The CDC estimates that around 96 million Americans are living with prediabetes and the numbers are expected to grow. Now what exactly does a diagnosis of prediabetes mean? Chad Thury, DO is a family medicine physician with the Avera Medical Group and provided some insight to prediabetes and explains how a diagnosis could actually be a blessing.
Is there a noticeable difference between Prediabetes and Diabetes?
There's certainly a noticeable difference in regard to clinical outcomes. One of the biggest risk factors for cardiovascular disease in particular is diabetes and so diabetes is more of a spectrum. Starting with prediabetes all the way up to people that have we would characterize as severe diabetes or longstanding diabetes that is in particularly uncontrolled or insulin dependent diabetes. The longer people have diabetes, the higher their A1C's are, the less well-controlled it is, it certainly impacts things as far as health outcomes.
What are the most common risk factors for developing Prediabetes?
Risk factors are going to be what we think about as far as metabolic syndromes and weight in particular so people at higher rates or obesity are going to be at higher risk for prediabetes. People that are more sedentary or those who don't participate in any type of activities on a regular basis are more at risk. Also, certainly diet is going to be a big part of it as well. Diet can be a big part regardless of sometimes weight and activity level. If the diet is really out of control, there's no symptom I would say as far as prediabetes. So generally speaking, people that are pre-diabetic or walking around prediabetes really don't have any symptoms.
How do I know if I have Prediabetes?
Weight can be a predictor. People that have a BMI that's in the overweight or obese category are going to be at higher risk for prediabetes. Generally I screen those patients on a more frequent basis than I would with other people that are normal weight based off of BMI. However, from a symptom standpoint, there's really nothing that would tip me off to say this patient has prediabetes or not.
What is the best way to reverse or prevent Prediabetes?
So really the reversal is, what we talked about. When people are not engaged in physical activity, their diet is out of control as far as those easy carbohydrates; reversing prediabetes is changing those things. I often tell patients to try and start with changing one thing. Start with something that's easy to do and then build from there. Even taking off 10-15 pounds can reverse what's going on in regard to prediabetes. The other thing I tell patients when they are diagnosed prediabetes, it's kind of a fork in the road. You have one option: eat better, exercise more, lose weight. The other option is keep doing what you're doing. And undoubtedly at some point you're going to develop diabetes and that's going to lead to more medications, potential complications, increased health costs and so on.
What do you hope the take home message is for readers?
It really does vary for each person, but what we generally see when it comes to prediabetes is people kind of go along gradually in regard to their progression to diabetes. There seems to be a tipping point where insulin resistance really takes off. I tell people it's like a hockey stick effect. You tend to gradually worsen as far as insulin resistance and then you get to a point where your body can't keep up anymore with the insulin resistance and you're able to see diabetes starts to form and take control and things start to go out of control.
