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Four Things You Should Know About Pre-diabetes

Four Things You Should Know About Pre-diabetes

Before a person develops Type 2 diabetes, they almost always have what is called pre-diabetes. Pre-diabetes is a term for a patient who does not yet have diabetes but their body doesn’t handle sugar or glucose normally. The good news about being diagnosed with pre-diabetes is that it gives you a chance to adopt healthier habits that could help you avoid developing diabetes. Here are four things you should know about pre-diabetes. 1. Who is at risk of pre-diabetes? Two factors that would put a person at risk of pre-diabetes is being overweight, and living a sedentary lifestyle. People who are overweight and/or who don’t exercise regularly are much more likely to have pre-diabetes than people who keep their weight down and are physically active. A family history of diabetes is also a significant risk factor. 2. What should you do if you are at risk? Talk to your doctor if you think you’re at risk for pre-diabetes. Pre-diabetes is diagnosed after a blood test called the A1c test, which measures a person’s average blood glucose levels over a three-month period. An A1c of 5.7% to 6.4% means that you have pre-diabetes; anything below 5.7% is normal and a number greater than 6.4% means a diagnosis of Type 2 diabetes. It is very important for people at risk of developing diabetes to know their A1c number so that they can make dietary and exercise changes when necessary. 3. What should you do if you have pre-diabetes? If your doctor tells you that your A1c level indicates pre-diabetes, the most important thing you can do is to focus on eating a healthy diet. The usual recommendation is to eat a balanced diet that’s got the right amount of complex carbohydrates. Complex carbohydrates break down slower in your digestive system, so the blood sugar doesn’t rise rapidly l Continue reading >>

How To Diagnose Prediabetes

How To Diagnose Prediabetes

Studies have shown that up to 30 percent of people with prediabetes will develop type 2 diabetes within five years. At a time when one in three U.S. adults has prediabetes, it’s important to identify which of your patients have this condition to help them get the interventions they need right away. Learn the ways to identify patients with prediabetes in your practice. Two screening options, three tests Prediabetes is a condition in which blood glucose or hemoglobin A1C (HbA1C) levels are higher than normal but not high enough to be classified as type 2 diabetes. There are two different approaches you can take to determine when patients have prediabetes: Identification at the point of care or via an electronic heath record (EHR) query that results in a listing or registry. For point-of-care identification, use a simple algorithm (log in) to walk through the steps. The process starts with giving patients a diabetes risk assessment (log in). If the patient is at risk and has a body mass index (BMI) of ≥24 kg/m2 (≥22 kg/m2, if Asian*) or a history of gestational diabetes, then you should use the results of a diagnostic test to determine whether the patient has normal blood sugar levels, prediabetes or diabetes. There are three kinds of tests you can order: HbA1C, fasting plasma glucose or oral glucose tolerance test. Experts recommend that you have patients complete the risk assessment before their visit and arrange for pre-visit lab testing so you can spend time talking with your patients about their results during the actual visit. (Tip: If you don’t routinely employ pre-visit planning, check out the AMA’s STEPS Forward™ module on pre-visit planning.) If you choose to identify patients with prediabetes via a registry, you can do that by querying your EHR and s Continue reading >>

Prediabetes In South Asians

Prediabetes In South Asians

What is prediabetes? Prediabetes is when your blood sugar is higher than normal, but not high enough to make you diabetic. If you have prediabetes, take this opportunity to make immediate lifestyle changes to prevent the onset of diabetes. Read the following information and see our PRANA video on prediabetes. Back to top How is prediabetes measured? There are three main types of tests that diagnose prediabetes. The most common test is a fasting blood sugar (FBS), which is typically measured the morning after an overnight fast (10 to 12 hours). If your FBS is less than 126 but more than 99 mg/dL, then you have prediabetes. If you want to be specific, you can say you have impaired fasting glucose or IFG, which is one type of prediabetes. The second type of test is called the A1C or glycohemoglobin test which has been used to monitor individuals with established diabetes. The A1C test indicates your average blood sugar levels over the past 2-3 months. A level between 5.7-6.4 percent may indicate an increased future risk of diabetes. A value of 6.5% or greater would indicate diabetes. No fasting is required to have this test done. For more information on this test, go to glycohemoglobin. The final test is called a glucose tolerance test, in which you drink a sugar-sweetened drink and then have your blood sugar checked two hours later. If your blood sugar is 140 to 199 mg/dl, then you have impaired glucose tolerance or IGT which also falls under the category of prediabetes. This test is less commonly done due to the convenience and ease of the fasting blood sugar and A1C tests. Back to top Why is prediabetes common in South Asians? South Asians have a very high prevalence of diabetes, so it makes sense that prediabetes is epidemic in this population. A combination of genetic Continue reading >>

One-third Of Slim American Adults Have Pre-diabetes

One-third Of Slim American Adults Have Pre-diabetes

Among normal-weight individuals, those who were inactive were more likely to have an A1C level of 5.7 or higher, which is considered to be pre-diabetic Among all the normal-weight inactive participants (aged 20 and over), about one-quarter were either pre-diabetic or diabetic When only those inactive people aged 40 and over were analyzed, the percentage rose to 40 percent Inactivity increases your risk of pre-diabetes even if you’re not overweight or obese By Dr. Mercola It's often assumed that in order to develop type 2 diabetes, you have to be overweight. While it's true that excess weight is clearly associated with insulin resistance and diabetes, it's the insulin resistance — not necessarily the weight gain — that drives the disease. As such, many people with a healthy weight are not metabolically healthy, putting them at risk of diseases like type 2 diabetes — even without being overweight or obese. One of the greatest risk factors, according to University of Florida researchers, is actually inactivity, which drives up your risk of pre-diabetes regardless of your weight. Inactivity Is Associated With Pre-Diabetes, Even if You're a Healthy Weight If you were looking for motivation to get moving, this study, published in the American Journal of Preventive Medicine, is as good as it gets.1 In a survey of more than 1,100 healthy-weight individuals, those who were inactive (physically active for less than 30 minutes per week) were more likely to have an A1C level of 5.7 or higher, which is considered to be pre-diabetic. Among all the inactive participants (aged 20 and over), about one-quarter were either pre-diabetic or diabetic. When only those inactive people aged 40 and over were analyzed, the percentage rose to 40 percent. The researchers suggested that peop Continue reading >>

Prediabetes Symptoms And Diagnosis

Prediabetes Symptoms And Diagnosis

What is prediabetes? About 41 million Americans between the ages of 40 and 74 have "prediabetes." Prediabetes is a condition that can be considered an early, yet potentially reversible stage of the development of type 2 diabetes. Prediabetes is sometimes called impaired glucose tolerance or impaired fasting glucose (IGT/IFG), depending upon the test that yielded the abnormal result. In prediabetes, a person's blood sugar (glucose) levels are slightly higher than the normal range, but not high enough for a true diagnosis of diabetes. People with prediabetes have a significant risk of developing full-blown diabetes. In the Diabetes Prevention Program study, about 11% of people with prediabetes developed type II diabetes each year during the three year follow-up time of the study. Importantly, people with prediabetes generally have no symptoms of the condition. Testing for Pre Diabetes Doctors generally use one of two different blood tests to diagnose diabetes and prediabetes. One is called the fasting plasma glucose test (FPG) in which a person's blood glucose level is measured first thing in the morning before breakfast. The normal fasting blood glucose level is below 100 mg/dl. A person with prediabetes has a fasting blood glucose level between 100 and 125 mg/dl. If the fasting blood glucose level is to 126 mg/dl or above, a person is considered to have diabetes. The second test used in the diagnosis of diabetes is the oral glucose tolerance test (OGTT), although this test is no longer commonly used as in the past. This test may be used to diagnose gestational diabetes in pregnant women. In this test, a person's blood glucose is measured in the morning after fasting overnight and again two hours after drinking a glucose-rich beverage. The normal value for blood glucose Continue reading >>

Do I Have Prediabetes Or Diabetes? Guide To The A1c, Fpg, And Ogtt Tests, Plus Tips For Prevention

Do I Have Prediabetes Or Diabetes? Guide To The A1c, Fpg, And Ogtt Tests, Plus Tips For Prevention

If you’ve been diagnosed with prediabetes, you may wonder what that means. It’s a condition where your blood glucose levels are above normal, but not high enough for you to be diagnosed with diabetes. Many doctors consider prediabetes to be the first stage of type 2 diabetes. Studies show that 15 to 30 percent of people with prediabetes will develop diabetes in as little as five years without intervention, such as weight loss or increased physical activity. In fact, most people who get type 2 diabetes had prediabetes first. Prediabetes is serious in and of itself. People with this condition have a greater risk of developing cardiovascular disease than those without it. There are three tests that doctors can do in order to determine whether you have high blood sugar. A1C This blood test, which is also called hemoglobin A1c, HbA1c, or glycosylated hemoglobin, measures the percentage of sugar that is attached to your hemoglobin. Hemoglobin is a protein in your red blood cells. The higher the A1C, the higher your average blood sugar levels have been running over the past two or three months. A normal A1C is below 5.7 percent. An A1C between 5.7 percent and 6.4 percent suggests prediabetes. An A1C of 6.5 or more indicates type 2 diabetes if the test is confirmed. If your results are questionable, your doctor will retest your A1C on another day to confirm the diagnosis. Fasting plasma glucose The fasting plasma glucose (FPG) test is a blood test that’s done after you’ve been fasting overnight. It measures the sugar in your blood. A normal fasting glucose test is lower than 100 milligrams per deciliter (mg/dL). A result between 100 and 125 mg/dL is diagnostic for prediabetes. One that is 126 mg/dL or above is indicative of diabetes. It’s recommended to retest this an Continue reading >>

Prediabetes

Prediabetes

What is Prediabetes? Prediabetes is when you have an increased level of glucose (sugar) in your blood, which is also a possible sign of metabolic syndrome. If you have prediabetes, your risk of developing diabetes increases. Your chance of developing heart disease and stroke goes up, too. The good news is that you can help control and possibly reverse prediabetes by making some basic lifestyle changes. Learn more about diabetes. Prediabetes affects 79 million people age 20 or older in the U.S., according to the American Diabetes Association (ADA). Many individuals with prediabetes go on to develop type 2 diabetes within 10 years. The condition is becoming more common in the United States according to estimates provided by the U.S. Department of Health and Human Services (DHHS). Depending on the test used to diagnose it, prediabetes is also called: Impaired fasting glucose (IFG): Glucose levels are a little high when it has been several hours after eating Impaired glucose tolerance (IGT): Glucose levels are a little higher than normal right after eating. Some individuals have both IFG and IGT. Prediabetes Symptoms Symptoms include excessive thirst and frequent urination. Learn more about prediabetes symptoms. Diagnosing Prediabetes Insulin is a hormone that helps cells turn glucose into energy. When your body's cells don't use insulin properly, you have insulin resistance. It can cause glucose to build up in the blood. We measure glucose levels using a fasting glucose test or a glucose tolerance test. According to the American Diabetes Association, you have prediabetes if your: Fasting glucose result ranges from 100 to 125 mg/dL Your glucose tolerance result ranges from 140 to 199 mg/dL A1C level is 5.7 to 6.4 percent Treating Prediabetes After your blood test, your doct Continue reading >>

Comparison Between Prediabetes Defined By Hemoglobin A1c (a1c) 5.7-6.4% And That Defined By Impaired Fasting Glucose (ifg) In A Japanese Population

Comparison Between Prediabetes Defined By Hemoglobin A1c (a1c) 5.7-6.4% And That Defined By Impaired Fasting Glucose (ifg) In A Japanese Population

1Department of Internal Medicine, Tachikawa Medical Center, Japan 2Medical Check-up Center, Tachikawa Medical Center, Japan 3Department of Research and Development, Tachikawa Medical Center, Japan Citation: Suzuki H, Oda E, Aizawa Y (2011) Comparison between Prediabetes Defined by Hemoglobin A1c (A1C) 5.7-6.4% and that Defined by Impaired Fasting Glucose (IFG) in a Japanese Population. J Diabetes Metab 2:153. doi:10.4172/2155-6156.1000153 Copyright: © 2011 Suzuki H, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Visit for more related articles at Journal of Diabetes & Metabolism Keywords Prediabetes; Hemoglobin A1c; Impaired fasting glucose; HDL cholesterol; Total bilirubin Introduction Hemoglobin A1c (A1C) at a range of 5.7-6.4% was proposed as a marker of prediabetes [1] in addition to impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) although the World Health Organisation has not recommended using A1C for diagnosis of prediabetes. A1C was significantly associated with risks of cardiovascular disease (CVD) and death from any cause adjusting for fasting glucose (FG), while FG was not significantly associated with risks of CVD and death from any cause adjusting for A1C in non-diabetic adults [2]. Saukkonen et al. reported that overlap between A1C 5.7-6.4%, IFG, and IGT was uncommon and isolated A1C 5.7-6.4% was associated with higher BMI, higher triglycerides, and lower HDL cholesterol compared with isolated IFG among an aging white population [3]. The overlap between A1C 5.7-6.4% and IFG was only 2% in their population [3]. In the present study, we investiga Continue reading >>

Pre-diabetes

Pre-diabetes

What Is It? In pre-diabetes, blood sugar levels are slightly higher than normal, but still not as high as in diabetes. If diabetes is "runaway blood sugar" think of pre-diabetes as blood sugar that is "halfway out the door." People almost always develop pre-diabetes before they get type 2 diabetes. The rise in blood sugar levels that is seen in pre-diabetes starts when the body begins to develop a problem called "insulin resistance." Insulin is an important hormone that helps you to process glucose (blood sugar). If usual amounts of insulin can't trigger the body to move glucose out of the bloodstream and into your cells, then you have insulin resistance. Once insulin resistance begins, it can worsen over time. When you have pre-diabetes, you make extra insulin to keep your sugar levels near to normal. Insulin resistance can worsen as you age, and it worsens with weight gain. If your insulin resistance progresses, eventually you can't compensate well enough by making extra insulin. When this occurs, your sugar levels will increase, and you will have diabetes. Depending on what a blood sugar test finds, pre-diabetes can be more specifically called "impaired glucose (sugar) tolerance" or "impaired fasting glucose." Impaired fasting glucose means that blood sugar increase after you haven't eaten for a while – for example, in the morning, before breakfast. Impaired glucose tolerance means that blood sugar levels reach a surprisingly high level after you eat sugar. To diagnose impaired glucose tolerance, doctors usually use what is called a "glucose tolerance test." For this test you drink a sugary solution, and then you have blood drawn after a short time. Having pre-diabetes does not automatically mean you will get diabetes, but it does put you at an increased risk. Pre- Continue reading >>

Diagnosis

Diagnosis

Print The American Diabetes Association (ADA) recommends that blood glucose screening for adults begin at age 45, or sooner if you are overweight and have additional risk factors for prediabetes or type 2 diabetes. There are several blood tests for prediabetes. Glycated hemoglobin (A1C) test This test indicates your average blood sugar level for the past two to three months. Specifically, the test measures the percentage of blood sugar attached to the oxygen-carrying protein in red blood cells (hemoglobin). The higher your blood sugar levels, the more hemoglobin you'll have with sugar attached. In general: An A1C level below 5.7 percent is considered normal An A1C level between 5.7 and 6.4 percent is considered prediabetes An A1C level of 6.5 percent or higher on two separate tests indicates type 2 diabetes Certain conditions can make the A1C test inaccurate — such as if you are pregnant or have an uncommon form of hemoglobin (hemoglobin variant). Fasting blood sugar test A blood sample is taken after you fast for at least eight hours or overnight. In general: A fasting blood sugar level below 100 milligrams per deciliter (mg/dL) — 5.6 millimoles per liter (mmol/L) — is considered normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 7.0 mmol/L) is considered prediabetes. This result is sometimes called impaired fasting glucose. A fasting blood sugar level of 126 mg/dL (7.0 mmol/L) or higher indicates type 2 diabetes. Oral glucose tolerance test This test is usually used to diagnose diabetes only during pregnancy. A blood sample is taken after you fast for at least eight hours or overnight. Then you'll drink a sugary solution, and your blood sugar level will be measured again after two hours. In general: A blood sugar level less than 140 mg/dL (7.8 mmo Continue reading >>

Dr. Jacqueline Gerhart: If You Have Prediabetes, Will You Get Diabetes?

Dr. Jacqueline Gerhart: If You Have Prediabetes, Will You Get Diabetes?

Madison, Wisconsin - UW Health Family Medicine physician Jacqueline Gerhart writes a column that appears Tuesdays on madison.com and in the Wisconsin State Journal. Columns are re-published here with permission. Dear Dr. Gerhart: I was just told I have prediabetes. What are the chances I'm going to get full-blown diabetes? Dear Reader: I'm sorry to hear you have prediabetes, also known as impaired fasting glucose or impaired glucose tolerance. It is diagnosed in patients with elevated blood sugars that are not yet high enough to be considered diabetes. There are a few ways to test for diabetes. Fasting blood sugar: This can be done either by a traditional blood draw or by a finger prick. If the value is from 100 to 125 mg/dL (milligrams per deciliter), you are considered to have impaired fasting glucose. If it is greater than 126 mg/dL on two different occasions, you are diagnosed with diabetes. Two-hour oral glucose tolerance test: This test is done less frequently because you have to drink a sugary drink, then wait two hours before your blood is drawn. On this test, if your blood sugar is 140 to 199 mg/dL, you have impaired glucose tolerance. Greater than 200 mg/dL means diabetes. Hemoglobin A1C: This test is often used for both the diagnosis and the ongoing management of diabetes. If your value is 5.7 to 6.4 percent, you have prediabetes. Greater than 6.5 percent is diabetes. Having prediabetes does place you at a high risk of developing diabetes. For example, people with hemoglobin A1C values of 5.5 to 6.0 have a 9 to 25 percent chance of developing diabetes in five years. Those with values from 6.0 to 6.4 have a 25 to 50 percent chance, and they are 20 times more likely to develop diabetes than those with a normal hemoglobin A1C. Prediabetes is associated with card Continue reading >>

What Is Prediabetes?

What Is Prediabetes?

Prediabetes is a wake-up call that you’re on the path to diabetes. But it’s not too late to turn things around. If you have it (like 86 million other Americans), your blood sugar (glucose) level is higher than it should be, but not in the diabetes range. People used to call it "borderline" diabetes. Normally, your body makes a hormone called insulin to help control your blood sugar. When you have prediabetes, that system doesn't work as well as it should. You might not be able to make enough insulin after eating, or your body might not respond to insulin properly. Prediabetes makes you more likely to get heart disease or have a stroke. But you can take action to lower those risks. Your doctor will give you one of three simple blood tests: Fasting plasma glucose test. You won't eat for 8 hours before taking this blood test. The results are: Normal if your blood sugar is less than 100 Prediabetes if your blood sugar is 100-125 Diabetes if your blood sugar is 126 or higher Oral glucose tolerance test. First, you'll take the fasting glucose test. Then you'll drink a sugary solution. Two hours after that, you'll take another blood test. The results are: Normal if your blood sugar is less than 140 after the second test Prediabetes if your blood sugar is 140-199 after the second test Diabetes if your blood sugar is 200 or higher after the second test Hemoglobin A1C (or average blood sugar) test. This blood test shows your average blood sugar level for the past 2 to 3 months. Doctors can use it to diagnose prediabetes or diabetes or, if you already know you have diabetes, it helps show whether it's under control. The results are: Normal: 5.6% or less Prediabetes: 5.7 to 6.4% Diabetes: 6.5% or above You may need to take the test again to confirm the results. Lifestyle change Continue reading >>

8 Actions To Take If You Have Prediabetes

8 Actions To Take If You Have Prediabetes

Changing the Path to Type 2 A whopping 86 million Americans have prediabetes. That’s according to the latest statistics from the U.S. Centers for Disease Control and Prevention (CDC) -- that's 37 percent of American adults over age 20 and 51 percent of adults over age 65. Research shows about 70 percent of people with prediabetes will develop type 2 diabetes over time. Despite these scary stats, only 11 percent of people who have prediabtes know it. The good news is you can prevent or slow the progression of prediabetes to type 2. Numerous research studies conducted over the last 30 years show that early and aggressive management with continued vigilance over time is what prevents or delays type 2 diabetes. And the earlier you detect it and put your plan into action, the better. Here are eight ways to manage prediabetes. 1. Get Tested to Know for Sure. Do you have family -- parents or siblings -- with prediabetes or type 2 diabetes? Are you carrying extra weight around your middle? Don't get enough exercise? These are a few of the risk factors for prediabetes. A good first step to see if you are at high risk is to use the American Diabetes Association (ADA) Type 2 Diabetes Risk Test. You can take the test by visiting diabetes.org/risk. If you’re at high risk, schedule an appointment with your health care provider to get a check of your blood glucose level -- or, better yet, your A1C (an average of your blood glucose over two to three months). See the blood test results to diagnose prediabetes on the next page. 2. Max Out Your Insulin-Making Reserves. It's well known that at the center of the storm of the slow and steady onset of prediabetes is insulin resistance -- the body's inability, due to excess weight and genetic risk factors, to effectively use the insulin th Continue reading >>

Prediabetes - The Problem And How You Can Prevent It

Prediabetes - The Problem And How You Can Prevent It

Roughly one-third to one-half of adults currently have prediabetes, but does that statistic really matter? After all, these adults aren’t actually diabetic yet, so the health risk isn’t actually there, right? Wrong. UnityPoint Health Diabetes Steering Committee Chair, David Trachtenbarg, MD, talks about how to prevent diabetes, starting with prediabetes. What is Prediabetes? Prediabetes is a condition where blood sugar levels aren’t quite high enough to be classified as type 2 diabetes, but without change, will most likely develop into diabetes in as little as 10 years. “The large number of adults who already exhibit signs of prediabetes indicates that millions of people are at risk for developing a serious disease with many serious complications, diabetes,” Dr. Trachtenbarg says. This is the concern of health care providers across the country, so much so that some are labeling prediabetes as “an epidemic that’s out of control.” There’s good reason to take prediabetes seriously. Even before an adult is diagnosed with diabetes, prediabetes can start to have the same negative effects on the body. “Although much less common than with overt diabetes, if you have prediabetes, you are at increased risk for heart attacks and strokes, as well as kidney, nerve and eye problems. The best way to detect if someone has prediabetes is through a blood test,” Dr. Trachtenbarg says. Blood glucose, or blood sugar, is closely examined when determining a prediabetes diagnosis. For someone who is diabetic, a fasting blood glucose result would be 126 mg/dL (milligrams per deciliter) or higher. Prediabetes blood glucose results would fall in the 100-125 mg/dL range. A provider might also do another blood test, an A1C, which looks at hemoglobin levels. A1C results of 6.5 Continue reading >>

12 Simple Ways To Fight Prediabetes

12 Simple Ways To Fight Prediabetes

At 28, Jennyvi Dizon wasn't expecting to be turned down for health insurance. "I thought I was fairly healthy," she says. The company disapproved her because she weighed 188 pounds and was 5 feet 3 inches tall. They wanted her to weigh 155 pounds or less. When she reapplied one month later, the insurer requested blood tests. This time, the news was even more startling: her blood glucose (blood sugar) level was above normal and her cholesterol was high. Jennyvi's mother has diabetes, so the elevated blood glucose reading was especially worrisome. Online, Jennyvi learned that her test level meant she had prediabetes—a condition that can lead to type 2 diabetes and also increases the risk of cardiovascular disease. "I had been in a little bit of denial because, really, I was overweight and unhealthy, but I didn't realize it," says Jennyvi, a bridal and evening gown designer from Phoenix. "I knew that if I get to the diabetes level, it'll cause me problems later." The hidden condition As many as 60 million people in the United States have prediabetes, yet more than 90 percent of them don’t know it. People with prediabetes usually have no symptoms, and many who learn about their prediabetes think it’s no big deal. "People do not take this as seriously as they need to," says Ann Albright, PhD, RD, director of the Division of Diabetes Translation at the Centers for Disease Control and Prevention in Atlanta. "The good news is there is something you can do about it," Dr. Albright adds. The best way to fight prediabetes and get your blood sugar back in the normal range is with a coordinated plan of healthy nutrition, increased physical activity and lifestyle coping strategies that support modest weight loss if you are overweight. (Modest weight loss is defined as losing 5 t Continue reading >>

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