Understand Pre-Diabetes


Q: What is pre-diabetes? How is it different from Type 2 diabetes?
-- Malcolm M. in Boston, Massachusetts

A: The bad news is that pre-diabetes is a warning sign that you are at risk for developing Type 2 diabetes. The good news is that Type 2 diabetes is preventable. So, being diagnosed with pre-diabetes should serve as your wake-up call; at this stage it is not too late to make small changes that will positively affect your medical outcome! This is your opportunity to reverse the condition or delay the progression to Type 2 diabetes.

With pre-diabetes your blood sugar levels are higher than normal, but they haven't yet reached Type 2 diabetes levels. In pre-diabetes there is resistance to insulin, the hormone the body needs to properly metabolize sugar. The pancreas, which makes insulin, has to work harder and harder to maintain a normal blood sugar level. Eventually, the pancreas fails to meet this need and Type 2 diabetes develops. Type 2 diabetes is a chronic, or life-long and irreversible, condition. Over time, it can lead to serious complications such as heart disease, stroke, blindness, nerve damage, and kidney disease.

The American Diabetes Association (ADA) reports that more than 40 million Americans between the ages of 40 and 74 have pre-diabetes; however, pre-diabetes affects younger people as well. Pre-diabetes is known as a silent condition with no symptoms. You are most likely to discover that you have pre-diabetes when you see your doctor for a regular check-up or an appointment for another illness.

Individuals with increased risk include: those with a family history of Type 2 diabetes, African Americans, Latinos, Native Americans, Pacific Islanders, and Asian Americans. The older you are, the greater the risk. If you believe that you are at risk for pre-diabetes, request a fasting blood glucose test from your primary care provider.

What you can do

The most important changes you can make to treat pre-diabetes and prevent Type 2 diabetes include small lifestyle changes.

Eat a balanced diet -- Eat a balanced diet that spreads carbohydrates throughout the day (to avoid sudden spikes in blood sugar). Eat foods that are low in saturated fat and high in fiber; choose baked seafood or poultry, include vegetables in every meal, and only buy 100-percent whole grain bread. The leaner you are, the better. Weight loss is often the cure.

Exercise regularly -- Try to get at least 30 minutes of exercise everyday. Exercise doesn't have to be grueling. Try walking fast, gardening, or dancing to get your daily fix.

Take medication, if needed -- In some cases, your health care provider may prescribe medication in addition to diet and exercise. However, an important study done in the U.S. (the Diabetes Prevention Program Study) showed that making lifestyle changes was more effective at lowering the risk of developing Type 2 diabetes than taking medication.

Stop smoking -- You have heard this one before. Smoking contributes to the early development of diabetes complications.

Monitor blood pressure and cholesterol -- If you have pre-diabetes, you are one and a half times more likely to develop cardiovascular disease than someone with normal blood glucose levels. Most drug stores have blood pressure testing machines; take advantage and test your blood pressure periodically. Notify your primary care provider if the results are greater than 130/80 mm Hg.

No matter how and when you start, it is important to remember that even small changes can lower your chances of developing Type 2 diabetes.
-- Dr. Bud Beck and Noelle Edwards, M.P.H., San Diego Diabetes Coalition