Prediabetes

By Davina Hayes Dansby, M.D.

Diabetes is one of the country’s fastest growing epidemics.  According to the CDC, 29 million Americans are affected with diabetes and 86 million are living with prediabetes.  Unfortunately, 90 percent of persons with prediabetes are unaware of their diagnosis. The good news you may ask?  Both conditions can be effectively managed with lifestyle changes.

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Diabetes occurs when the body is not able to use its primary fuel source, glucose, efficiently.  The pancreas produces insulin.  Insulin pushes glucose into various cells in the body and allows those cells to use glucose to fuel various cellular processes.  In diabetes, the body does not recognize insulin.  The pancreas has to produce more insulin than normal resulting in pancreatic burnout, increased fat deposits and ultimately prediabetes turning into type 2 diabetes.  

Type 2 diabetes is one of the leading causes for death in America.  It is one of the number one causes for strokes, heart attacks, kidney failure, limb amputation and blindness.

Patients are typically diagnosed with Type 2 diabetes 8-10 years into the disease process.  With better diagnostic tools available, clinicians are now able to identify patients earlier in the disease process.  Patients at risk for diabetes can be identified when repeated fasting glucose measurements are above 100 mg/dL or when A1C measurements are above 5.7%.  Diabetes is diagnosed when repeated fasting glucose measurements are above 125 mg/dL or when A1C measures above 6.4%.

Two pivotal trials, the Diabetes Prevention Program (DPS) in 2005 and the more recent YMCA Diabetes Prevention Program, proved that diet and exercise can prevent or delay the progression of Type 2 diabetes.  DPS randomized 3,234 patients with impaired fasting glucose (defined as a fasting glucose level between 95 mg/dL – 125mg/dL) to three groups. One group was given placebo, the second group initiated lifestyle changes which included a 7% weight loss and 150 minutes of vigorous exercise per week, and the third group was given metformin 850 mg twice daily.  DPS showed that the lifestyle modifications group outperformed the metformin group!  

Ask to be screened for prediabetes and if found, start lifestyle modifications immediately.  Diet and exercise are proven strategies to delay progression of diabetes. 

Just Do It!

Dr. Dansby is a physician at DeKalb Medical Physicians Group Rockbridge Family Medicine at Snellville.  Visit rockbridgefamilymedicinesnellville.org for more information or call their office at 678.495.2843. 

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