Losing weight is difficult for many people, regardless of any additional health conditions. With the diagnosis of Type 2 diabetes, it can make losing weight feel even more daunting. Fortunately, when it comes to managing both prediabetes and type 2 diabetes, the necessary lifestyle changes are also helpful for weight management.
Approximately 34 million adults in the United States have diabetes with the vast majority of those cases being type 2 diabetes. Type 2 diabetes is a form of diabetes where the body may still produce the hormone insulin but is unable to effectively use it to remove glucose from the bloodstream and into cells. Getting a diagnosis of type 2 diabetes can be frightening, especially since it increases the risk of other conditions such as cardiovascular disease, hypertension, and nerve damage. However, type 2 diabetes doesn’t just happen, it is usually preceded by a condition called prediabetes.
In fact, over 88 million adults are thought to be prediabetic. However, over 75% of these individuals don’t even realize that they are at increased risk of developing type 2 diabetes. Keep reading to learn about what prediabetes is, how to identify if you are at increased risk, and what you can do about it.
What is prediabetes?
Prediabetes is somewhat a precursor to type 2 diabetes. Having prediabetes shows that you are at a higher risk for later developing type 2 diabetes. Prediabetes occurs when blood sugars are higher than normal but are below what is determined for type 2 diabetes markers. Many people who have prediabetes are not aware that they have it, so awareness of risk factors and warning signs can be very important.
Prediabetes occurs when your cells begin to show insulin resistance and they do not respond well to the hormone insulin. Insulin helps the cells of our bodies take in sugar, or glucose, from our blood. The pancreas, which provides the body with insulin, tries to produce more insulin to get the cells to use blood glucose for energy. As the pancreas works to overcompensate for cells not responding well to insulin, it eventually cannot keep up and blood sugars remain increased.
There are no clear symptoms of prediabetes which causes it to frequently go unnoticed until a type 2 diabetes diagnosis occurs. Some people may experience symptoms similar to diabetes, some may not. A potential symptom of prediabetes is darkened skin patches on places such as the knuckles, elbows, armpits, knees, or neck.
According to the CDC, there are certain risk factors for developing prediabetes such as those:
- Overweight
- 45 years and older
- Family history of type 2 diabetes
- With low physical activity
- With or previously with gestational diabetes
- With polycystic ovary syndrome
- Certain races and ethnicities are also at an increased risk (African Americans, Hispanic/Latino Americans, American Indians, Pacific Islanders, and some Asian Americans)
There are three main tests that are typically used for diagnosing prediabetes. The American Diabetes Association defines prediabetes as having one of the following: an A1C test of 5.7%-6.4%, a fasting plasma glucose test of 100-125 mg/dL, or an oral glucose tolerance test of 140-199 mg/dL. These three tests look at slightly different markers, essentially checking blood sugar levels and how the body has been responding to insulin.
Why is it important to learn about prediabetes?
Chances are, we all know someone who has a type 2 diabetes diagnosis, whether it be a friend or family member. But how many of us know someone with a prediabetes diagnosis? Probably not as many. A shocking 1 in 3 adults in the U.S. has prediabetes. However, over 84% of people living with prediabetes are unaware they even have this condition!
Knowing you have a prediabetes diagnosis gives you the power to make the lifestyle changes necessary to prevent, reverse or delay serious health problems associated with prediabetes. Having high blood sugar long-term increases the risk of developing the following:
-Type 2 diabetes
-Cardiovascular (heart) disease
-Stroke
You can drastically reduce your risk of developing these health complications and slightly reverse your prediabetes by having well-controlled blood sugar. Individuals who learn they have prediabetes usually have better blood sugar levels and reduced fat stores within the first year of diagnosis. This is usually done by simply improving the diet and increasing physical activity and weight loss.
Could you have prediabetes? Take the Prediabetes Risk Test, a tool developed by the American Diabetes Association (ADA) and the Centers for Disease Control (CDC) to bring awareness to prediabetes. A score of 5 or higher indicates you are at significant risk for having prediabetes and should schedule an appointment with your healthcare provider.
How does prediabetes progress towards type 2 diabetes?
There is a strong genetic predisposition to having a dysfunctioning pancreas, which results in diabetes. Remember, the pancreas makes the insulin which allows the glucose to get into our cells. When the cells in our muscles, fat, and liver don’t respond well to insulin, they can’t easily remove the glucose from the blood, leaving it elevated.
When blood glucose levels stay chronically elevated, the pancreas has to work extremely hard to make more insulin in an effort to decrease the blood glucose levels. For a while, the pancreas is able to keep up and produce a large amount of insulin to help lower blood glucose. You could think of this as the prediabetes state, where our blood glucose still looks generally “normal” due to the overactive pancreas.
However, eventually, the pancreas simply can’t keep producing such large amounts of insulin to lower the blood glucose. At this point, the blood glucose remains high chronically, and the condition becomes classified as type 2 diabetes.
What are the warning signs of Prediabetes?
As mentioned earlier, the majority of people living with prediabetes are unaware they have this condition. This is largely due to the fact that prediabetes does not display clear signs or symptoms. Many discover they had prediabetes once they have been diagnosed with type 2 diabetes. Certain symptoms of type 2 diabetes may be a warning that prediabetes has developed into type 2 diabetes.
Some of these symptoms include:
-Excessive hunger and/or thirst
-Frequent urination
-Blurred vision
-Fatigue
If you are experiencing these symptoms, it may be important to speak with your doctor about getting tested for diabetes.
Taking control of prediabetes: What you can do to lower your risk and prevent Type 2 diabetes
Learning of a prediabetes diagnosis can be intimidating, scary, and confusing all at the same time. The good news is that being aware of a prediabetes diagnosis means you have the chance to prevent or delay progression to developing type 2 diabetes. Increasing physical activity and eating healthy are by far the most important actions to preventing the progression of prediabetes. In fact, diet and exercise are more effective at reversing prediabetes and reducing the development of type 2 diabetes than pharmaceutical medications. Now, for most people, learning that diet and exercise is helpful is not a new phenomenon. However, it is extremely effective for preventing diabetes for multiple reasons.
1. Exercise: While exercise may not be the primary factor when it comes to weight loss, it can be highly beneficial when it comes to managing blood sugars. When the muscles contract during physical activity, the cells are able to take in blood sugar to use as an energy source. Even a brisk walk requires our muscles to pull in excess sugar from the blood. Walks are especially helpful after mealtimes when our blood sugar is higher. Being physically active at least five days a week for at least 30 minutes a day is recommended.
2. Balancing Carbohydrates: There is no need to completely cut out carbohydrates from your diet if you have diabetes or prediabetes. However, balancing your carbohydrate sources with fat, protein, or fiber helps slow down the release of glucose into the bloodstream rather than cause a more drastic spike. Additionally, limiting carbohydrate consumption to 45-60 grams per meal reduces the amount of glucose the body has to pull out of the blood. With prediabetes, the body is very slow and inefficient at lowering blood glucose due to insulin resistance. So giving your body less carbohydrate to digest will prevent blood glucose from staying high.
If counting carbs sounds overwhelming, start by looking at what foods are on your plate. Try to make half your plate full of non-starchy vegetables, because these are low in carbohydrates and high in fiber. The other ¼ of the plate can be lean protein, and the last ¼ can be starchy vegetables (such as a potato or corn) or a whole grain (such as quinoa or brown rice).
3. Weight loss: Both exercise and balancing carbohydrates can aid in weight loss. Slow and steady weight loss of roughly 1-2 pounds per week has been shown to be more sustainable than drastic weight loss from restrictive diets. The most helpful type of weight loss for preventing diabetes is losing fat mass and maintaining (or gaining) muscle. The muscles help lower blood glucose and the fat stores contribute to insulin resistance. Losing a small amount of weight, even just 5-7% of your current body weight can reduce your risk of developing type 2 diabetes.
What’s Next?
Understanding your risks and how to minimize them is important. Just as important as knowing where to start when making changes to your diet and lifestyle. Meeting with a nutrition professional may help provide additional guidance.
Additionally, we now know that diabetes is a genetically predisposed condition. Gaining a better understanding of how your body may respond to certain nutrients or eating patterns to further customize your diet and optimize your health can be a great first step.
If you haven’t already, you can learn more about making healthier choices based on your unique genes, by exploring your Eating Insights Report.
References
1. Center for Disease Control. (May 19, 2019). Type 2 Diabetes. Retrieved from https://www.cdc.gov/diabetes/basics/type2.html#:~:text=More%20than%2034%20million%20Americans,adults%20are%20also%20developing%20it.
2. Center for Disease Control. (June 11, 2020). What is Diabetes?. Retrieved from https://www.cdc.gov/diabetes/basics/diabetes.html
3. Center for Disease Control. (June 11, 2020). Prediabetes - Your chance to prevent type 2 diabetes. Retrieved from https://www.cdc.gov/diabetes/basics/prediabetes.html
4. Center for Disease Control. National Diabetes Statistics Report 2020. Estimates of diabetes and its burden in the United States. Retrieved from https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf
5. Mayo Clinic. (November 2, 2020). Prediabetes. Retrieved from https://www.mayoclinic.org/diseases-conditions/prediabetes/symptoms-causes/syc-20355278
6. American Diabetes Association. (November 2, 2020). Diagnosis. Retrieved from https://www.diabetes.org/a1c/diagnosis
7. Zand, A., Ibrahim, K., & Patham, B. (2018). Prediabetes: Why Should We Care?. Methodist DeBakey cardiovascular journal, 14(4), 289–297. https://doi.org/10.14797/mdcj-14-4-289
8. Zand, A., Ibrahim, K., & Patham, B. (2018). Prediabetes: Why Should We Care?. Methodist DeBakey cardiovascular journal, 14(4), 289–297. https://doi.org/10.14797/mdcj-14-4-289
9. American Diabetes Association. (November 2, 2020). What is the diabetes plate method? Retrieved from https://www.diabetesfoodhub.org/articles/what-is-the-diabetes-plate-method.html#:~:text=The%20Diabetes%20Plate%20Method%20is,you%20need%20is%20a%20plate!
