Borderline does not mean ‘it’s fine’

During a recent conversation, a friend told me that she didn't have diabetes. Her doctor told her that she was "borderline," so she assumed that it was nothing to be concerned about. This article is written in response to her and the 57 million Americans that are diagnosed with borderline diabetes. When it comes to diabetes, don't assume that borderline is fine. Borderline diabetes - or pre-diabetes as it now is called - has been shown to cause some of the same long-term complications as diabetes, suggesting that treatment is needed even before the official diagnosis of diabetes occurs.

Pre-diabetes occurs when blood sugar levels are above the normal range, but are not elevated high enough to be considered diabetes. It can be diagnosed through the following tests: fasting plasma glucose (FPG), hemoglobin A1c (A1c) or an oral glucose tolerance test (OGTT). Look at the box on this page for the associated values for each test.

People with pre-diabetes do not typically have any symptoms, so screening tests are vital. According to the American Diabetes Association (ADA) and the National Institutes of Health (NIH), everyone over the age of 45 should be tested for pre-diabetes. Testing also should be performed on those under the age of 45 who are overweight (body mass index greater than 25) and have other risk factors for diabetes. Risk factors for diabetes include:

• Abdominal obesity

• Inactivity

• High blood pressure

• Abnormal cholesterol and/or lipid levels

• Age 45 and older

• Certain ethnicities - African American, Asian American, Native American, Pacific Islander or Hispanic/Latino

• Family history of diabetes

• Polycystic Ovarian Syndrome (PCOS)

• History of gestational diabetes

• Giving birth to a baby weighing more than 9 pounds

The ADA reports that those with pre-diabetes are at a one-and-a-half times higher risk of developing a heart attack or stroke. In my office, I have seen several patients with a new diagnosis of diabetes who already have the beginning stages of neuropathy (nerve damage) or nephropathy (kidney damage) - suggesting that complications developed during the pre-diabetes stage.

There is good news, however. Moderate weight loss and regular physical activity can prevent and/or delay the development of diabetes and its complications. In fact, a study on the prevention of diabetes found that losing just 5-10 percent of total body weight through a combination of daily physical activity and healthy eating decreased the development of type 2 diabetes by 58 percent.

If you think you are at risk for pre-diabetes, ask your doctor to perform a simple screening test. A screening test now could save your health later. To learn more or receive an individualized treatment plan for pre-diabetes, contact Blount Memorial's Diabetes Management Center at 865-977-5767.

Barbie Haas is a registered nurse and certified diabetes educator for the Blount Memorial Weight Management Center.

© 2011 All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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