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Treating Prediabetes With Metformin

Treating Prediabetes With Metformin

Go to: Abstract To determine if the use of metformin in people with prediabetes (impaired glucose tolerance or impaired fasting glucose) would prevent or delay the onset of frank type 2 diabetes mellitus. MEDLINE was searched from January 1966 to the present, and articles meeting the selection criteria were hand searched. Randomized controlled trials that involved administration of metformin to delay or prevent type 2 diabetes in individuals with impaired glucose tolerance or impaired fasting glucose were included. Development of diabetes was a required outcome measure; follow-up time of at least 6 months was required. Three studies met these criteria. The 3 studies varied in ethnicity of the population studied, in the rates of conversion to diabetes from prediabetes, and in the dose of metformin used. In general the studies were well done, although 2 of the 3 did not do true intention-to-treat analyses. A sensitivity analysis was completed by converting all data to intention-to-treat data and assuming a worst-case scenario for the people who were lost to follow-up. Metformin decreases the rate of conversion from prediabetes to diabetes. This was true at higher dosage (850 mg twice daily) and lower dosage (250 mg twice or 3 times daily); in people of varied ethnicity; and even when a sensitivity analysis was applied to the data. The number needed to treat was between 7 and 14 for treatment over a 3-year period. Summary of results from reviewed trials: Development of diabetes outcomes. STUDY OUTCOME EER n/N (%) CER n/N (%) RRR % (95% CI) ARR % (95% CI) NNT N (95% CI) YATES CORRECTED P VALUE COMMENTS Li et al,22 1999 (Primary analysis of 70 participants) Development of diabetes at 12 mo 1/33 (3.0) 6/37 (16.2) 81.3 (−9.5 to 97.0) 13.2 (−0.9 to 17.9) 7.6 (5.5 to infinit Continue reading >>

When To Call A Doctor

When To Call A Doctor

A A A Prediabetes (cont.) When you have prediabetes, it's important to watch for symptoms of type 2 diabetes. Call your doctor if you notice that you are: Feeling very thirsty a lot of the time. Urinating more often than usual. Feeling very hungry a lot of the time. Having blurred vision. Losing weight without trying. You may want to talk to your doctor about testing for prediabetes if you are: Overweight and get little or no exercise. Interested in reducing your risk for getting type 2 diabetes. Exams and Tests Who should be tested for prediabetes? If you haven't yet been diagnosed with prediabetes, you may want to talk to your doctor about testing. The American Diabetes Association recommends testing adults for prediabetes, which may lead to type 2 diabetes, if you:1 Are age 45 or older. Are younger than 45 and overweight, and you have high blood pressure, high cholesterol, a family history of type 2 diabetes, or other risk factors. If the tests are normal, the American Diabetes Association recommends repeat testing at least every 3 years. A child who weighs too much may develop serious health problems, including type 2 diabetes. For more information about testing children for diabetes, see the topic Type 2 Diabetes in Children. What tests will you have for prediabetes? Your doctor will do a medical history, a physical exam, and blood glucose testing to find out if you have prediabetes and are at risk for getting type 2 diabetes. Blood tests used to identify prediabetes in adults include: Fasting blood glucose test. This test is usually done after you fast overnight for 8 hours. Hemoglobin A1c. This test estimates your blood sugar over the past 2 to 3 months. Oral glucose tolerance test (OGTT). For an OGTT, your blood sugar is measured after fasting and then again 2 h Continue reading >>

Prediabetes

Prediabetes

What is prediabetes? Prediabetes occurs when blood glucose levels are higher than normal, but not high enough for a diabetes diagnosis. Over time, this can increase your risk of heart disease and stroke, as well as your risk of developing type 2 diabetes. Unfortunately, prediabetes symptoms are hard to spot, so many people have the condition without a proper diagnosis. Who is at risk? The U.S. Centers for Disease Control indicates that about 79 million American adults over the age of 20 have prediabetes. As the population ages, becomes increasingly overweight and increasingly inactive, the number of adults with symptoms of prediabetes continues to grow. The number of young people with this condition is also increasing. Common risk factors include: Being obese or overweight Not getting enough exercise A family history of type 2 diabetes Being 45 or older Having African-American, Latino/Hispanic or American Indian family background Having had gestational diabetes Giving birth to a baby weighing more than 9 pounds Symptoms of prediabetes Unfortunately, there are almost no symptoms of prediabetes. The only way to know for sure that you have the condition is with a blood test. Three blood tests can be used to diagnose the condition. These include: Fasting blood glucose test (FBG) — Blood is drawn after a period of fasting for at least 8 hours. Oral glucose tolerance test (OGT) — Requires an 8 hour fast, after which blood is drawn before you drink a sugary solution and again 2 hours later. Hemoglobin A1c test (HbA1C) — A blood test that shows an estimate of average blood glucose levels for a period of three months. Why should you be concerned about prediabetes? Every year, one out of ten people with prediabetes will develop type 2 diabetes, and many are not even aware t 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 >>

What You Should Know About Prediabetes

What You Should Know About Prediabetes

Prediabetes is a warning sign that your glucose levels are higher than normal, but not high enough for your condition to be diagnosed as diabetes. While prediabetes can lead to complications such as nerve damage, raised blood pressure levels and raised cholesterol levels, it can be turned around. Here’s what you need to know. When will I know I have prediabetes? A normal fasting blood sugar level is 5.6 mmol/L. Anything between 5.7 mmol/L and 7.0 mmol/L can be considered prediabetic. Prediabetes is an indication that you could develop type 2 diabetes if you don't make crucial lifestyle changes fast. Prediabetes usually leads to type 2 diabetes as this is the type of diabetes mostly linked to lifestyle factors and the most common type of diabetes people develop later in their life. Type 1 diabetes is when the body produces no insulin. When your glucose levels are higher than they should be, you might not show any symptoms at all. But there might be some symptoms indicating prediabetes: An unusual increase in appetite Fatigue Thirst Frequent urination If your blood glucose level is slightly abnormal, your doctor can diagnose prediabetes by means of the following tests: An oral glucose tolerance test A fasting blood sugar test A glycated haemoglobin test, which tests your average blood sugar over the preceding two to three months Who gets prediabetes? Researchers are not sure exactly why people’s glucose levels go haywire. There are, however, several risk factors that make you more susceptible to prediabetes: Being overweight A lack of physical activity and a sedentary lifestyle A family history of diabetes Your age. From the age of 45, your risk for diabetes increases. How do I treat prediabetes? Our diabetes expert Dr Wayne May says that trials done in high-risk pati Continue reading >>

Prediabetes

Prediabetes

Prediabetes means you have blood glucose, or blood sugar, levels that are higher than normal but not high enough to be called diabetes. Glucose comes from the foods you eat. Too much glucose in your blood can damage your body over time. If you have prediabetes, you are more likely to develop type 2 diabetes, heart disease, and stroke. Most people with prediabetes don't have any symptoms. Your doctor can use an A1C test or another blood test to find out if your blood glucose levels are higher than normal. If you are 45 years old or older, your doctor may recommend that you be tested for prediabetes, especially if you are overweight. Losing weight - at least 5 to 10 percent of your starting weight - can prevent or delay diabetes or even reverse prediabetes. That's 10 to 20 pounds for someone who weighs 200 pounds. You can lose weight by cutting down on the amount of calories and fat you eat and being physically active at least 30 minutes a day. Being physically active makes your body's insulin work better. Your doctor may also prescribe medicine to help control the amount of glucose in your blood. NIH: National Institute of Diabetes and Digestive and Kidney Diseases Continue reading >>

5 Ways To Prevent Prediabetes From Becoming Diabetes

5 Ways To Prevent Prediabetes From Becoming Diabetes

Prediabetes, or elevated blood sugar, puts you at high risk of developing type 2 diabetes, especially if you are overweight, but you can take steps to prevent it. Type 2 diabetes is not inevitable. More than 86 million American adults—approximately one-third of those over age 18 and half of those over 65—have prediabetes, and most of them don’t even know it. If you have prediabetes, it means your blood sugar levels are consistently higher than normal, but not yet high enough to be diagnosed as diabetes. Prediabetes puts you at higher-than-normal risk of developing type 2 diabetes, heart disease, and stroke. According to U.S. Centers for Disease Control, up to 30% of overweight men and women with prediabetes will develop type 2 diabetes within five years of diagnosis. You don’t have to be one of them! Here are five steps you can take to reduce your diabetes risk. Welcome to the Type 2 Diabetes Center! This is your launching pad for living better with type 2 diabetes. We’ve gathered all the latest type 2 diabetes information, research updates, and advances in devices and medications. And because diabetes impacts every facet of your life, you’ll also find practical advice from leading experts and other people living with type 2 diabetes featured here. That includes mouth-watering, healthy recipes; money-saving tips; advice to help navigate social, professional, and relationship issues; and inspiring personal stories from people just like you. Explore the resources here and be sure to subscribe to our newsletter to be alerted to new additions. Continue reading >>

How One Woman With Prediabetes Uses Diet And Exercise To Prevent Diabetes

How One Woman With Prediabetes Uses Diet And Exercise To Prevent Diabetes

Kathy Lawrence lost 15 pounds when she started exercising 45 minutes a day.(KATHY LAWRENCE)If you have prediabetes, two of the most important things you can do to avoid diabetes are change your diet and increase your exercise. In a study published in 2002 by the Diabetes Prevention Program Research Group, people with prediabetes slashed their risk of diabetes by more than half if they lowered the fat and calories in their diet, boosted exercise, and lost weight. Kathy Lawrence, who is 61 and lives in Austin, developed some worrying symptoms in her late 50s. She had cat scratches on her feet that refused to heal. Slow-healing wounds are a sign of diabetes, so she visited her doctor and had her blood sugar tested. Lawrence had a fasting blood glucose of 119 mg/dL, just short of the level that signifies diabetes (over 126 mg/dL). Although she technically had prediabetes, not diabetes, her doctor told her: "We're going to count you as having it." More about diabetes Alter your diet She started by making some changes in her diet. "You ate your way into this disease, and you can eat your way out of it," her gynecologist once told her. That's not entirely true; she had some type 2 diabetes risk factors she couldn't changeher age, a family history of the disease and gestational diabetes during pregnancy. However, she did have some risk factors she could change, including her weight (she knew she could lose a few pounds in her midsection) and her activity level. She first looked at the types of carbohydrates she was eating. Carbohydrates are a key part of the human diet, but some raise blood sugar more than others. Next Page: Sticking with the diet [ pagebreak ]She focused on getting carbohydrates from fruits, vegetables, and whole-grain foods, which are rich in nutrients and fi Continue reading >>

How Do I Lower My Blood Glucose To Prevent Diabetes And Prediatebes?

How Do I Lower My Blood Glucose To Prevent Diabetes And Prediatebes?

Regular exercise can help you lose weight and increase insulin sensitivity. Increased insulin sensitivity means your cells are better able to use the availablesugar in your bloodstream. Exercise also helps your muscles use blood sugar for energy and muscle contraction. If you have problems with blood sugar control, you should routinely check your levels. This will help you learn how you respond to different activities and keep your blood sugar levels from getting either too high or too low. Good forms of exercise include weight lifting, brisk walking, running, biking, dancing, hiking, swimming and more. 2. Control your carb intake Your body breaks carbs down into sugars (mostly glucose), and then insulin moves the sugars into cells. When you eat too many carbs or have problems with insulin function, this process fails and blood glucose levels rise. However, there are several things you can do about this. The American Diabetes Association (ADA) recommends controlling carb intake by counting carbs or using a food exchange system . Some studies find that these methods can also help you plan your meals appropriately, which may further improve blood sugar control. Many studies also show that a low-carb diet helps reduce blood sugar levels and prevent blood sugar spikes. What’s more, a low-carb diet can help control blood sugar levels in the long run. 3. Increase your fiber intake Fiber slows carb digestion and sugar absorption. For these reasons, it promotes a more gradual rise in blood sugar levels. There are two kinds of fiber: insoluble and soluble. While both are important, soluble fiber specifically has been shown to lower blood sugar levels . Additionally, a high-fiber diet can help manage type 1 diabetes by improving blood sugar control and reducing blood sugar lows Continue reading >>

An Alarming Number Of Adults Have Prediabetes—and Doctors Aren’t Doing Anything About It

An Alarming Number Of Adults Have Prediabetes—and Doctors Aren’t Doing Anything About It

Just because you leave the doctor’s office empty-handed, it doesn’t mean you have a clean bill of health: Most people with prediabetes aren’t given treatment for the disease, new research from the University of Florida found. In the study, 34 percent of people ages 45 and older were found to meet the criteria for prediabetes. That means their levels on the A1C test—a measure of your average blood sugar levels over the past two to three months—were between 5.7 and 6.4 percent. In comparison, a normal reading is below 5.7 percent, and a level of 6.5 percent or higher indicates full-fledged diabetes. But of the people who had blood sugar levels in the prediabetes range, only 23 percent of them received any kind of treatment for it. “The doctors may be more focused on treating diabetes, not something that may lead to diabetes,” says study author Arch Mainous, Ph.D. Related: 5 Surprising Habits That Raise Your Risk of Diabetes That’s bad news, because treating prediabetes—either with drugs like metformin or through a weight loss program incorporating healthy eating and exercise—is very successful at preventing or delaying the development of diabetes, he says. And by preventing diabetes from occurring, you can stave off the serious implications of the disease, including damage to your kidneys, nerves, eyes, and heart, he says. Your move, then, is to take a more active role in your own health. Current guidelines by the United States Preventive Services Task Force recommend that all adults over 40 who are overweight or obese get their blood sugar tested. Related: Do You Need to Get Screened For Diabetes? If you fall into that category, ask your doctor for a test. And when the results come in, follow up with him or her—don’t just sit back if your hear “ Continue reading >>

Naturopathic Diagnosis And Treatment Of Diabetes And Prediabetes

Naturopathic Diagnosis And Treatment Of Diabetes And Prediabetes

By Mona Morstein, ND, DHANP Diabetes seems to be occurring to everyone—most people know a friend or family member who has developed it. Our country is in crisis regarding this disease because, quite simply, diabetes is at epidemic levels in the United States. And the statistics of diabetes are devastating—over the next 24 hours, 2200 people will be diagnosed with diabetes, 512 diabetics will die, 66 diabetics will go blind, 77 diabetics will be diagnosed with end-stage renal disease, and 153 diabetics will require an amputation. 24 million Americans are diagnosed with diabetes, and 47 million Americans with “prediabetes.” In fact, the Centers for Disease Control state that if things don’t change, one out of every three born today will become a diabetic, and that half of all Americans will be a diabetic by 2050. There are several types of diabetes: gestational, whereby a woman becomes diabetic during her pregnancy; Type 1, which occurs both in children and adults due to an auto-immune disease destroying cells in the pancreas; and, Type 2, which is the most common form, occurring in 90-95% of diabetic patients, including pediatric patients. Type 2 diabetes is related to insulin resistance, which means the pancreas is producing insulin but the body cells are no longer sensitive to it, so glucose levels in their blood stay high. Type 2 diabetes is caused by a number of factors, most of them controllable. There is a genetic association with diabetes, which people cannot change, but if everyone kept the controllable factors well-managed, we still would not be seeing the preponderance of diabetics. The controllable factors include: poor diet, over-eating, nutritional deficiencies, high refined grains and sugars consumption, high saturated fat consumption, lack of exe Continue reading >>

How To Treat Prediabetes With Diet

How To Treat Prediabetes With Diet

For people with prediabetes, lifestyle modification is considered “the cornerstone of diabetes prevention.” Diet-wise, this means individuals with prediabetes or diabetes should aim to reduce their intake of excess calories, saturated fat, and trans fat. Too many of us consume a diet with too many solid fats and added sugars. Thankfully the latest dietary guidelines aim to shift consumption towards more plant-based foods. Lifestyle modification is now the foundation of the American Association of Clinical Endocrinology guidelines, the European Diabetes Association guidelines, and the official standards of care for the American Diabetes Association. Dietary strategies include reducing intake of fat and increasing intake of fiber (meaning unrefined plant foods, including whole grains). The recommendation to consume more whole grains is based on research showing that eating lots of whole grains is associated with reduced risk of developing type 2 diabetes. New research even suggests that whole grains may protect against prediabetes in the first place. According to the American Diabetes Association’s official standards of care (which you can see in my video Lifestyle Medicine Is the Standard of Care for Prediabetes), dietary recommendations should focus on reducing saturated fat, cholesterol and trans fat intake (meat, dairy, eggs and junk food). Recommendations should also focus on increasing omega 3’s, soluble fiber and phytosterols, all three of which can be found together in flax seeds; an efficient, but still uncommon, intervention for prediabetes. In one study, about two tablespoons of ground flax seed a day decreased insulin resistance (the hallmark of the disease). If the standards of care for all the major diabetes groups say that lifestyle is the preferred Continue reading >>

Can Prediabetes Be Cured?

Can Prediabetes Be Cured?

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 5-10% of body weight.) Research shows that following such a plan not only reduces diabetes risk, but does it better than using medication. Improvements in glucose levels may be seen in as little as three months. If you have prediabetes, you need to start making lifestyle changes quickly. There's a window of only about three to six years in which you can turn around elevated glucose levels. If your health care provider informs you that you have prediabetes, do not give up! There are lifestyle choices you can make that can help prevent prediabetes from becoming diabetes and may even place you out of the prediabetes category. The most effective way to lower your blood sugar and stop insulin resistance is by losing weight. As little as 10 pounds or 5% of your body weight can make a huge difference in blood sugar control. Working on keeping a healthy and active lifestyle by exercising 30 minutes every day and incorporating more fruits and vegetables into your diet are other ways to curb your diabetes risk. Here are 5 key diet and lifestyle recommendations from the American Diabetes Association to reduce your risk of both diabetes and prediabetes: Lose Some Excess Weight. Research suggests that even a modest weight loss (approximately 5- 7% of your body weight) can reduce the cell’s resistance to insulin so that glucose will be taken up by the cells, and thus, improve blood glucose levels. Move at Least 2½ Hours Weekly. Physical activity has been shown to improve the cells sensitivity to i Continue reading >>

Diet For Prediabetes In Pregnancy

Diet For Prediabetes In Pregnancy

If you are pregnant you will likely be tested during your second trimester for a condition known as gestational diabetes, which is a form of diabetes that occurs only during pregnancy. However, the test may have borderline results. You may be labeled as prediabetic. Following a healthy diet is one way to prevent prediabetes from developing into diabetes, and also helps maintain the health of you and your baby. Video of the Day A label of prediabetes means someone you are "almost" diabetic. According to the American Diabetes Association, prediabetes is the state in which your blood glucose levels are higher than they should be, but are not consistently high enough to be labeled diabetic. The glucose tolerance test taken during your pregnancy involves drinking a sweet beverage and having blood tested for glucose levels after certain intervals of time. If you have borderline results you may be advised to change your diet to prevent a full case of gestational diabetes from forming. Managing blood sugar levels during pregnancy involves two things: watching what you eat, and watching how much you eat. Portion size is important, according to the American Diabetes Association. However, the types of foods you eat have an impact as well. If you have prediabetes you may need to limit the amount of carbohydrates you eat, and you should focus on foods that are high in nutrition and low in calories. While every woman’s needs are different based on height, weight and general activity level, following a general guideline can help you keep blood glucose levels in check. If you have gestational diabetes you should limit your starchy or sweet carbohydrates to only about half of your daily caloric intake, according to Medline Plus. Carbohydrates include such foods as fruits and vegetable Continue reading >>

Your Guide To Understanding And Managing Prediabetes

Your Guide To Understanding And Managing Prediabetes

When your blood sugar climbs higher than normal, but not so high that you fit the definition of diabetes, we say that you have prediabetes. It’s very common — an estimated 86 million Americans have prediabetes and another 120 million have actual or frank diabetes. So prediabetes isn’t an actual disease so much as a warning sign. Getting a prediabetes diagnosis doesn’t mean you’re guaranteed to progress to full on Type 2 diabetes, which brings heightened risks of heart disease, kidney disease, nerve damage and more. The good news is if you’re motivated now to make some simple lifestyle adjustments, you can reverse prediabetes and live a healthy life. Your Guide to Understanding and Managing Prediabetes How is prediabetes diagnosed? What causes prediabetes? What is the treatment for prediabetes? What medications are used to treat prediabetes? What are some easy ways to make better food choices? How can I get more exercise in my day? How is prediabetes diagnosed? Prediabetes is a laboratory diagnosis. Most commonly it’s detected when a routine blood test shows that your fasting blood sugar is elevated. Other tests that may detect prediabetes are a hemoglobin A1c, which measures your average blood sugar over the preceding several weeks, and a glucose tolerance test, in which your blood sugars are sampled at various times after consuming a large quantity of sugar. Most patients do not have any of the typical symptoms we associate with diabetes, such as increased thirst, increased urination or blurry vision. Why is high blood sugar bad for you? The answer to this question still isn’t fully understood, but we do know that a high blood sugar can itself be harmful and is associated with many other metabolic abnormalities — such as resistance to the hormone insu Continue reading >>

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