What is Prediabetes and How Can I Help?

“Many people have prediabetes and don’t know it. If you have risk factors for diabetes or a strong family history of diabetes, you should be coming in to be screened routinely. Prediabetes does not necessarily guarantee that you will develop diabetes- instead, you can think of it as a wake up call to change those risk factors which can be changed before it is too late”.

-Dr. Bella Zimilevich, MD

What is prediabetes?

Prediabetes is characterized by blood sugar levels that are abnormally high but are not yet high enough to be classified as full-blown type 2 diabetes. Untreated, prediabetes often progresses to type 2 diabetes within 10 years. Even if you do not yet have diabetes, changes may already be occurring in your heart and blood vessels as a result of even sporadically high blood sugar levels. The good news is that you can halt the progression of prediabetes to diabetes by making some lifestyle changes- diabetes does not have to be your future!

What are the symptoms of prediabetes?

Most people who have prediabetes are unaware that they have the condition, because their condition has not progressed to the point of experiencing symptoms. In fact, many people with diabetes type 2 are not aware they have diabetes until it is discovered during routine health screening.

One of the few visible signs that you are at risk of developing diabetes is discoloration of the skin. The skin in certain areas of your body may be darker than normal. Areas frequently affected include the neck, elbows, knees, knuckles and armpits (see picture).

Symptoms of type 2 diabetes include:

• increased thirst
• increased urination
• blurry vision
• fatigue

What conditions affecting the musculoskeletal system can you treat?

By the time you begin to experience these symptoms, you likely already have diabetes.

What are the risk factor for prediabetes and diabetes?

There are many situations that put you at increased risk of developing prediabetes. Some of these risk factors can be modified while others can’t.

Risk factors that cannot be modified include your age (increasing age is a risk factor for diabetes), your family history and your race (African Americans, Hispanics and Asian people are at increased risk for diabetes).

If you are a woman and you had gestational diabetes during pregnancy you are at higher risk of developing type 2 diabetes. Also, if you have been diagnosed with PCOS (polycystic ovarian syndrome) you are at risk for developing diabetes.

What causes diabetes?

Researchers have identified specific genes associated with insulin resistance. Excess abdominal fat and lack of exercise are also implicated in type 2 diabetes.

People who have prediabetes and diabetes cannot process sugar in the same efficient way that others do. In healthy people, the pancreas secretes insulin in response to a meal or a snack. Insulin is a hormone which allows the body’s cells to use glucose for energy. In people with prediabetes and diabetes type 2, their bodies cannot use insulin as effectively, so that sugar builds up in the bloodstream instead of being used by the cells that require glucose to do their jobs (in type 1 diabetes, the pancreas does not secrete insulin at all, or secretes very little).

How do I know if I should be screened for prediabetes?

If you have any of the risk factors listed above, you are at risk of developing prediabetes. You should make an appointment to come in and see me so that we can assess your level of risk and determine how often you should be screened. We can also discuss what you can do to decrease your risk, including weight loss, exercise and management of high blood cholesterol and high blood pressure. By successfully managing your risk factors, you can significantly reduce your risk of developing diabetes.

What should I expect when I come in to see you?

When you come in to see me, I will first need to gather some information. I will need to know about your past medical history if you are a new patient. I will also need to know if you are taking any medications and if you have any allergies.

Next, we’ll explore your personal risk factors. I may weigh and measure you and so that I can determine your BMI (body mass index- a standardized scale combining height and weight that helps to determine amount of body fat). I will take your blood pressure.

I will ask you about other risk factors you may have (i.e. gestational diabetes, family history of diabetes). I will ask you about your diet and exercise patterns. I will also want to know whether you have symptoms of diabetes (increased thirst and urination, fatigue, vision changes).

Screening will involve some diagnostic testing, including a fasting blood glucose level and cholesterol testing. I may order other tests depending on your results and whether you have any other health conditions.

Once I have gathered all the information I need, I will have you return to see me so that we can discuss your results. If your blood glucose is normal but you have risk factors for prediabetes, we can talk about ways to reduce your risk. If your blood glucose is found to be high and you have prediabetes or diabetes type 2, we will discuss how to manage this.

If you are at high risk for developing diabetes, it is important to be screened regularly and to find a physician that you can work with to decrease your risk and modify those risk factors which can be modified. I would love to partner with you to help you avoid developing diabetes, or to manage your condition if you have it. Please call to make your prediabetes screening appointment today.

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