During the prediabetes phase, your pancreas still produces enough insulin in response to ingested carbohydrates. The insulin is less effective at removing the sugar from the bloodstream, though, so your blood sugar remains high. This condition is called insulin resistance. In , it was estimated that People with prediabetes have a 5 to 15 times higher risk for type 2 diabetes than someone with normal blood sugar levels. Someone with insulin resistance in its early stages can develop type 2 diabetes if it continues long enough.
Prediabetes is a silent condition, so getting a regular wellness checkup is important for early detection. If you think you might have borderline diabetes, discuss your concerns with your doctor.
An HbA1c level between 5. This can leave you vulnerable to a variety of health risks and chronic health conditions. For example, uncontrolled diabetes can lead to:. A large, multicenter research study called the Diabetes Prevention Program looked into how lifestyle changes could help prevent diabetes.
What they found should give people at risk of diabetes a lot of hope. With modest weight loss and exercise, study participants reduced their risk of developing diabetes by 58 percent over three years. Take charge of your health by focusing on simple dietary and lifestyle changes. Focus on whole foods and complex carbohydrates such as beans, grains, and starchy vegetables.
Pass on the simple sugars , like those in processed baked goods. Those can raise blood sugar without providing wholesome nutrition. Patients at higher risk should be screened with a fasting plasma glucose level. When the diagnosis of impaired glucose tolerance or impaired fasting glucose is made, physicians should counsel patients to lose 5 to 7 percent of their body weight and engage in moderate physical activity for at least minutes per week.
Drug therapy with metformin or acarbose has been shown to delay or prevent the onset of diabetes. However, medications are not as effective as lifestyle changes, and it is not known if treatment with these drugs is cost effective in the management of impaired glucose tolerance. Type 2 diabetes mellitus is a major health problem that is associated with significant mortality and morbidity.
Diabetes can be prevented or delayed through lifestyle interventions. An expert committee sponsored by the American Diabetes Association ADA has identified an intermediate group of patients who have blood glucose values that are higher than the defined normal level but not high enough to meet the diagnostic criteria for diabetes. IGT is defined as two-hour g oral glucose tolerance test values of to mg per dL 7. IFG is defined as fasting plasma glucose values of to mg per dL 5.
The rightsholder did not grant rights to reproduce this item in electronic media. For the missing item, see the original print version of this publication. Among U. In an analysis of six prospective studies, 6 the risk of developing diabetes was found to be approximately 3. Elevated fasting glucose levels, elevated two-hour postchallenge glucose values, and BMI greater than 27 kg per m 2 were associated with the development of diabetes in these patients.
The Adult Treatment Panel III of the National Cholesterol Education Program 13 has identified metabolic syndrome as a constellation of lipid and nonlipid risk factors for coronary artery disease.
The syndrome is characterized by insulin resistance, atherogenic dyslipidemia high triglyceride level, low high-density lipoprotein cholesterol level, and small, dense low-density lipoprotein cholesterol particles , hypertension, abdominal obesity, and prothrombotic and proinflammatory states. Metabolic syndrome is diagnosed when three or more of the risk factors in Table 2 13 are present. It is important for family physicians to identify patients with metabolic syndrome and to intervene aggressively to reduce the risk of diabetes and macrovascular disease.
In a prospective study 14 conducted in Finland, cardiovascular disease and all-cause mortality were increased in men with metabolic syndrome even in the absence of cardiovascular disease and diabetes.
Women who have been diagnosed with gestational diabetes mellitus constitute another group at high risk for progression to diabetes. In a study of 1, women with recent gestational diabetes tested at one to four months postpartum, 14 percent were diagnosed with type 2 diabetes. It is recommended that women diagnosed with gestational diabetes undergo postpartum glucose testing at six weeks and every three years thereafter. The American Academy of Family Physicians policy 16 on screening for type 2 diabetes is consistent with the U.
When these patients are specifically targeted for screening, the number needed to screen to prevent a cardiovascular event is lower than screening of the general population. The ADA acknowledges the lack of data from prospective studies on the benefits of screening for diabetes and therefore recommends using clinical judgment and patient preference as a guide. Based on expert opinion, selective screening is recommended Table 3. The ADA also prefers to use the fasting plasma glucose level for screening, because it is faster, more acceptable to patients, and less expensive than other screening tests.
The fasting plasma glucose level also is more reproducible than the g oral glucose tolerance test and varies less between patients. However, the g oral glucose tolerance test is more sensitive. No data are available to assess possible harms of diabetes screening. Potential harms include labeling patients as having a chronic illness, which may cause anxiety and make it difficult for them to obtain life or health insurance, and subjecting patients to the risks of long-term treatment with uncertain benefits.
The progression from normal glucose tolerance to type 2 diabetes is characterized by dual defects that include insulin resistance and an insulin secretory defect caused by beta-cell dysfunction Figure 1. Initially, plasma glucose levels are maintained in the normal range.
In patients who will eventually develop diabetes, there is a decline in beta-cell secretory capacity. The first glucose abnormality that is detected is a rise in the postprandial glucose levels because of reduced first-phase insulin secretion. With time, further decline in beta-cell function leads to elevation of the fasting glucose levels. Eventually, diabetes occurs, with more insulin secretory loss. The natural history of type 2 diabetes. Implications for clinical practice. Prim Care ; Recent studies of patients with IGT have shown success for lifestyle interventions in delaying or preventing the development of diabetes Table 4.
Patients with IFG and IGT should be advised on the benefits of modest weight loss, good dietary habits, and regular physical activity. In the Diabetes Prevention Program, 1 3, patients with IGT and a BMI greater than 24 kg per m 2 were randomly assigned to one of the following groups: placebo, metformin Glucophage , or intensive lifestyle modification.
The lifestyle modification group was offered a lesson curriculum aimed at achieving a weight loss goal of more than 7 percent of their initial body weight through a low-calorie, low-fat diet and moderate-intensity exercise for minutes per week.
Diabetes Prevention Program 1. Metformin Glucophage , mg twice daily. Finnish Diabetes Prevention Study 2. Diet plus exercise. Food and Drug Administration.
Food and Drug Administration has withdrawn troglitazone from the market because of liver toxicity. Information from references 1 through 3 , and 21 through After an average follow-up of 2. The relative risk reduction was 31 percent in the metformin group compared with the placebo group. In this study, lifestyle intervention was effective in men and women, and in all ethnic groups.
It was most beneficial in patients older than 60 years; in this group, it reduced the incidence of diabetes by about 71 percent. This allows you to develop a truly personalized nutrition plan and modify your lifestyle to reach optimal health. Wearing a CGM will give you an assessment of your overall metabolic health and help you identify conditions such as insulin resistance and insulin sensitivity. Once you develop an understanding of how your blood glucose levels react to your diet and lifestyle, you can alter your nutrition and daily habits until everything is performing optimally.
Maintaining blood glucose levels within a healthy range is vital to keeping your body healthy, reducing your risk of long term conditions, developing cardiovascular disease like hypertension, and maintaining a healthy BMI. Glucose intolerance is rapidly increasing in our society due to processed foods and increased stress, yet most people who have prediabetes are completely unaware. Even if you follow the recommended diabetes prevention lifestyle changes to reduce the risk of prediabetes and type 2 diabetes, it's not always easy to have a comprehensive understanding of your glucose levels unless you monitor them.
You do not have to be diabetic or prediabetic to use a CGM. Using a CGM is a type of preventative medicine. Our team of professional healthcare practitioners are trained to work with people at all stages in their health journey. Join the program today to take charge of your health and future. Our Dietitians What to Expect. Podcasts Testimonials. Featured Articles. Recent Podcasts. Will Carbohydrates Give me Diabetes? The CGM Episode! Promotional Message with link to subscription page.
Healthcare Workers. Shop Programs. NutriSense Services. Nutrisense services. Recent Posts See All. Team NutriSense. Learn more about the risk of developing diabetes if it runs in your family and what lifestyle modifications you can make to help prevent it. Do you know what the phrase Time in Range refers to? Learn about the importance of this glucose metric and find out more about how to monitor it using a CGM. Wondering where your sugar cravings come from?
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