By Gary Kim, MD, internal medicine physician at The Portland Clinic.
An estimated one in three people has prediabetes. Could you be one of them?
It might be hard to know — as many as 90% of people who have prediabetes don’t know it. But knowing is really important.
Not knowing puts you in danger of quietly progressing to full-blown Type 2 diabetes. It also raises your risk of a heart attack or stroke. Knowing doesn’t remove these dangers, but it puts you in charge so you can do something about them.
If you don’t know, take this one-minute risk test at doihaveprediabetes.org.
If your risk test says that you’re at high risk for prediabetes, make an appointment with your primary care provider for a simple blood test to find out for sure. Prediabetes is diagnosed when blood sugar (glucose) levels are higher than normal, but not quite high enough to be considered diabetes. This is defined as a fasting glucose level of 100-125, or a hemoglobin A1C of 5.7%-6.4%.
If your blood test confirms prediabetes, take your diagnosis as a warning, an opportunity and a clear message: it’s time to take control of your lifestyle, make positive changes and turn your health around.
Diabetes doesn’t have to be your destiny. But choosing a healthy lifestyle is essential. The National Diabetes Prevention Program has shown that by making healthy changes, you can prevent or delay Type 2 diabetes, and potentially even reverse prediabetes. Making changes in three key areas can make the difference:
Work your way up to getting 30 minutes of moderate physical activity five days a week (150 minutes total per week). This has been shown to improve insulin sensitivity and reduce abdominal fat. Aim for the intensity of a brisk walk. Strength training can count for up to 75 minutes of your weekly goal.
Success tip: make exercise a priority by scheduling it into your day, like a standing appointment. If you wait until you have time, something else always comes up.
Cut back on added sugars and refined grains, which raise blood sugar, and focus mainly on whole, nutritious foods that help keep your blood sugar in balance. The Mediterranean-style eating pattern is great for dialing back prediabetes. It emphasizes non-starchy vegetables, fruits, whole grains, legumes, nuts, fish and healthy fats. Eating like a Mediterranean allows plenty of flexibility to plan meals around your personal likes, needs and goals.
Success tip: make changes that you can live with for the long haul. Changes that you dislike are doomed to fail.
If you are overweight, set a goal to lose at least 7% of your body weight (for a 200-pound person, that’s 14 pounds). Even this small amount can make a big difference in preventing or delaying diabetes. Aim for a sustainable weight loss pace of 1–2 pounds per week, and make it happen by choosing lower-calorie foods and being more active (see above).
Success tip: MyFitnessPal is an excellent app that can help you calculate healthy calorie goals, track your calories-in (meals) and calories-out (activity), monitor your progress and stay motivated.
These changes are absolutely doable! I’ve seen many patients reverse prediabetes. For all of them, it has come down to realizing that they need to take charge of their personal health, and then making the necessary changes. Once they do, they tell me that they feel much better. In many cases, they’re even able to reduce their blood pressure and cholesterol medications.
This isn’t something that you have to do alone — your primary care provider is here to guide you, and our dietitian can evaluate your diet and suggest meaningful changes. Ultimately, though, you are the key to making it happen. Regardless of what we advise, it’s up to you to make the changes. The power is in your hands. I hope you’ll grab it.