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Reversing Prediabetes

Did you know November is National Diabetes Month? This year’s theme is prediabetes. Let’s celebrate by learning more about prediabetes and what we can do to improve our health!  

What is prediabetes?

In prediabetes, your body doesn’t use insulin well. Insulin helps the cells in your body use sugar for energy. If your body doesn’t use insulin well, the sugar stays in your bloodstream, and your blood sugar rises. Prediabetes causes higher than normal blood sugar levels, but not high enough to be type 2 diabetes. Too much sugar in your blood can lead to serious long-term problems for your eyes, kidneys, heart, and brain. I don’t like the sound of that, so how do you know if you have prediabetes? Let’s find out. 

How do I know if I have prediabetes?

More than 1 in 3 people in the US have prediabetes, and more than 84% of them don’t know it! There are often no signs or symptoms of prediabetes. Many people have it and don’t even know they are at risk for serious health problems. Is there some good news here? Yes! A simple blood test can tell us if you have prediabetes. 

Certain people are at higher risk. It’s important to know if you are at higher risk to discuss with your healthcare provider and find ways to lower your risk. Risk factors for prediabetes include:

  • Being 45 years or older.
  • Being overweight.
  • Having a parent or sibling with type 2 diabetes.
  • Not being physically active.
  • Ever having gestational diabetes.
  • Having polycystic ovary syndrome.

African Americans, Hispanic/Latino Americans, American Indians, and Pacific Islanders are also at increased risk. 

The CDC has an online test you can take to help you determine your risk can find it at this link: https://www.cdc.gov/prediabetes/risktest/ 

Do you want more good news? If you know you have prediabetes, there are many things you can do to prevent long-term complications, including type 2 diabetes. You can even reverse prediabetes! 

How can I reverse prediabetes and prevent type 2 diabetes?

Start small! You don’t have to do all of these all at once. Making lifestyle changes is hard. Small, manageable goals are more sustainable. Get support from your friends and family. Remember, you can start small, and you can start today- don’t wait for the new year for new goals! 

  • See your healthcare provider: A simple blood test can be done to check for prediabetes and diabetes. Remember, there are often no symptoms or signs of prediabetes, so regular checkups with your healthcare provider and discuss your risks are essential! Make an appointment today. 
  • Exercise: It’s okay to start small. Try to find something you enjoy doing and do it with people you enjoy spending time with. The goal is 30 minutes of exercise 5 days per week. 
  • Healthy diet: Choose foods that are lower in fat and sugar. Try to balance your plate with vegetables, lean protein, and grains. Avoid sweetened beverages and drink more water. 
  • Lose weight: A small amount of weight can make a big difference! Losing just 5-7% of your body weight can lower your risk of getting type 2 diabetes.
  • Quit Smoking: If you smoke, consider quitting. Get help quitting by talking to your healthcare provider. If you don’t smoke, don’t start. 
  • Stay up to date on vaccinations: This may not prevent prediabetes, but it can prevent serious complications if you get sick with a vaccine-preventable illness like the flu or COVID-19. Come in to get updated on your vaccines today! 

Happy National Diabetes Month! Pick one of these steps to start this November to celebrate! 

References 

Center for Disease Control and Prevention. (2020). Prediabetes- Your chance to prevent type 2 diabetes. https://www.cdc.gov/diabetes/basics/prediabetes.html 

National Institute of Diabetes and Digestive and Kidney Diseases. (2021). National Diabetes Month 2021.  https://www.niddk.nih.gov/health-information/community-health-outreach/national-diabetes-month 

Resources 

https://www.cdc.gov/diabetes/prevention/index.html

https://www.cdc.gov/diabetes/index.html

https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-type-2-diabetes/game-plan

https://www.cdc.gov/prediabetes/risktest/

Understanding Diabetes

At the age of 11, my younger brother started to experience the three key symptoms of diabetes; excessive thirst, frequent urination, and extreme hunger. He was continually eating food and drinking water, but we thought he was going through a growth spurt.

However, he was later admitted to Primary Children’s Hospital in Salt Lake City and diagnosed with type 1 diabetes. I was 15 years old at the time of his diagnosis. I remember my parents telling me what was “wrong” with him, but I had no understanding of the disease or that it would be a life-long battle for him.

When my little brother stabilized and was getting closer to being discharged, we had to meet with the diabetes educator; this is where I learned that my brother would need to give himself a shot of insulin daily.  I don’t know about you, but at 15, I had a strong dislike and fear of needles. Even with that fear, I had to help my family when I could and somehow got convinced into letting my little brother practice on me. I don’t remember much else from that day, but I won’t forget the shot he administered in my abdomen and him testing my blood sugar. 

As I finished high school and started thinking about career options, I knew that I wanted to be a nurse. While in nursing school, I learned about different diabetes types, such as type 2 diabetes and gestational diabetes. I already knew about type 1 diabetes because of my personal experience with the disease, and now I had to understand these different types. When I began my career as a bedside nurse, I quickly learned that I would be dealing more with type 2 diabetes than type 1. Type 2 diabetes is more common than type 1 diabetes because it directly correlates with obesity and living sedentary lifestyles.

In the United States, approximately 1 in 10 people struggle with diabetes (CDC, 2019). Type 1 diabetes likely occurs after an environmental trigger occurs in a susceptible person. This environmental trigger initiates the immune system to destroy the insulin-producing cells in the pancreas. Once these cells are destroyed, your body can no longer make insulin to lower their blood sugar. Type 2 diabetes develops when insulin resistance occurs, and the liver produces too much glucose, or when insulin secretion from the pancreas becomes inadequate. Early within the disease process, the muscles, liver, and fat become resistant to insulin. This isn’t damaging to the body in the beginning because the pancreas will compensate for these systems. The pancreas notices the increase in blood sugar levels and will make more insulin to cover the needed amount. Eventually, the pancreas becomes overworked, and it stops producing enough insulin to compensate. When this happens, our blood sugar level remains elevated, and a diagnosis of type 2 diabetes occurs.

At this point, you may be asking yourself, “how do I know if this is happening to me?” The best way to know if you have type 2 diabetes or are prediabetic is to come to any provider at Canyon View Medical Group. Your provider can perform a lab test called Hemoglobin A1C. The lab result gives your provider your average blood glucose level for the last three months.

A normal A1C, meaning no diabetes, is less than 5.6%. An A1C that is concerning for prediabetes is represented by an A1C of 5.7% to 6.4%. A patient is considered diabetic if their A1C is greater than or equal to 6.5%.        

If your provider informs you that you are prediabetic, they will provide counseling on the importance of changing your diet and initiating an exercise program. These two interventions are critical to lowering your A1C and preventing you from becoming a type 2 diabetic. If you have type 2 diabetes, your provider will stress the importance of lifestyle changes similar to what is done for prediabetic patients and will likely start you on medicines to lower your A1C. The medications your provider prescribes will work well at reducing your blood sugar level, but the best results come from a combination of drugs, diet, and exercise. Once you have type 2 diabetes, you will visit your healthcare provider every three months to check your A1C%. Most type 2 diabetics have an A1C goal of less than 7%.

The importance of maintaining an A1C of less than 7% is to prevent chronic complications of type 2 diabetes. These complications affect many organ systems and are responsible for most morbidity and mortality with the disease (Fauci et al., 2017, p. 2285). The complications associated with type 1 and type 2 diabetes include both vascular and nonvascular. The vascular complications, meaning the problem exists within the veins, include; issues with the eyes, nerves, kidneys, heart, arteries, and brain (Fauci et al., 2017, p. 2285). The nonvascular complications, which is when the problem occurs outside of the veins, include; slow gastric emptying, infections, and skin changes (Fauci et al., 2017, p. 2285).

Diabetes is a serious disease. Type 2 diabetes can be prevented or reversed by implementing lifestyle changes, like changing your diet and exercising. If you have more questions about diabetes or want to get tested for the disease, please call and make an appointment with your provider.

References

CDC. (2019, May 13). Diabetes. Retrieved October 11, 2020, from https://www.cdc.gov/diabetes/basics/type2.html

Fauci, A. S., Braunwald, E., Kasper, D. L., Hauser, S. L., Longo, D. L., Jameson, J. L., & Loscalzo, J. (2017). Harrison’s principles of internal medicine (17th ed.). McGraw Hill Medical.

Avoiding and/or Treating Diabetes

Years ago, I had a gentleman come into my office not feeling well. He couldn’t figure out what was going on, but he knew something was wrong and couldn’t explain his severe fatigue. After running some blood tests it was determined he had type 2 diabetes and his sugar levels were very elevated. Talking further with him, he mentioned he had been seeing another provider years ago and was told he had prediabetes but didn’t think he needed to do anything else about it. I was saddened to hear this and wondered if somehow the healthcare system had failed him. We discussed how it wasn’t all of a sudden that he now had type 2 diabetes but that generally type 2 diabetes slowly develops over the years. He expressed many concerns about how to treat his diabetes, whether to use medications or not and the cost of treatment. Slowly we developed a treatment plan and over the next couple of years, he was able to manage his diabetes to the point where he has been able to stop all his diabetes medications.

While this example is possible, it is generally an exception to the norm. Diabetes is complex and each person is unique in the approach, however, working with this gentleman I learned some valuable lessons that can be applied even if one does not have diabetes.

Diabetes needs to be looked at as a continuum. There are many risk factors for developing diabetes. Some of these risk factors such as diet, being overweight, and inactivity can be modified to delay or even prevent diabetes. Therefore, early detection and education can be very important. More importantly, developing healthy lifestyle choices early on can have a significant impact on one’s health.

Regular office visits with a healthcare provider are important. This gentleman expressed concerns over the cost of healthcare. We discussed how studies show that regular follow up visits can help decrease or even prevent complications from diabetes. He realized that by preventing the complications from occurring, he may in fact decrease costs, prevent future hospital stays, and see the improved overall quality of life that he desired.

This gentleman expressed the desire to limit medications, especially expensive ones. There are many wonderful diabetes medications, but some of them are very expensive. We discussed the importance of medications when treating diabetes, but set goals to work on other areas in addition to medications. We set goals for weight loss, increasing activity levels, and healthier nutrition choices. We found that creating small goals at first was easier for him to keep focus, find successes, and build upon. 

He started simply by cutting out sugary drinks, eating smaller portion sizes, and limiting certain food choices to special occasions. We set small exercise goals such as standing more during the day and walking after eating dinner instead of sitting down to watch television.

I am passionate about helping to prevent illness whenever possible. In some situations, this may not be possible, but healthy lifestyle choices are important in the prevention of disease, especially diabetes.

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