I have “prediabetes” — what does this mean?

Posted June 13, 2013, 2:00 am

I recently had some blood tests done, and my doctor told me I have “prediabetes.” What does this mean? Do I have diabetes or not?

Diabetes doesn’t usually appear all of a sudden. Many people have a long, slow, invisible lead-in to it called prediabetes. During this period, blood sugar levels are higher than normal. However, they’re not high enough to cause symptoms or to be classified as diabetes. It’s still possible at this stage to prevent the slide into full-blown diabetes. Think of prediabetes as a wake-up call.

Type 2 diabetes is a chronic disease marked by high levels of sugar in the blood. During digestion, carbohydrates are broken down into simple sugars, primarily glucose. Glucose is an important source of energy for the body’s cells. But to provide energy to the cells, glucose needs to leave the blood and get inside the cells.

Insulin, a hormone produced by the pancreas, signals the cells to extract glucose from the blood. When levels of glucose in the blood rise (for example, after a meal), the pancreas produces more insulin. That drives more glucose into the cells.

Type 2 diabetes occurs when your body’s cells do not react efficiently to insulin. As a result, not as much glucose is driven into the cells, and more stays in the blood. As glucose starts to build up in the blood, the pancreas makes extra insulin to maintain a normal blood sugar. The cycle escalates. Finally, the pancreas cannot keep up with the demand for more and more insulin. As a result, blood glucose levels remain elevated.

Diabetes increases the chances of having a heart attack, stroke or other form of cardiovascular disease. It can lead to blindness, kidney disease and loss of feeling in the legs.

Fortunately, you have the opportunity to make changes that could keep you from ever going down that road. I recommend this three-part strategy to help stave off diabetes:

Modest weight loss.Increased physical activity, such as walking 30 minutes a day. Even if it doesn’t help you to lose weight, the regular physical activity will reduce your risk of getting diabetes.Choosing a healthy, well-balanced diet that emphasizes fruit, vegetables, whole grains and lean protein.

Not everyone with prediabetes goes on to develop diabetes, but many do. You’ve gotten the warning. Now it’s up to you to respond. If you want to avoid getting diabetes, you can do more to protect yourself than your doctor can do for you. And the solutions are all “natural” — no medicines or medical procedures are necessary.

These lifestyle changes are healthy for everyone, but especially for people like you who are at high risk for getting diabetes. No, it’s not easy to make the changes, but it’s a lot easier than living with the complications of diabetes.

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After a Prediabetes Diagnosis: How to Prevent Diabetes

What to do to stop prediabetes from becoming diabetes.

Getting diagnosed with prediabetes is a serious wake-up call, but it doesn't have to mean you will definitely get diabetes. There is still time to turn things around.

“It’s an opportunity to initiate lifestyle changes or treatments, and potentially retard progression to diabetes or even prevent diabetes,” says Gregg Gerety, MD, chief of endocrinology at St. Peter’s Hospital in Albany, N.Y.

Making these seven changes in your daily habits is a good way to start.

Becoming more active is one of the best things you can do to make diabetes less likely.

If it's been a while since you exercised, start by building more activity into your routine by taking the stairs or doing some stretching during TV commercials, says Patti Geil, MS, RD, author of What Do I Eat Now?

“Physical activity is an essential part of the treatment plan for prediabetes because it lowers blood glucose levels and decreases body fat,” Geil says.

Ideally, you should exercise at least 30 minutes a day, five days a week. Let your doctor know about your exercise plans and ask if you have any limitations.

If you're overweight, you might not have to lose as much as you think to make a difference.

In one study, people who had prediabetes did 30 minutes a day of moderate exercise and lost 5% to 7% of their body weight (just 10-14 pounds in someone who weights 200 pounds) cut their chances of getting diabetes by 58%.

See your doctor every three to six months, Gerety says. 

If you're doing well, you can get positive reinforcement from your doctor. If it's not going so well, your doctor can help you get back on track. 

"Patients like some tangible evidence of success or failure," Gerety says.

Load up on fruits and vegetables, especially the less-starchy kinds such as spinach, broccoli, carrots, and green beans. Add more high-fiber foods into your day. Choose whole-grain foods instead of processed grains -- for example, brown rice instead of white rice.

Also, swap out high-calorie foods. “Drink skim milk rather than whole milk, diet soda rather than regular soda,” Geil says. “Choose lower-fat versions of cheese, yogurt, and salad dressings.”

Instead of snacking on high-fat, high-calorie chips and desserts, choose fresh fruit, or whole wheat crackers with peanut butter or low-fat cheese, Geil says.  

Not getting enough sleep  regularly makes losing weight harder, says Theresa Garnero, author of Your First Year With Diabetes.

A sleep shortfall also makes it harder for your body to use insulin effectively and may make type 2 diabetes more likely.

Set good sleep habits. Go to bed and wake up at the same time every day. Relax before you turn out the lights. Don't watch TV or use your computer or smartphone when you're trying to fall asleep. Avoid caffeine after lunch if you have trouble sleeping.

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