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Don’t be misled by the “pre” in prediabetes—even though the condition is not yet full-blown diabetes, it’s likely to become so if you ignore it.
Prediabetes and diabetes occur because you have too much glucose (sugar) in your blood. Insulin, a hormone produced by your pancreas, helps transport glucose from your bloodstream into your cells, where it is used for energy or stored for later use. Prediabetes and diabetes develop when your body can’t produce enough insulin to remove glucose from your blood and/or when your body doesn’t respond properly to the insulin that is produced, a condition that is sometimes referred to as “insulin resistance.”
An elevated blood glucose level affects all of the blood vessels in your body, so it can damage many of your body’s organs and systems. Consequences of diabetes may include:
- Vision loss and/or blindness (diabetic retinopathy)
- Nerve damage, pain, loss of feeling, and sores that won’t heal, especially in the legs and feet (diabetic neuropathy)
- Kidney disease (nephropathy)
- Cardiovascular disease, including an increased risk of heart attack and stroke
- Skin conditions, including bacterial and fungal infections
If you have prediabetes, you are unlikely to experience any symptoms. Even people who have diabetes often have no symptoms or mild symptoms that go unnoticed—that’s why it is important to have your doctor test your blood glucose annually, or more frequently if your doctor recommends it. (See What You Should Know for symptoms.)
WHAT YOU SHOULD KNOW
Symptoms of prediabetes and diabetes may include:
- Frequent urination
- Excessive thirst
- Feeling hungry, even though you are eating or have just eaten
- Blurred vision
- Wounds and bruises that heal slowlyPain, numbness, and/or tingling in the hands and feet
Blood Glucose Tests
Physicians can use three different tests to check the amount of glucose circulating in your bloodstream. A fasting plasma glucose test is often a standard part of your annual blood work. The hemoglobin A1C (HbA1C or A1C) test measures the amount of glucose that is bound to red blood cells and indicates the average blood glucose level for the preceding two to three months. An oral glucose tolerance test (OGTT) measures your blood glucose levels before and after you drink a sweetened liquid (see chart below).
If your blood test results show you’re in the prediabetes range, consider that as your cue to make some lifestyle changes.
Being overweight or obese is the strongest risk factor for prediabetes. Losing weight requires a change in your eating pattern and your exercise habits, and both of these strategies can also help lower your blood glucose level.
Foods that contain carbohydrates are broken down into glucose, so controlling the amount and type of carbohydrates you eat will have the most significant impact on your blood glucose. High-carb foods include grains and grain products, such as bread, pasta, crackers, and baked goods, and starchy vegetables, such as beans, potatoes, peas, and corn.
Limiting your carb intake is a common strategy for regulating blood glucose, but making smart choices about the types of carbs you consume is also important. Eat whole or minimally processed foods that contain fiber; the fiber slows digestion and allows glucose to be released gradually. Good choices for grains include whole wheat, barley, quinoa, bulgur (cracked wheat), wheat berries, oatmeal, and millet. Skip breads, pasta, snack foods, and baked goods that are made with refined flour, which often appears as “enriched flour” on ingredient lists.
Foods and drinks that are high in added sugar should be avoided altogether; they cause rapid rises in blood glucose.
As for exercise, get at least 30 minutes of activity at least five days per week. If you’re currently inactive, start slowly by taking a 10-minute walk once or twice a day, and then gradually increase your time.If you need help creating an effective exercise program, ask your doctor to refer you to an exercise physiologist or other healthcare professional.
The bottom line: If you eat healthier and move more, you will reduce your diabetes risk, and you’ll be taking steps that also decrease your risk of many other chronic diseases.