We are seeing an alarming trend in the area of diabetes management over the past few years - not only an increase in type 2 diabetes, but also an increase in the number of patients with a diagnosis of “pre-diabetes.” As many as 57 million Americans have pre-diabetes. According to the American Diabetes Association, “Before people develop type 2 diabetes, they almost always have pre-diabetes - blood glucose levels that are higher than normal, but not yet high enough to be diagnosed with diabetes.”
So, how exactly do you know if you have pre-diabetes? Pre-diabetes is diagnosed in one of two ways, either with a fasting blood glucose test or with an oral glucose tolerance test. With a fasting blood glucose test, a glucose level between 100-125 mg/dl is a positive diagnosis of pre-diabetes. Normal fasting blood glucose is below 100. A fasting glucose of 126 or above indicates that a person has diabetes.
With an oral glucose tolerance test (OGTT), a person’s glucose is checked first after fasting and then typically two hours after drinking a glucose-rich drink. A two-hour blood glucose of 140-199 mg/dl indicates diabetes. Normal glucose two hours after the drink is below 140. If the two-hour blood glucose is 200 or greater, that indicates the presence of diabetes.
Unfortunately, recent research indicates that some long-term damage to the body, especially the heart and circulatory system, may already be occurring during pre-diabetes. However, there is good news for those who do have pre-diabetes. The Diabetes Prevention Program study showed that it is possible for people with pre-diabetes to prevent the development of diabetes with healthy eating, regular physical activity and weight management.
If you, or someone you love, have been diagnosed with pre-diabetes, what are some practical steps you can take?
n Work up to exercising for 30 minutes a day. Make sure to start slowly and increase gradually. Even walking for 30 minutes a day at a moderate pace can help.
n Aim to lose five to 10 percent of your body weight. For example, if you weigh 200 pounds, a weight loss of 10-20 pounds is likely to improve your blood glucose control.
These small steps can greatly reduce one’s risk of developing type 2 diabetes. But, don not feel like you have to change everything overnight. Make changes slowly and gradually. You are most likely to maintain lifestyle changes if they are made slowly - think baby steps. Behavior change is not easy; so do not get discouraged if you have setbacks along the way. Just get right back on track. And, reach out for support if you need it. The Blount Memorial Diabetes Management Center has regular diabetes support groups that are free and open to the public to help with motivation and support. For more information, call the diabetes management center at 865-977-5767.
Angie Tillman is a registered dietitian, certified diabetes educator and the director of the Blount Memorial Weight Management Center.