Eat Well to Be Well: A prescription for prediabetes – be proactive

We’ve all heard of type 1 or type 2 diabetes, but what about prediabetes? The prevalence of prediabetes is a major problem in this country. It’s estimated 79 million Americans have it, with about 35 percent of adults aged 20 and older and 50 percent of adults aged 65 and older. It is an under diagnosed and under treated condition that is affecting our economy and the cost of medicine. The cost of prediabetes increased by 74 percent to $44 billion from 2007 to 2012 – in 2012, diabetes exceeded $322 billion due to high medical costs and lost productivity. The progression of prediabetes to diabetes needs to be delayed or reversed before it causes major health problems in individuals and collapses our healthcare system.

“Obesity has significantly increased the diagnosis of prediabetes in America,” said Dr. David Samadi, chairman of urology and chief of robotic surgery at Lenox Hill Hospital in New York City. “According to the Centers for Disease Control and Prevention, approximately 79 million American adults have prediabetes. As you might guess, prediabetes can develop into diabetes.”

Prediabetes is a condition in which blood glucose levels are higher than normal but not high enough to be classified as full-blown type 2 diabetes. There are often no signs or symptoms of prediabetes but if you experience any of the following or other unusual symptoms, schedule an appointment with your doctor: fatigue, frequent urination, blurred vision, or increased thirst.

Risk factors that increase the likelihood of developing prediabetes include:

  • Being overweight or having a body mass index 25 or over.
  • Age 45 and older.
  • Physically inactive.
  • Family history.
  • High blood pressure.
  • Being African American, Hispanic, American Indian, Asian American or Pacific Islander.
  • If you’re a woman who has had gestational diabetes or has polycystic ovary syndrome.

Type 2 diabetes is when the pancreas may not make enough insulin or the body is unable to use the insulin it does make. As a result, the glucose (blood sugar) remains in the bloodstream causing blood sugar levels to be too high. This leads to increased risk of health complications such as heart disease, stroke, vision problems and blindness, kidney damage or failure, nerve damage (neuropathy), foot problems, skin complications, and dental disease.

Type 1 diabetes is a chronic condition in which the pancreas produces little to no insulin, usually diagnosed in childhood and requires daily insulin shots for the rest of the diabetic’s life.

Below is a chart showing the diagnosis of either prediabetes or diabetes comparing it people without diabetes:

Blood test Without diabetes Prediabetes Diabetes
Fasting blood glucose Less than 100 mg/dl 100-125 mg/dl 126 mg/dl or higher
Oral glucose tolerance test Less than 140-199 mg/dl after 2 hours Between 140-199 mg/dl after 2 hours 200 mg/dl or higher after 2 hours
Random blood glucose Less than 140 mg/dl Between 140-199 mg/dl 200 mg/dl or higher

Being told you have prediabetes is both a wake-up call and a call to action – you’re on the path to developing type 2 diabetes, but it’s not too late to reverse course. If you don’t take steps to delay or reverse prediabetes, the quality of your life may be greatly impacted in a negative way.

Be proactive to delay or reverse prediabetes

Once diagnosed with prediabetes, you need to think proactively.

Dr. Samadi stressed, “The good news, is that a diagnosis of prediabetes does not sentence you to a diagnosis of diabetes. Rather, with some lifestyle changes, diabetes can be prevented.”

Here are some steps that can help you to avoid major health issues and steer you in the right direction away from type 2 diabetes. Using the acronym PROACTIVE, begin today to start the process:

P – Prevent heart disease: The risk of heart disease goes up dramatically with diabetes so it’s important to have a heart-healthy lifestyle. Don’t smoke or use chewing tobacco and know your family history of heart disease.

“Unfortunately, chances are that the cardiovascular damage that occurs with type 2 diabetes is already occurring with prediabetes,” stated Dr. Samadi.

R – Regular sleep: If you’re not getting sufficient sleep each night (preferably 7 to 8 hours), you may not be using insulin effectively and it can make losing weight harder. Develop good sleep habits like going to bed and getting up at the same time each day, avoid caffeine before bedtime, and turn off computers and cell phones.

O – Overturn being overweight or obese: Most people who are diagnosed with prediabetes are either overweight or obese. Losing just 10 percent of your body weight can have a significant impact on decreasing development of type 2 diabetes.

A – Activity: This means you’ve got to move more often or exercise. Physical activity helps lower weight, blood glucose levels and decreases body fat. If you haven’t exercised for awhile, check with your doctor first, and slowly add more activity into your daily routine. Thirty minutes a day of walking is a good goal to strive for – also taking the stairs, walking the dog, parking farther away from a store entrance, and standing more, all add up to burning more calories.

C – Commit: Make a commitment to do your best each day to lead a more healthy lifestyle. Having a good attitude will help with this – don’t be too hard on yourself if you slip-up. If you do, start fresh the next day committed to stopping prediabetes in its tracks.

T – Take medicine if needed: Once diagnosed with prediabetes, your doctor may want to start you on an oral medicine that helps control blood sugar levels. Follow your doctors’ advice and ask questions if you don’t understand something.

I – Identify support: Following all of this advice can be made easier if you have someone to be accountable to and who cheers you on. Consider joining a support group or meet with a certified diabetes educator who can give you further ideas on preventing diabetes.

V – Vitals: Know your vitals such as blood pressure, blood cholesterol, and hemoglobin A1C. Knowledge is power and the more informed you are about your health the more likely you’ll want to take good care of yourself.

E – Eat healthy: This can be one of the major keys to reversing prediabetes. Choose a balanced diet by:

  • Avoiding sweetened beverages.
  • Limiting sweets – cookies, cake, pie, pastries, etc.
  • Reducing saturated and trans fats.
  • Reducing calories.
  • Following the guidelines at www.choosemyplate.gov – make at least half your plate filled with fruits and vegetables, with the other half made up of whole grains and lean meat choices.
  • Limiting eating at fast food restaurants.
  • Cooking more often from scratch at home.

“Start with evaluating your lifestyle habits,” Dr. Samadi said. “Healthy daily rituals can minimize the risk of developing diabetes from prediabetes. Exercise, focus on a healthy diet, get at least 7 to 8 hours of sleep, and monitor your blood pressure and cholesterol levels, are a great start.

“Even further, pay attention to the ingredients you’re cooking with. Swap unhealthy oils for healthier ones such as olive oil and use grass-fed butter. And lastly, if you’re a smoker, work to quit. If you drink excessive amounts of alcohol, limit your drinks. Alcohol breaks down into sugar, and if risk factors for prediabetes have been detected, the odds are your body will struggle to break down the alcohol sufficiently.”

All good decisions begin with a single step in the right direction. The more proactive steps you make a part of your lifestyle, the more likely you can at least delay if not reverse prediabetes. Think proactive, be proactive, and watch your life turn towards better health and away from diabetes.

Photo: CDC/Amanda Mills


Cheryl's-Headshot-2015-80x1Cheryl Mussatto MS, RD, LD, is a registered dietitian and an adjunct professor at Allen Community College, Burlingame, and Butler County Community College, Council Grove; she teaches Basic Nutrition and Therapeutic Nutrition. She is also a certified health and wellness coach, and a consulting dietitian for the Cotton O’Neil Clinic in Osage City. She writes Eat Well to Be Well, a column about health and nutrition, and is a blog contributor for Dr. David Samadi at www.samadimd.com. Contact her at [email protected], visit her website www.eatwell2bewellrd.com, or like “eat well 2 be well” on Facebook.


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