Prediabetes - Am I at Risk?

What is Prediabetes?

Prediabetes can put a patient at high risk for developing type 2 diabetes. Most people who develop diabetes have prediabetes first, but may not know it. Prediabetes is defined as abnormally high blood sugar levels, but not high enough to be officially diagnosed with diabetes. People with prediabetes may have insulin resistance, a condition in which the body produces insulin but does not use it effectively. Your doctor can complete tests and take a history and physical to determine if you have prediabetes or diabetes. Only 7.3% of Americans with prediabetes have been told they have it. The good news is prediabetes is reversible if you take action to lose some weight, eat healthy, and exercise.

What is the Cost Impact of Diabetes in the U.S. Healthcare System?

The cost of diagnosed diabetes in the U.S. healthcare system is immense. The total cost of diabetes care in 2012 was close to $245 billion, with roughly $70 billion in lost productivity costs such as disability, work loss, or premature death attributed to diabetes. In addition, the average medical expenditures among people with diabetes were 2.3 times higher than in those without diabetes. One in five health care dollars is spent caring for people with diabetes. However, the overall cost of undiagnosed diabetes might even be greater. Only after a diagnosis of prediabetes or diabetes can a patient know to take action to change their lifestyle and prevent complications.

Should I Be Tested for Prediabetes or Diabetes?

Follow these guidelines:
  • If you are over 45 years and overweight, get tested.
  • If your weight is normal but you are over 45 years, ask your doctor.
  • If you are under age 45, but overweight with high blood pressure, low HDL (“good”) cholesterol, or high triglycerides you may need testing.
  • Get tested if you have a family history of diabetes, diabetes in pregnancy, or you gave birth to a baby over 9 pounds.
  • Black, Hispanic, Pacific Islander, Asian, or American Indian ancestries may need to be tested.

What are the Complications from Having Prediabetes or Diabetes?

Diabetes complications due to high blood sugar can damage your nerves, and result in harm to small and large vessels in your body. Long-term and potentially life-threatening complications may occur such as:
  • Heart disease and stroke
  • High blood pressure
  • Blindness due to diabetic retinopathy in the eye
  • Kidney disease requiring dialysis or transplant
  • Nervous system damage (neuropathy)
  • Lower-limb amputations

What are the Symptoms of Prediabetes or Diabetes?

Not all people with prediabetes have recognizable symptoms. In fact, diabetes usually develops slowly. The fact is that most people with prediabetes will develop diabetes within 10 years or sooner if action is not taken. Symptoms of diabetes may include:
  • Excessive thirst
  • Frequent urination
  • Blurred vision
  • Extreme fatigue
  • Frequent infections
  • Slow healing cuts or bruises
  • Numbness in hands/feet
  • Darkened skin areas (neck, armpits, or elbows)

How is Prediabetes and Diabetes Diagnosed?

There are several tests that can be used to diagnose prediabetes or diabetes. You may need to return to your doctors office for more than one visit to have tests repeated to confirm a diagnosis. However, high blood glucose combined with a history of symptoms may be all that your doctor needs to diagnose prediabetes or diabetes.

Some of these tests may require that you have not had anything to eat for 12 hours (fasting) and only water to drink, so check with your doctor before you have blood tests completed.

What Tests Are Used to Diagnose Diabetes?

  • A1C: The A1C test measures your average blood glucose over the past 2 to 3 months; results greater than 6.5% usually results in a diagnosis of diabetes.
  • Fasting Plasma Glucose (FPG): Diabetes is diagnosed with values greater than or equal to 126 mg/deciliter (dL).
  • Oral Glucose Tolerance Test (OGTT): Your blood sugar levels are checked before and 2 hours after you consume a sweet drink; a positive result is over 200 mg/dL.
  • Random Plasma Glucose Test: Diabetes is diagnosed with glucose greater than 200 mg/dL.

How Do I Know if I Have Prediabetes?

Seeing your doctor and having blood tests done if you have risk factors for diabetes is key to diagnosing prediabetes. The tests used to diagnose prediabetes are the same as the ones used to diagnose diabetes, but the blood sugar results are lower. Catching elevated blood sugars in the prediabetes phase may allow you to make lifestyle changes and avoid drug treatment. Test results that may guide your doctor to a diagnosis of prediabetes include:
  • An A1C of 5.7% to 6.4%
  • A fasting blood glucose of 100 – 125 mg/deciliter (dL)
  • An OGTT 2 hour blood glucose of 140 mg/dL – 199 mg/dL

My Tests Show I Have Prediabetes - What Now?

Prediabetes should be a wake-up call for a healthier routine. You can reduce your risk of developing diabetes through lifestyle changes, including eating a healthy diet, losing weight and regular exercise. Consult with your doctor, a diabetes specialist and possibly even a dietician who can help guide you through these changes. Research shows that you can cut your risk for type 2 diabetes in half by meeting these two goals:
  • Losing about 7% to 10% of your body weight (15 to 20 pounds if you weigh 200 pounds).
  • Moderate exercise (such as brisk walking, swimming or bicycling) 30 minutes a day, 5-6 days per week.

Is There a Treatment for Prediabetes?

Initial treatments for diabetes, such as metformin, sulfonylureas, or insulin are not typically started at this point, but your doctor will discuss if medications are need. Lifestyle changes, weight loss and healthy eating is usually your first approach. If you have been diagnosed with prediabetes, eating healthy foods that are low in fat and calories, and increasing your intake of high fiber foods may help you lower blood sugar and keep it from progressing to type 2 diabetes. Exercising 30 to 60 minutes a day, 5-6 times per week is important, too. Losing just 10 to 20 pounds if you weigh 200 pounds can reduce the risk of developing type 2 diabetes.

Finished: Prediabetes - Am I at Risk?

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Sources

  • American Diabetes Association. Diabetes Basics. Prediabetes. Accessed July 28, 2013 at http://www.diabetes.org/diabetes-basics/prevention/pre-diabetes/
  • American Diabetes Association. Diabetes Basics. Prediabetes FAQs. Accessed July 28, 2013 at http://www.diabetes.org/diabetes-basics/prevention/pre-diabetes/pre-diabetes-faqs.html
  • American Diabetes Association. Fast Facts. Data and Statistics About Diabetes. Accessed August 30, 2014 at http://professional.diabetes.org/admin/UserFiles/0%20-%20Sean/FastFacts%20March%202013.pdf
  • U.S. Department of Health and Human Services. National Diabetes Information Clearinghouse (NDIC). Prediabetes - What you need to know. Accessed July 28, 2013. http://diabetes.niddk.nih.gov/dm/pubs/prediabetes_ES/
  • U.S. Department of Health and Human Services. National Diabetes Information Clearinghouse (NDIC). Insulin resistance and prediabetes. Accessed July 28, 2013. http://diabetes.niddk.nih.gov/dm/pubs/prediabetes_ES/
  • Drugs.com. Health Tip: Should I Be Screened for Prediabetes? Accessed July 28, 2013 at http://www.drugs.com/news/health-tip-should-screened-prediabetes-42359.html.
  • U.S. Diabetes Rate Jumps to 29 Million:CDC. Drugs.com, June 10, 2014. Accessed August 28, 2014 at http://www.drugs.com/news/u-s-diabetes-rate-jumps-29-million-cdc-51944.html
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