Be Pro-Active with Pre-Diabetes

The term pre-diabetes is used to define blood sugar that is above normal readings, but not quite high enough to be considered diabetes. Pre-diabetes will progress to diabetes, unless changes are made - this is why screening blood work is important. I like to check A1C levels for those at higher risk, because this gives a three month average of blood sugars rather than just one sugar reading at one point in time. A normal A1C is less than 5.7, and diabetes is diagnosed at 6.5. The A1C values in between are the pre-diabetes range.

These A1C values are picked for a reason. When sugar levels are significantly elevated to an A1C of 6.5 or higher, we start to see complications of diabetes happen. Treating pre-diabetes is essential to prevent this slow snow ball effect of rising sugars. The course of diabetes tends to be quite deceiving in this way. Usually when diabetes is diagnosed, a person has no symptoms. And if they chose to not take medications or make life style changes, they generally don’t develop any symptoms in the short term, so it’s often hard to convince patients to buy in. However, after about a decade, things start to fall apart. And with diabetes, they fall apart epically - heart attacks, strokes, neuropathy, retinopathy, ulcers that won’t heal and lead to amputations….the list goes on.

So really, the time to get serious about sugars is when an A1C enters that pre-diabetes range. I don’t typically start with medication, although an argument certainly could be made to go for a GLP-1, especially if weight loss is a looked for benefit. Rather, just as with my approach to high blood pressure and cholesterol, the real effort starts with life style changes.

The first change to make is reducing added sugars in your diet. Sugar hides EVERYWHERE in food. This is one reason it’s so important to check nutrition labels, with an eye towards ‘added’ sugars specifically. Natural sugars, as found in fruits for example, are much healthier than refined sugars and therefore a preferred substitute to satisfy a sweet tooth.

Next in diet, look to substitute simple carbs for more complex carbs. The body turns carbs into sugar. This process is fast when digesting simple carbs like white bread, leading to a spike in blood sugar. Complex carbs, like whole wheat bread, take longer to break down to sugar and thus result in a slower, more controlled rise in blood sugar.

Exercise is also key to managing blood sugar. When you increase movement, your muscles need sugar to convert to energy. This helps the body to clear extra sugar out of the blood stream.

There are a few programs in the area and online that are available to help with diabetes prevention, and certainly worth exploring if your A1C is in that grey zone of pre-diabetes. Check out the CDC National Diabetes Prevention Program or Upper Chesapeake’s Diabetes Prevention Program.

Frustratingly, medical insurance doesn’t typically cover interventions for pre-diabetes. You can, however, work with your direct access primary care provider to create your own personalized approach to preventing diabetes!