Prediabetes: A Wake-up Call

Lifestyle changes help stave off heart attack and stroke

Prediabetes: A Wake-up Call

About 86 million Americans have prediabetes. That’s one in three of us who are 18 and older, and half of us who are 65 and older.

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The problem is, most of us don’t know it.

“Prediabetes increases your risk of developing diabetes and implies that your risks for heart attack and stroke are already increased. It should be a wake-up call for adopting a healthier lifestyle,” says Robert Zimmerman, MD.

A slippery slope

  • In prediabetes, your blood sugar (glucose) levels are higher than normal, and your risk for heart disease is one and a half times higher.
  • Without intervention, you will develop type 2 diabetes in three to 10 years, and your risk of heart disease will be 2 to 4 times higher than normal.
  • Eventually, impaired circulation can affect your kidneys, eyes and limbs as well.

Who’s at risk

“There is a high incidence of type 2 diabetes in patients whose parents have the disease, so we know there is a genetic factor,” says Dr. Zimmerman.

Ethnicity also matters. Native Americans, Latinos, Asian-Americans, Pacific Islanders and African-Americans have a higher chance of developing diabetes.

“But there is also an environmental factor,” says Dr. Zimmerman. “People with a genetic tendency to develop diabetes if they become overweight may not get it if they maintain a normal body weight.”

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Women: Heightened concern

The number of women with prediabetes has climbed alarmingly, from 15.5 percent in 2001 to 50.5% in 2010. And while the death rate from diabetes has remained stable for men, it has risen dramatically for women since the 1970s.

A slower metabolism makes weight gain problematic for both men and women as they age. But women have extra challenges:

  • Female hormones tend to promote fat formation and fat storage.
  • The muscle mass women begin losing at age 40 is often replaced by body fat.

What to expect from testing

If your doctor orders blood sugar testing, here are the tests you’ll have:

  • Hemoglobin A1c:7 to 6.4 percent indicates prediabetes (6.5 percent and up indicates diabetes)
  • Fasting blood sugar: 100 to 125 indicates prediabetes (126 and up indicates diabetes)
  • Glucose: 140 to 199 two hours after a glucose challenge indicates prediabetes (200 two hours after eating indicates diabetes)

You may need testing earlier or more often if you have:

A few pounds can make a difference

“We now know that people with prediabetes can delay or prevent the onset of type 2 diabetes through lifestyle changes. If lifestyle interventions make you healthier, it’s the way to go,” says Dr. Zimmerman.

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Rather than aim for dramatic weight loss, try to lose 10 to 15 pounds by transitioning to a healthy diet that’s low in carbohydrates and fat:

  • Focus on fresh fruits and vegetables, whole-grain breads and cereals, skim milk and yogurt, and lean meats.
  • Limit soda, sweets, snack foods, fruit juices and alcohol.

Being more active helps, too

Incorporate exercise into your life, and you’ll burn additional calories.

  • Try brisk walking or another moderate-to-intense activity (like swimming or dancing) 35 minutes a day, five days a week.
  • Choose an activity you enjoy that keeps you moving.
  • You can also lift weights and strengthen muscles to boost your metabolic rate, which helps burn extra calories even at rest.
  • Set small, easily attainable goals, like walking for 10 minutes once a day.
  • Weigh yourself just once a week, at the same time.
  • Set timelines, track your progress and build on your successes by adding to your goals each week.

If you have prediabetes, these lifestyle changes will lower your blood sugar levels better than medications. “Medications have potential side effects and are less effective. Exercise can help reduce weight, blood sugars and blood pressure,” says Dr. Zimmerman.

Other benefits to changing your lifestyle: You’ll look and feel your best.