Nearly 60 million Americans have prediabetes, about 70 percent of whom will develop type 2 diabetes in their lifetimes, according to a 2007 study published in Diabetes Care. Most are overweight.
Yet prediabetes, defined as being at high risk for type 2 diabetes, often goes undiagnosed. A study published in April in the American Journal of Preventive Medicine estimates that just 7 percent of people with prediabetes have been told they have it. Of this small number, only half were taking action to prevent type 2 diabetes, such as by trying to lose weight and increasing physical activity. And just a third had been counseled by their healthcare providers about how to reduce their risk.
Prediabetes is diagnosed when blood sugar levels are higher than normal, but not high enough to qualify as diabetes. An A1C test (a measure of blood glucose over time) or one or more blood glucose readings are used for diagnosis. An A1C level of 5.7 to 6.4 percent means prediabetes, as well as a fasting blood glucose level of 100 to 125, or glucose levels of 140 to 199 at the 2–hour point of a glucose tolerance test.
Research shows that the window of opportunity to prevent or slow the progression of prediabetes to type 2 diabetes is about 3 to 6 years, the period of time during which significant lifestyle changes can make a difference. If you are concerned about prediabetes and or type 2 diabetes, there are steps you can take now:
Step 1: Find out if you have or are at risk for prediabetes or type 2 diabetes. Take the American Diabetes Association's Risk Test. This 1-minute quiz includes questions about age, weight, and family history of diabetes. The results tell you if you are at low, moderate, or high risk of diabetes.
[Another quick self assessment, published in December in the Annals of Internal Medicine, can also help determine your risk.]
Step 2: Talk to your healthcare provider. If the ADA's quiz results indicate that you are at high risk of diabetes, tell your healthcare provider right away. Ask for a blood glucose test to find out for sure where you stand.
Step 3: Make permanent lifestyle changes. Research shows that losing 5 to 7 percent of your body weight (about 10 to 20 pounds for someone who weighs 200 pounds) by reducing your calorie and fat intake, as well as getting at least 150 minutes of physical activity per week, can decrease blood glucose levels and help accomplish other health goals, such as improving blood pressure, raising HDL (good cholesterol), and lowering triglycerides.
[Slideshow: High Blood Pressure? 5 Key Ways to Bring It Down.]
Step 4: Keep an eye on your blood glucose. For those diagnosed with prediabetes, the goal is to reverse the condition and push your blood glucose levels back into a normal range—or at least to delay the onset of type 2 diabetes. But because there is always the possibility of recurrence, lifelong lifestyle changes—including healthy eating and regular exercise—are key. As you age, gain weight, or slide back into unhealthy habits, blood glucose is likely to rise again. To assess the impact of lifestyle changes on your blood glucose, talk to your healthcare provider about whether you should use a home glucose monitor or rely on occasional lab tests. The ADA recommends that people with prediabetes get A1C or glucose levels checked annually to monitor disease progression.
About the author: Hope Warshaw is a dietitian and diabetes educator with more than 30 years of experience as an author, consultant, and counselor. Her specialties include weight control, healthy eating, and meal planning for people at risk of or diagnosed with prediabetes or diabetes. She has written several books published by the American Diabetes Association, including Diabetes Meal Planning Made Easy, Real Life Guide to Diabetes, and Guide to Healthy Restaurant Eating. Warshaw is also a contributing editor for Diabetic Living, a Better Homes and Gardens publication. Follow Warshaw on Twitter.