Should you worry about prediabetes?

An estimated 34 million Americans — just over one in 10 — have type 2 diabetes. However, approximately 88 million — more than one in three — have prediabetes, a condition in which the average amount of sugar (glucose) in the blood is high, but not high enough to be diagnosed as diabetes. More than 84% of people with prediabetes don’t know they have it.

Older adults tend to ignore the seriousness of prediabetes because, on average, they are less likely to get full-blown diabetes compared with younger people. Still, prediabetes can greatly raise their risk for heart attack and stroke.

“Older adults need to understand the potential danger of elevated blood sugar levels even if they are not worrisome yet, so they can address the problem before it worsens,” says Dr. Jorge Plutzky, director of preventive cardiology at Harvard-affiliated Brigham and Women’s Hospital.

The sticky issue of glucose

How does prediabetes (and diabetes) occur? When you eat, your body breaks down carbohydrates from food into a simple sugar called glucose. At the same time, your pancreas produces a hormone called insulin that signals the body’s cells to absorb glucose from the bloodstream.

Type 2 diabetes, the most common type, happens when the body has trouble using glucose for energy because cells become resistant to the action of insulin. So your pancreas makes more insulin to try to get cells to respond. Eventually, the pancreas can’t keep up, and blood sugar builds up in the bloodstream. The difference between diabetes and prediabetes is how high blood sugar levels get.

Diabetes is known to increase a person’s risk of heart attack and stroke. But prediabetes also can be dangerous. “Even mildly elevated glucose levels can trigger inflammation that damages blood vessels, cause them to narrow, and lead to blockages,” says Dr. Plutzky. That’s why it’s so important for people with prediabetes to lower other cardiovascular risk factors by controlling blood pressure and cholesterol levels.

Prediabetes usually has no symptoms, which is why many people are unaware they have it. The common risk factors are the same as those for full-blown type 2 diabetes, such as excess weight, poor diet, and a family history of diabetes. Less often, some people with prediabetes notice dark patches on the skin around their armpits, elbows, knees, knuckles, or neck.

The big three

Older men should get their blood sugar levels checked even if they are in good health overall. “Those are often the people who need to be the most mindful,” says Dr. Plutzky. (See “Blood check.”)

The best way to treat prediabetes is also the best way to prevent it. You need to focus on the big three: weight, exercise, and diet.

Weight. If you are overweight, even a small amount of weight loss — 5% to 7% — can lower your risk of prediabetes and protect against diabetes. “Focus on smaller amounts at first, like five pounds, and when you reach that, aim for another five pounds,” says Dr. Plutzky.

Exercise. Staying active even when you carry a higher-than-ideal weight is associated with a lower risk of prediabetes. Dr. Plutzky suggests looking beyond traditional workouts, and adopting sports and physical activities you like, such as golf, dancing, or yoga. “If you enjoy it, you’ll do it more often, and consistency is what’s important,” he says.

Diet. Reduce your intake of simple carbs, such as bread, pasta, rice, potatoes, and high-sugar beverages like fruit juice and soda. These carbs are quickly digested and can cause blood sugar levels to quickly rise and fall. Simple carbs also can trigger cravings that may lead to overeating and weight gain. In turn, replace simple carbs with complex ones, such as those in whole grains, beans, and lentils. Also, eat more fiber-rich foods. Fiber slows the absorption of sugar and helps balance blood sugar levels.

If you are diagnosed with prediabetes, Dr. Plutzky suggests getting another blood test in two to three months after adopting these changes. “The results will determine if you need to make any adjustments,” he says. “If your numbers have improved, seeing the change can inspire you to keep going.”

Blood checkAs with diabetes, prediabetes is diagnosed from blood sugar tests. Your doctor will probably suggest one of these:A hemoglobin A1C test reflects your average blood sugar for the past two to three months.A fasting plasma glucose test measures your blood sugar after you’ve avoided eating or drinking for at least eight hours.An oral glucose tolerance test checks how well the body processes sugar after drinking a sweet drink.According to the American Diabetes Association, prediabetes is suspected with an A1C from 5.7% to 6.4%, a fasting blood sugar level of 100 to 125 milligrams per deciliter (mg/dl), or a blood sugar level of 140 to 199 mg/dl during an oral glucose tolerance test.
  1. Bible verses for today’s meditation and inspiration: Matthew E. McLaren
  2. Matthew 12:31
    And so I tell you, every kind of sin and slander can be forgiven, but blasphemy against the spirit will not be forgiven.
  3. Acts 3:19
    Repent, then, and turn to God, so that your sins may be wiped out, that times of refreshing may come from the Lord.
  4. Ephesians 4:31
    Let all bitterness and wrath and anger and clamor and slander be put away from you, along with all malice.
  5. Matthew 6:12
    And forgive us our debts, as we also have forgiven our debtors.
  6. Proverbs 10:12
    Hatred stirs old quarrels, but love overlooks insults.
  7. 1 John 1:9
    If we confess our sins, he is faithful and just to forgive us our sins and to cleanse us from all unrighteousness.
  1. Matthew 6:15
    But if you do not forgive others their sins, your father will not forgive your sins.
  2. 2 Corinthians 5:17
    Therefore, if anyone is in Christ, he is a new creation. The old has passed away; behold, the new has come.
  3. Psalm 86:5
    You, Lord, are forgiving and good, abounding in love to all who call to you.
  4. Colossians 3:12-13
    Put on then, as God’s chosen ones, holy and beloved, compassionate hearts, kindness, humility, meekness, and patience, bearing with one another and, if one has a complaint against another, forgiving each other; as the Lord has forgiven yo

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