Eighty-six million Americans are walking around with a precursor to a disease they don’t know they could develop, but one they can help prevent. It’s called prediabetes and it’s so important that the US Centers for Disease Control (CDC), American Diabetes Association (ADA), American Medical Association and the Ad Council are linking arms to make you aware of it. The theme of the new campaign is “No one is excused from prediabetes.” It will get your attention via TV, radio, print and social media ads and videos, provided in English and Spanish. A simple seven-question risk assessment test on the website: doihaveprediabetes.org can help you figure out if your risk is high.
What is prediabetes?
Type 2 diabetes results when your body doesn’t use the hormone insulin effectively. Insulin moves glucose, a type of sugar that results when carbohydrates are broken down during digestion, out of the bloodstream and into cells. A warning sign of diabetes is a condition called prediabetes. With prediabetes, your blood sugar levels are above normal, but not high enough for an official diabetes diagnosis. (See Sidebar, “Testing for Prediabetes.”) But that doesn’t mean you’re home free. Elevated sugar levels in the blood are known to contribute to cardiovascular disease, such as heart disease and strokes. According to the CDC, 15%–30% of people with prediabetes will develop type 2 diabetes within five years.
Who’s at risk?
The ad campaign uses a real-time test during 60-second TV commercials so viewers can find out on the spot if they’re at risk. Here are the main risk factors for prediabetes:
- Age: Over 45 years old
- Weight: Being overweight or obese
- Family history: a sibling or parent with diabetes
- Ethnicity: African American, Hispanic/Latino, American Indian, Asian American, Pacific Islander
- Low HDL (good) cholesterol and/or high triglycerides
- Sedentary lifestyle
- High blood pressure or taking high blood pressure medication
- Gestational diabetes when pregnant; delivering a baby weighing 9 pounds or more
- Polycystic ovary syndrome
People in the bleeding disorders community have their own risk factors that increase the likelihood of prediabetes leading to full-blown diabetes. Viral infections, such as HIV and hepatitis C infection (HCV) contracted decades ago from contaminated factor products, can cause chronic inflammation, which can lead to diabetes. Further, some HIV medications are linked with higher rates of diabetes. In addition, HCV is known to prevent the body’s regulation of blood sugar levels, another contributor to diabetes. (Read “The Details on Diabetes”)
Group accountability
Although some people are self-motivated, lots of us need the accountability of a group to take action when it comes to our health. The CDC’s National Diabetes Prevention Program uses lifestyle coaches in a small group setting to encourage people to proactively manage prediabetes. The groups meet weekly for about six months. Each week they tackle such topics as: “Be a Fat and Calorie Detective,” “Talk Back to Negative Thoughts,” “Jump Start Your Activity Plan” and “Ways to Stay Motivated.” The coach helps participants learn to choose healthy foods, add some activity into their daily planner and maintain a healthier lifestyle permanently. Find out if your insurance company or employer covers such programs, which also may be offered by your local YMCA.
Small steps, large improvements
If you’re feeling overwhelmed by the changes you want to make, remember that small steps can lead to large improvements. According to the CDC, losing just 5%–7% of your body weight (around 10–14 pounds for a 200-pound person) can slow or reverse prediabetes. To start, you might swap sugary sodas for water or substitute a crunchy apple for your nightly ice cream habit. If you’ve been inactive, taking up a new sport may seem daunting, but most everyone can walk. Give up 30 minutes of TV watching to take a daily walk with your spouse or grandkids. The CDC recommends at least 150 minutes of activity each week. “Activity” can mean anything from house cleaning to weeding.
Lastly, having a plan can keep you motivated. Set realistic goals, such as making one change in your diet or adding one new activity. The ADA says some of the keys to weight loss success in people with prediabetes or diabetes are: eating breakfast, reducing daily calories and fats consumed, being active most days of the week and documenting your data. No longer do you have to write down in a journal everything you eat and drink, when you exercised last and how much you weighed. There are phone apps that do all of that and more, such as MyFitnessPal.com, a web-based program that includes a smartphone app.
Defeating prediabetes
If you’ve taken the prediabetes risk test and scored a 5 or higher, don’t make a list of excuses for why you can’t deal with it right now. Schedule an appointment to see your primary care physician. Together you can map out a strategy for defeating prediabetes. Your payback for investing in yourself will be a longer, healthier life.