Prediabetes: What Can You Do About It?

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At this point, it’s well known that diabetes is a growing concern in the U.S. and around the world. According to the CDC’s National Diabetes Statistics Report from 2020, more than 34 million Americans, or about 10% of the population, already have it.

However, what's even more alarming are the statistics related to prediabetes, which is a state of higher blood sugar levels that indicates an increased risk of developing diabetes. The same CDC report from 2020 indicates that 88 million adults in the U.S. have prediabetes. That’s almost one-third of the population.

A prediabetes problem

Ronald B. Goldberg, M.D., an endocrinologist at the University of Miami Health System, says there are several reasons to be concerned about this trend. For one, the numbers that qualify somebody for prediabetes are not too far off from diabetes itself. For example, the American Diabetes Association says that people with diabetes will have a fasting blood sugar of higher than 126 milligrams per deciliter. Prediabetes is just below that, with fasting blood sugar levels between 100 and 125 milligrams per deciliter. The same is true for the A1C blood test, as people with prediabetes are between 5.7% and 6.4%, while people with diabetes are 6.5% or higher. The margins are pretty thin.

Now, take those thin margins and compound it with the alarmingly high number of people with prediabetes, and you can see why Dr. Goldberg is concerned. “We’ve been looking at this issue for over 25 years, and we know that prediabetes represents a 60% or higher risk of developing diabetes later in life,” he says. “So yes, we’re looking at a great number of people who have a chance of developing a dangerous, life-threatening condition in the years ahead.”

A reason for optimism

While the numbers related to prediabetes are alarming to both health professionals and the general public alike, Dr. Goldberg says there is some reason for optimism.

While prediabetes indicates a high likelihood of getting diabetes later in life, it’s not too late to do something about it. In fact, for many, it has served as a wake-up call that it’s time to make some positive health changes. “If you have prediabetes and make some lifestyle changes, you can do a lot to slow it down, if not prevent it altogether,” says Dr. Goldberg.

prediabetesSimple steps can help you avoid diabetes

How can you turn things around if you’re trending toward diabetes? According to the American Diabetes Association, working closely with a health care provider can help you begin a treatment plan that includes diet and lifestyle changes. Here are a few suggestions to help you get started.

  • Lose weight. As part of the Diabetes Prevention Program, Dr. Goldberg and his colleagues at the University of Miami were one of 27 sites around the nation that examined the impact of lifestyle changes and medication on preventing diabetes. During the course of that research, it became clear that the key to preventing prediabetes from becoming diabetes was a weight loss of 7%, which reduced the risk of diabetes by 58%. Of course, this is easier said than done, which is why he recommends focusing on cutting calories just a little bit at a time and focusing on small victories. But with diabetes, the bottom line is that weight loss is critical to success.
  • Get moving. “One of the important factors that helps you maintain weight reduction is increasing physical activity,” says Dr. Goldberg. If you’re not meeting the CDC’s recommendations to get at least 150 minutes of moderate intensity activity a week, now is the time to start. Dr. Goldberg says this doesn’t have to be super elaborate or challenging at first. Even a simple walk or yardwork can provide benefit as you work toward a more active lifestyle.
  •  Embrace sustainable habits. Rather than losing weight through a diet that is difficult to sustain, Dr. Goldberg says habits that you can continue for the long-term are important. “When you prescribe a diet for a person, it may have recommendations that are hard to stick with,” he says. “It’s really more about changing your overall eating behavior toward healthier choices.”
  •  Don’t give up! Finally, Dr. Goldberg says that it’s important to realize that you’ll have setbacks. We all do from time to time. But rather than letting them get you off course, you should recognize them, acknowledge them, and then get back on track toward meeting your goals. “The key is to recognize that you will slip up. It happens to everybody,” he says. “Rather than getting into negative thinking and a downward spiral, it doesn’t mean you failed. Just learn from your past mistakes and keep moving forward.”

Wyatt Myers is a contributing writer for UMiami Health News.


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