You've been diagnosed with Prediabetes, but what does this mean?

A diagnosis of prediabetes is given when your blood sugar is higher than normal, but not high enough to cause diabetes. You can develop prediabetes when your body does not make enough of insulin or if the insulin that you are making is not working well enough.

When you eat carbohydrates foods like breads, cereals, fruit, dairy, beans and starch vegetables, your body breaks them down into a simple sugars called glucose. The insulin helps the take the glucose into the muscle cells where you can use it. If you don’t have enough of insulin or if your insulin is not working well,  your blood glucose will remain too high.

Research shows that people with prediabetes have a 40% decline in their insulin-producing cells compared to people without prediabetes. If your body is not responding to the insulin produced, your pancreas will work extra hard to make more insulin to help lower your blood glucose. Over time, this extra work to make more insulin can cause permanent malfunction or death of the insulin producing cells.

 
Risk factors for prediabetes include: 

• Obesity, mainly in the abdomen. 
• Family history of diabetes, overweight, or obesity
• Polycystic ovary syndrome
• Gestational diabetes
• Western-pattern diet, increased consumption of processed meat and sugar-sweetened beverages, smoking, and lack of magnesium and exercise
  
  

Diagnosis 

Prediabetes has no symptoms and is usually diagnosed by screening people at risk. Many times, you make go to the doctor for an annual physical or another reason and discover that you have prediabetes. The common blood tests used to diagnose prediabetes are fasting blood glucose and hemoglobin A1c.

Your fasting blood glucose tells you what your blood glucose is at the time the lab draw, but your hemoglobin A1c is an average of your blood glucose over the past 3 months.

A high hemoglobin A1c means you have too much glucose in your blood. High blood glucose raises your chance of having serious problems with your kidneys, eyes, or feet

• Normal A1C is < 5.7%
• Diabetes is at 6.5% or above
• Prediabetes is usually diagnosed at 5.7%-6.4%
  
  

 Fasting Blood Glucose (FBG)

This test checks your fasting blood glucose levels after not eating or drinking, except water, for at least 8 hours before the test.

• Normal FPG is less than 100 mg/dl
• Diabetes 126 mg/dl or higher
• Prediabetes 100 mg/dl to 125 mg/dl

Oral Glucose Tolerance Test (OGTT)

This test checks your blood glucose levels before and two hours after you drink a sweet drink. It shows how your body processes sugar. This test is usually performed when you are pregnant and tells your primary care practitioner if you have gestational diabetes, rather than prediabetes. If you were diagnosed with gestational diabetes, you may have had undiagnosed prediabetes prior to pregnancy.

• Normal blood glucose is less than 140mg/dL
• Prediabetes is diagnosed between 140 mg/dl to 199 mg/dl
• Diabetes is diagnosed at 2-hour blood sugar of 200 mg/dl or above

Management

Lifestyle interventions such as diet, activity, weight loss, and smoking cessation are the first-lines of treatment.

The American Diabetes Association recommends:

• ≥ 7% weight loss
• Moderate-intensity physical activity to ≥ 150 minutes/week. 
• Consumption of a high fiber diet (≥ 14 g of fiber/1,000 kcal) such as non-starchy vegetables, fruits, and whole grains.
• Mediterranean-style diet rich in monounsaturated, polyunsaturated fats and omega-3 fatty acids such as fatty fish, nuts, and seeds. These healthy fats improve blood sugar metabolism and reduce the risk of heart diseases. 
• Replacing sugar-sweetened beverages with water. This helps to control weight and blood sugar and reduces the risk of heart and fatty liver diseases.
• Avoiding cigarettes, e-cigarettes, or other tobacco products  
• Yearly check-ups for the development of diabetes and screening for modifiable risk factors for diabetes.
  
  

If you have been diagnosed with prediabetes and would like to expert guidance to help you created a nutrition plan that is realistic and reduces your risk of developing diabetes, give us a call at 303-779-9355 to schedule an appointment with one of our caring registered dietitians or certified diabetes care and education specialists.​

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Marwa Moftah, MB BCh, MPH, MSc. and Jeremy Thararoop, DCN, RD, CDCES