/dL or a triglyceride level above 250 mg/dL; polycystic ovary syndrome; cardiovascular disease; regularly sleep fewer than six hours or more than nine hours a night; have a dark, velvety rash around your neck or other areas; have blood vessel problems affecting your heart, brain, or legs; and other conditions.

The diagnostic criteria for diabetes and prediabetes have changed over time. This criteria is currently based on the results of three blood tests – Hemoglobin A1c (A1c), Fasting Plasma Glucose (FPG), and a 2-hour Oral Glucose Tolerance Test (OGTT), as shown in the arrowed diagram. Additional testing may include such tests as a Lipid Panel and/or Microalbumin.

Treatment & Prevention

If you do have prediabetes, research has shown that you can prevent or delay type 2 diabetes with these lifestyle changes – and in some cases, return your blood glucose levels to normal by:
• losing 5-7 percent of your body weight (10-14 lbs. for a 200-
lb. person)
• getting at least 150 minutes of physical activity each week
• not smoking
• taking a medication such as metformin or acarbose
• getting at least six hours or more of sleep each night

Make an appointment today with your physician to discuss whether or not you should be tested for prediabetes, a potential silent stalker of your good health. The sooner you know, the quicker you can get your health “back on track” by setting some goals and then achieving them.

Metropolitan Medical Laboratory, PLC is one of the largest accredited laboratories in the states of Illinois and Iowa, and has provided this community with quality laboratory services for 99 years. Visit www.metromedlab.com. See Metro’s NEWEST location which opened last month – located near the intersection of Kimberly and Marquette in northwest Davenport:

3906 Lillie Avenue,Suite #3
Davenport, Iowa 52806
Phone (563) 386-3000
Hours: Mon.-Fri. 6 am – 6 pm; Sat. 6 am – noon

Tell your doctor, “I want to go to Metro.”

Filed Under: Health & Wellness