Pre-Diabetes: Screening and Management
Why is it important to know if my blood sugar is high?
Having your blood glucose checked periodically is an important way to identify if you are at risk for, or have developed diabetes. Diabetes is a common disease that can be asymptomatic for years prior to diagnosis. Screening can lead to earlier diagnosis, which is essential to help prevent or slow down secondary damage, particularly to blood vessels and eventually nerves, which can lead to increased risk of heart attacks, strokes, and other medical complications.
When should I start having my blood sugar checked?
Most people should have a screening glucose, or blood sugar test, between the ages of 30 and 45. While diabetes has historically been a disease afflicting adults, it has become increasingly prevalent in obese adolescents and children, and therefore screening may be a good idea for those who are overweight.
If your blood glucose is normal, this test should be repeated every 3 years. If the results reveal hyperglycemia (elevated blood sugar), or if you have significant risk factors for developing diabetes your primary care provider will want to repeat the test more often. These risk factors include: heart disease, high blood pressure, high cholesterol, being overweight or obese, strong family history of diabetes, having other known medical conditions indicating insulin resistance, or belonging to certain ethnic groups (Hispanic, African/African-American) that are predisposed to developing diabetes.
My doctor told me that I have pre-diabetes. What does this mean?
Pre-diabetes is a term that means you have an increased risk for diabetes. This is diagnosed when a fasting glucose level ranges from 100-125 mg/dL. An elevated hemoglobin A1C level from 5.7 to 6.4% indicates that glucose levels have been too high over the past several months. Elevated random blood glucose testing, which may be incidentally noted during regular check ups, may also indicate the need for further testing.
While there are several different types of diabetes, type II diabetes accounts for 90-95% of all people with diabetes in the United States. The term pre-diabetes typically only refers to type II diabetes, which is characterized by hyperglycemia, resistance to the effects of insulin, and impaired insulin secretion. In simplified terms – our bodies break down food into glucose, which functions as an energy source for our cells. The pancreas secretes insulin, which is a hormone that helps to deliver blood glucose into cells. When the insulin secretion is decreased, or when cells become resistant to insulin, the glucose stays in the bloodstream, which leads to hyperglycemia. Eventually this will cause damage to blood vessels and nerves, leading to problems in numerous organs such as the skin, brain, heart, eyes, and kidneys.
What can I do to keep pre-diabetes from progressing to diabetes?
There are several things that you can do to prevent progression to diabetes, including focusing on a healthy diet, exercising regularly, and maintaining a healthy weight. Most people with pre-diabetes and diabetes are overweight (defined as a body mass index, or BMI, of 25-29.9) or obese (defined as BMI >30).
To check your BMI you can use this online calculator. If your BMI is greater than 25, I would encourage you to speak with your primary care provider about evaluating your blood sugar, weight loss strategies like focusing on a healthy diet, and increasing exercise. Many of Fletcher Allen’s primary care practices now have Community Health Teams to help you manage diabetes and pre-diabetes.
Even a weight loss of 5 to 10 pounds can have a significant positive impact on your health! For more tips on healthy living and diabetes prevention please visit the American Diabetes Association website.
Gretchen Klein, DO is a family medicine physician at Colchester Family Practice – a certified medical home – and a clinical assistant professor of Family Medicine at the University of Vermont College of Medicine.
Like what you read? Subscribe to our blog! You’ll be the first to know when we post something new. Just provide your email address in the WordPress link on the left-hand side of the page.