Health Hotline

By Erin Louks Smith, M.D.

****

Most people recognize diabetes as a serious disease, but what many may not realize is that diabetes typically has a gradual onset, which most often begins as a condition called prediabetes. According to the American Diabetes Association, 86 million people - or about one in four - has prediabetes, and many are unaware they have the condition.

This is because prediabetes is often a silent disease without any symptoms. One symptom that sometimes occurs is darkened skin on the neck, armpits, elbows, knees and knuckles. This is called acanthosis nigricans. Signs that you’ve moved from prediabetes to type 2 diabetes are increased thirst, increased urination, fatigue and blurred vision.

Prediabetes occurs when your body doesn’t process sugar normally and this results in elevated levels of glucose in your blood. Prediabetes occurs when the blood glucose level is above normal, but not high enough to cause a diagnosis of diabetes.

Risk factors for prediabetes include:

Age - people over 45 have a greater likelihood of developing prediabetes.

Weight - people with a body mass index of 25 or higher, especially for those who carry their weight in the stomach and have excess belly fat.

Family history - having a parent or sibling with type 2 diabetes raises your risk.

A sedentary lifestyle - lack of exercise increases risk.

Smoking - according to the Centers for Disease Control, smokers are 30 to 40 percent more likely to develop prediabetes and type 2 diabetes than nonsmokers.

Having high cholesterol, high triglycerides, low HDL cholesterol and high LDL cholesterol.

Race - people who are African American, Hispanic/Latino, American Indian, Asian American and Pacific Islander are at greater risk.

A history of gestational diabetes or giving birth to a baby weighing more than nine pounds.

Sleep issues - such as obstructive sleep apnea.

Having a condition called polycystic ovary syndrome.

According to the CDC, prediabetes puts you at risk for developing type 2 diabetes. Without lifestyle changes to improve health, 15 to 30 percent of people with prediabetes will develop type 2 diabetes within five years. But developing type 2 diabetes isn’t inevitable. Prediabetes can be an opportunity to improve your health and stop or minimize the long-term damage - especially to your heart and circulatory system - that can be complications of type 2 diabetes.

Some risk factors, such as your age, can’t be changed. But certain lifestyle changes can decrease your overall risk.

Maintain a healthy weight, or lose 5 to 7 percent of your body weight if you are overweight. For a person weighing 200 pounds a weight loss of just 10-14 pounds would meet this goal.

Eat healthy. A healthy diet doesn’t have to be complicated. Aim for a diet that includes lean protein, whole grains and is rich in fruits and vegetables (aim for a variety of colors). Limit serving sizes. Avoid processed foods. Drink plenty of water.

Exercise - try to get at least 30 minutes a day five days a week. Check with your healthcare professional before starting any new exercise regime.

Treat high blood pressure and high cholesterol by following the recommendations of your health care provider.

Quit smoking.

Get enough sleep. Insufficient sleep makes it harder to lose weight. It also makes it harder for your body to process sugar effectively.

Follow the advice and treatment plan from your health care professional.

If you have multiple risk factors for prediabetes, or if you had an abnormal blood sugar reading in the past, have heart disease or show signs of insulin resistance, your healthcare provider may recommend you be tested for prediabetes by performing one of three different blood tests that check for the disease. The sooner prediabetes is identified, the sooner you can get on track to make lifestyle changes that can stop it in its tracks.

Complications of type 2 diabetes are serious and include high blood pressure, high cholesterol, heart disease, stroke, kidney disease, blindness and amputations. Prediabetes can serves as a warning and wake up call for you to make healthy changes in your lifestyle and avoid having prediabetes develop into something much more serious.

If are interested in evaluating your risk factors for prediabetes, the CDC offers an online quiz to help you assess your risk. You can find it at: www.cdc.gov/diabetes/basics/prediabetes.html.