What is Prediabetes and What Does it Mean for Your Diabetes Risk?

More than one in three U.S. adults have prediabetes, but most do not know it. If that sounds hard to believe, many people with the disease do not have any symptoms, making it hard to know when it’s time to see the doctor, especially if you don’t already visit annually. While something with the word “pre-” in it sounds a bit harmless, without intervention prediabetes is likely to become type 2 diabetes within 10 years.

In prediabetes, the fasting blood sugar may be between 100-125, and the A1C (3 month average of blood sugars) may be from 5.7-6.4. In diabetes, the fasting blood sugar may be 126 or greater and the A1C 6.5 or greater.

Angela Bunyard, a registered nurse and certified diabetes educator at Texas Health Arlington, says prediabetes’ elusiveness only adds to the confusion many people have regarding the disease, and many don’t know how it differs from a full-blown diabetes diagnosis or what it means for their health now and in the future.

“Prediabetes is a condition that comes before diabetes — it means the blood glucose levels are higher than normal but aren’t high enough to be called diabetes,” Bunyard explains. “Many people are unaware that they have prediabetes. Sometimes the old term ‘borderline diabetes’ is used and tends to be confusing. Patients may be advised to eat healthily and lose weight, but often, they may not understand or have access to education about prediabetes. In some instances, a lack of insurance coverage for prediabetes may also be a barrier.”

Because prediabetes does not have any clear symptoms, it can be hard for you to know that you have it. Most often, your health care provider discovers it during routine testing, especially if you have a family history of the disease.

Risk factors for prediabetes and diabetes are the same:

  • Family history
  • Being overweight
  • Leading a sedentary lifestyle
  • Hypertension
  • High cholesterol
  • A history of gestational diabetes
  • Women who have delivered a baby over nine pounds

Bunyard says patients with the risk factors listed above are commonly tested using their fasting blood glucose levels, those present in the blood when you have not had anything to eat or drink (except water) for at least eight hours. An A1C test may be performed instead of a fasting plasma glucose test, which measures the average blood glucose for the past two to three months.

Since more than 2.1 million Texans have prediabetes and more than 3.2 million have diabetes, chances are you know multiple people with the disease. According to the Centers for Disease Control and Prevention (CDC), Palo Pinto County has the highest percentage per population of diabetics in North Texas, followed closely by Hood, Somervell, Parker, Wise, and Hunt counties.

Bunyard says there are multiple reasons why Texas may have higher incidence rates of diabetes and prediabetes, like its ethnically diverse population and an appetite for fried or smoked food that could give Big Tex a run for his money. But rural communities tend to get hit a bit harder than big cities.   

“In rural areas people may have more access to local produce sold in roadside stands, but less available in the grocery stores. However, these foods must be prepared and are not ‘fast’ so they may not opt for them,” Bunyard says. “The restaurant options are also really limited and fast food is much more prevalent.”

Diet is a huge contributing factor to the development of diabetes, but contrary to popular belief, consuming excessive amounts of sugar isn’t directly correlated to the disease. Bunyard explains that it’s the carbs that we consume that are the more likely culprit. Since most Americans’ diet consists of 45 to 65 percent carbs, reducing our carbohydrate intake can be tough, particularly with foods that many Texans love, like rice, pasta, beans, tortillas, bread and sweets.

Although you may need to make some changes in what and how much you eat if you have been diagnosed with prediabetes, you do have some flexibility in deciding what you can eat and nothing is necessarily “off limits.”

Bunyard suggests avoiding sugar-sweetened beverages, being cognizant of portion control and using a healthy eating plan like “The Plate Method,” which has you split a 9-inch plate down the center, focusing half the plate on non-starchy vegetables, then splitting the other half into half again, dedicating a quarter of your plate to grains and the last quarter to protein. The American Diabetes Association has an interactive tool, along with lists of diabetes-friendly foods to help you visualize the healthiest meal. 

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Bunyard says being active is also one of the best ways to prevent type 2 diabetes, and it doesn’t have to be strenuous; walking for 30 minutes, five days a week is all you need. But don’t worry if 30 minutes is a bit too tough, any increase in activity is a step in the right direction, and you can aim to increase your time and number of days as you get stronger. Bunyard adds that if you are overweight, even a 7 percent drop in weight may prevent or delay your risk of diabetes.

Lifestyle changes play an important role in preventing or delaying the onset of type 2 diabetes, starting with making regular visits to a primary care provider who can partner with you to monitor your glucose levels and answer any questions you may have. In addition, Texas Health has 10 diabetes education centers located across the DFW Metroplex that are staffed with qualified diabetes educators, such as Bunyard, who can provide education individualized to your specific health, physical activity and lifestyle.

“Prevention is key! Our everyday choices matter,” Bunyard stresses. “Regular check-ups with a health care provider, moving more, maintaining a healthy weight, avoiding sugar-sweetened drinks and eating healthy with portion control in mind is important for all of us to prevent or delay the onset of type 2 diabetes.”

For more information about prediabetes and diabetes, Texas Health’s diabetes outpatient centers and to take a diabetes risk assessment, visit TexasHealth.org/Diabetes.

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