Pre-diabetes: what is it and what can be done

by Sean M. Crosetti, MBA, PharmD, Crosetti Health & Wellness
 

     Pre-diabetes is the bodies inability to either produce sufficient amounts of insulin or the body becomes resistant over time to the insulin it does produce. 
     As of the latest report from 2018, 88 million (1 in 3) people have pre-diabetes.  “Wow that is quite a few people, but I thought you were either diabetic or you were not.”  I have heard that several times over the past few months.  The thing is, just like many other diseases (high blood pressure, hardening of the arteries, arthritis, glaucoma, obesity, etc.) this is a gradual migration that, if identified and corrected early, it will not only be easier to treat, but the detrimental side effects of pre-diabetes can also be stopped or even possibly reversed. 
    If pre-diabetes is not corrected it can lead to kidney damage, unrecognized heart attacks, and of course full-blown diabetes. 
     So how do you know if you have pre-diabetes?
     There is only one potential symptom of pre-diabetes, darkening of the skin on certain parts of the body:
     Neck
     Armpits
     Elbows
     Knees
     Knuckles
 
     The best way to decide when you should talk to your health care provider is to count the number of risk factors you have (more than 2 then schedule a visit for an A1c test):
 
     Weight. Being overweight is a primary risk factor for pre-diabetes.
     Waist size. The risk diabetes goes up for men with waists larger than 40 inches and for women with waists larger than 35 inches.
     Diet.  A diet high in fruits, vegetables, nuts, whole grains and olive oil is associated with a lower risk of pre-diabetes.
     Inactivity. The less active you are, the greater your risk of pre-diabetes.
     Age. Although diabetes can develop at any age, the risk of pre-diabetes increases after age 45.
     Family history. Your risk of pre-diabetes increases if you have a parent or sibling with type 2 diabetes.
     Race or ethnicity. Although it is unclear why, people of Black, Hispanic, American Indian or Asian American decent are more likely to develop pre-diabetes.
     Gestational diabetes. If you had diabetes while pregnant (gestational diabetes), you and your child are at higher risk of developing pre-diabetes.
     Polycystic ovary syndrome. Women with this common condition have a higher risk of pre-diabetes.
     Sleep. People with obstructive sleep have an increased risk of insulin resistance.
     Tobacco smoke. Smoking may increase insulin resistance.
     When you do get an A1c test (per your request or normal screening) please look at the chart below to see where your results pertaining to diabetes with your A1c score fit:
Below 5.7                         Normal
Between 5.7 and 6.4      Pre-Diabetes
6.5 or above                    Diabetes
 
     Now that you know you have pre-diabetes (or diabetes), what can be done with it?  Have a discussion with your care provider to see his/her viable options.
     Healthy lifestyle choices can provide non-medication based correction of your blood sugar levels to return them to the normal levels. Try to:
    Eat healthy foods (reduce processed foods, simple sugars, increase vegetables and fruits, etc.)
     Get at least 150 minutes of moderate aerobic physical activity a week, or about 30 minutes on most days of the week
     Lose excess weight
     Control your blood pressure and  
     cholesterol
     Don't smoke
     The main idea behind this is the old adage “an ounce of prevention is worth a pound of cure” whereby, identifying this issue early and making some simple, yet life challenging, choices, you will not have to deal with all the complications and hardships facing the person with full-blown diabetes for the rest of your life.
 
     Please feel free to reach out to us at [email protected] with any questions about this article or if you would like me to write about a topic of your interest.