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Do you have prediabetes?

By Dr. Philip A. Kern from May 2014 Issue

Before Type 2 diabetes develops, there is generally a period of prediabetes where glucose levels are in a "gray area"—above normal but below diabetic. According to the Centers for Disease Control and Prevention, one in three American adults is prediabetic, but only 11 percent know it. 

Is prediabetes dangerous?
Prediabetes is a serious concern because many diabetic disease processes—including nerve damage, eye problems, and heart disease—have already begun in the body, even though diabetes hasn't been diagnosed. Without intervention, there is a high likelihood that prediabetes will progress to diabetes. People with prediabetes are also at 50 percent higher risk for heart disease and stroke. 

What are the risk factors?
Prediabetes often has no obvious symptoms and can occur at any age, so it's important that you know and monitor your glucose numbers (and your children's glucose numbers). This is especially true if you have any of these risk factors for diabetes:

  Overweight or obese

  Central fat distribution around the abdomen (sometimes called an "apple" shape)

  History of elevated glucose levels or gestational diabetes

  Family history of diabetes 

  Symptoms of diabetes, including increased thirst, frequent urination, fatigue, and blurred vision

What can I do if I'm prediabetic?
You can make lifestyle changes, including weight loss, exercise, and smoking cessation, to prevent progression to diabetes and reduce your risk for conditions like heart disease, stroke, high cholesterol, and high blood pressure.

Studies show that weight loss, healthy eating, and increased physical activity can often return glucose levels to a healthy range. Losing just 10 percent of your body weight can reduce the likelihood that you will progress to diabetes. Choose foods that are low in saturated fat and calories, and high in fiber, like vegetables, fruits, and whole grains. 

Incorporate 30 to 60 minutes of moderate physical activity into your schedule at least five times a week. Getting at least six hours of sleep nightly can also help to reduce insulin resistance. 

Can I ever get back to normal?
With permanent lifestyle changes, prediabetes can often be reversed and diabetes and its complications avoided or delayed. Because prediabetes is a risk factor for heart disease, stroke, and other conditions, consult your healthcare provider for additional guidance. 


DR. PHILIP A. KERN is a professor of endocrinology and molecular medicine, and director of the Barnstable Brown Kentucky Diabetes and Obesity Center at the University of Kentucky.