Francisco Barrera, MD

What Is Prediabetes?

Prediabetes is a condition where blood sugar levels are elevated but not high enough to be diagnosed as diabetes. This stage is critical because it serves as a warning sign. If not addressed, prediabetes can progress to type 2 diabetes, which can lead to serious health issues like heart disease, kidney damage, and nerve problems.

The Importance Of Screening

Screening for prediabetes is essential because many people with this condition do not experience any symptoms. Regular screening can help catch prediabetes early, allowing for timely interventions that can prevent or delay the onset of type 2 diabetes.

Who Should Get Screened?

Health organizations recommend that certain individuals be screened for prediabetes regularly. Here’s who should consider getting screened:

• Adults Over Age 45: If you are 45 years or older, you should be screened for prediabetes.
• Overweight or Obese Individuals: If your body mass index (BMI) is 25 or higher (or 23 or higher if you’re of Asian descent), you should be screened, especially if you have additional risk factors.
• Family History of Diabetes: If you have a parent or sibling with type 2 diabetes, your risk is higher, and you should be screened.
• Sedentary Lifestyle: If you do not engage in regular physical activity, you are at increased risk and should get screened.
• Women with a History of Gestational Diabetes: If you had diabetes during pregnancy, you should be screened for prediabetes every three years after giving birth.
• Individuals with High Blood Pressure or Abnormal Cholesterol Levels: If you have a history of high blood pressure (140/90 mmHg or higher) or high cholesterol, you should be screened.
• Certain Ethnic Groups: People from specific ethnic backgrounds, including African Americans, Hispanic Americans, Native Americans, Asian Americans, and Pacific Islanders, are at higher risk and should be screened more frequently.

What Happens During Screening?

Screening is usually done through a simple blood test. Your health care provider may use one of the following tests:

• Fasting Plasma Glucose Test: Measures blood sugar after an overnight fast (8 hours)
• Oral Glucose Tolerance Test (OGTT): Measures blood sugar before and two hours after drinking a sugary solution
• Hemoglobin A1c Test: Provides an average of your blood sugar levels over the past two to three months

Understanding Your Results

• Normal: A fasting blood sugar level below 100 mg/dL, A1c below 5.7%
• Prediabetes: A fasting blood sugar level between 100 and 125 mg/dL, A1c between 5.7% and 6.4%
• Diabetes: A fasting blood sugar level of 126 mg/dL or higher, A1c of 6.5% or higher

Prediabetes is a critical health warning that signals the need for immediate attention. Fortunately, the good news is that with proactive lifestyle changes, you can reverse prediabetes and significantly reduce your risk of developing type 2 diabetes.

Why Lifestyle Changes Matter

Making changes to your daily routine can help lower blood sugar levels and improve insulin sensitivity. Studies have shown that even modest weight loss (5-10% of your body weight) and increased physical activity can lead to significant improvements in glucose metabolism and may reverse prediabetes.

Key Lifestyle Changes To Consider

Adopt A Healthy Diet

• Focus on Whole Foods: Emphasize fruits, vegetables, whole grains, lean proteins, and healthy fats. These foods are nutrient-dense and can help stabilize blood sugar levels.
• Limit Processed Sugars and Refined Carbohydrates: Reduce your intake of sugary beverages, sweets, and white bread. Instead, opt for whole grains like brown rice, quinoa, and oats.
• Portion Control: Be mindful of portion sizes to help manage caloric intake. Using smaller plates and bowls can help with this.
• Increase Fiber Intake: Foods high in fiber, such as legumes, whole grains, and vegetables, can help slow the absorption of sugar and improve blood sugar control.

Engage In Regular Physical Activity

• Aim for at Least 150 Minutes a Week: The American Diabetes Association recommends at least 150 minutes of moderate-intensity aerobic activity each week. This can include brisk walking, cycling, or swimming.
• Incorporate Strength Training: Include resistance exercises at least two days a week. Building muscle helps improve insulin sensitivity.
• Stay Active Throughout the Day: Look for opportunities to move more during your day. Take the stairs instead of the elevator, park further away from store entrances, or take short walking breaks (3-5 minutes every hour) 

Achieve And Maintain A Healthy Weight

• Set Realistic Goals: Aiming for a 5-10% reduction in body weight can lead to significant health benefits. If you weigh 200 pounds, losing 10-20 pounds can make a substantial difference.
• Seek Support: Consider working with a registered dietitian, nutritionist, or a weight loss support group to help you create a personalized plan.
• Join Community Groups: Visit hope-health.org/community/events to learn about and sign up for free community classes HopeHealth offers. Topics range from healthy cooking to diabetes management, prioritizing movement, carbohydrate counting, and more. Additionally, the Diabetes Institute at HopeHealth offers the Diabetes Prevention Program. This program is designed to help patients with prediabetes make lifestyle changes, manage weight loss, and stay motivated to prevent the development of type 2 diabetes.

Manage Stress

• Practice Mindfulness and Relaxation Techniques: Techniques such as yoga, meditation, or deep-breathing exercises can help reduce stress, which has been linked to higher blood sugar levels.
• Get Enough Sleep: Aim for 7-9 hours of quality sleep per night. Poor sleep can negatively affect insulin sensitivity and blood sugar control.

Monitor Your Progress

• Regular Check-ups: Work with your provider to monitor your blood sugar levels and overall health. Regular check-ups can help you stay accountable and motivated.
• Track Your Food and Activity: Keeping a food diary or using a mobile app to track your meals and exercise can help you stay on track and become aware of your habits.
• Consider Medication: In some cases, especially if you’re younger, have a high body weight, or had diabetes during pregnancy, your doctor may suggest metformin, a safe and affordable medication that can lower blood sugar.

You are not alone in this journey, and it’s never too late to start. Take the first step towards better health today!