Understanding Pre-diabetes

Katherine Grady, 46, never suspected she had pre-diabetes, but she knows her moderately high blood glucose levels mean it’s time for change.

"I’ve started reading food labels so I can avoid extra sugar," the Marquette, Mich. (pop. 19,661), woman says. She’s also given up her nightly indulgence—a dish of ice cream with chocolate sauce and peanuts—in favor of fresh fruit or a rice cake. "And I’m trying to get myself in gear to exercise more on the stationary bicycle and treadmill we have."

A talk with a dietician has helped Grady get on track for more balanced eating, including plenty of vegetables and fruit, lean meat and low-fat dairy products.

"The dietician gave me a meals schedule which helps me plan," says Grady, who works as a cashier. "I’m only a little overweight, but I’ve already lost eight pounds."

She also tests her blood sugar daily and keeps a log of it to discuss with her doctor. "It’s mostly mind over matter," she says of the lifestyle changes she’s making in hopes of returning her blood sugar to a normal range. "It’s something I have to do if I want to stay healthy."

What’s pre-diabetes?

Pre-diabetes, sometimes called impaired-glucose tolerance, happens when glucose levels in the blood are higher than normal, but not high enough to be officially called diabetes.

Many people are unaware of pre-diabetes and how it can affect their long-term health. "An estimated 48 million Americans have pre-diabetes and the majority will eventually have diabetes if they don’t take steps to change their lifestyles," says Dr. Richard Guthrie, an endocrinologist from Andover, Kan. (pop. 6,698).

Symptoms of pre-diabetes are the same as for diabetes—increased thirst and urination, weight loss and blurred vision. But many people with pre-diabetes have no symptoms. That’s because their glucose levels may have increased slowly over several years and their bodies have adjusted to the gradual increase.

Diabetes is diagnosed with a blood sample taken after a patient has not eaten, usually overnight. Glucose levels of 100 to 126 are considered pre-diabetes; higher than 126 is considered diabetes. Diabetes occurs when the insulin your pancreas makes is no longer able to enter your body’s cells or when your pancreas doesn’t make enough insulin. Insulin allows glucose, your body’s source of energy, to enter cells. As the glucose builds up outside the cells, it can cause serious health complications.

Diabetes is a major cause of heart and vascular disease, high blood pressure and increased risk of stroke, blindness, kidney failure and amputation. "This damage doesn’t just start with the diagnosis of diabetes," Dr. Guthrie explains. "It starts early, when insulin levels first begin rising."

Change for the better

People who have pre-diabetes may be able to prevent or delay becoming diabetic with lifestyle changes.

"The good news is just minor changes in exercise, in your diet and other things can bring blood glucose levels down," says Ann Constance, a diabetes educator with the Upper Peninsula Diabetes Outreach Network in Marquette. "And that can help prevent diabetes and the complications it causes."

Constance suggests these tips:

• Eat right—Building meals around fresh fruits and vegetables, healthful oils such as canola or olive oil, lean meats and low-fat or fat-free dairy products provides the fuel your body needs while reducing glucose levels.

• Lose weight—Losing as little as 5 percent of overall body weight can be enough to prevent diabetes.

• Be fit—Walking one mile a day can help reduce your glucose levels. Look for ways to build more activity in your day, such as taking the steps, doing stretches during your favorite television shows or walking at the mall or in your neighborhood.

• Cut salt—High blood pressure is a side effect of diabetes. By reducing salt in your diet, you can reduce your blood pressure, which prevents damage to blood vessels and reduces your risk of stroke. Try alternative seasonings such as salt substitutes, fresh herbs or lemon juice.

Mardy Fones is a freelance writer in Nashville, Tenn.

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