The silent warning: Understanding prediabetes

Dear Savvy Senior,

My 60-year-old brother was recently diagnosed with prediabetes, which surprised all of us because he’s fairly active and isn’t overweight. Now I’m wondering if I could be at risk too. Does prediabetes run in families, and what exactly does it mean?

Younger Sister

Dear Younger,

Yes, you could be at risk. Having a close family member with diabetes increases your chances of developing it yourself, though family history is just one factor. Age, weight, lifestyle, blood pressure, cholesterol and certain ethnic backgrounds also affect risk. Here’s a clearer look at prediabetes and what you should know.

What is prediabetes?

Prediabetes occurs when blood sugar levels are higher than normal but not yet high enough to be diagnosed as type 2 diabetes. It is far more common than most people realize.

The Centers for Disease Control and Prevention estimates about 115 million American adults have prediabetes, and the majority don’t know it. Without intervention many will develop type 2 diabetes within 10 years.

Even before diabetes develops, elevated blood sugar can quietly damage blood vessels and raise the risk of heart disease, stroke, kidney disease, nerve damage and vision problems. Once diabetes develops, daily blood sugar monitoring, medications or insulin, and lifestyle adjustments may become necessary, which can affect overall quality of life.

The good news is prediabetes does not make diabetes inevitable. In many cases it can be reversed. Modest weight loss, regular physical activity and healthier eating habits can significantly reduce — or sometimes eliminate — the risk of progression. In some situations medications also may be prescribed to help control blood sugar.

Who should get tested?

Prediabetes usually causes no noticeable symptoms, so testing is the only reliable way to know if you have it.

Adults age 45 and older should be screened, particularly if overweight. Younger adults also should consider testing if they are overweight and have other risk factors such as high blood pressure, high cholesterol, a sedentary lifestyle or a family history of diabetes. Certain ethnic groups including Latino, Black, Asian and Native American adults have higher risk and may benefit from earlier screening.

To quickly assess your risk, take the free online screening test at www.DoIHavePrediabetes.org.

How it’s diagnosed

If you are at risk, your doctor can order one of three blood tests. The fasting plasma glucose test requires an eight-hour fast. The oral glucose tolerance test measures how your body processes sugar. The hemoglobin A1C test reflects your average blood sugar over two to three months and can be done at any time, regardless of when you last ate.

Most Medicare and private insurance plans generally cover diabetes screening tests at little or no cost if you meet risk criteria such as being overweight, having high blood pressure or having a family history of diabetes. Home glucose meters are not intended to diagnose prediabetes.

Take action

If you are diagnosed with prediabetes, don’t panic. Many people restore healthy blood sugar with lifestyle changes alone. Losing 5-7% of your body weight, getting at least 150 minutes of moderate exercise per week and reducing refined carbohydrates can make a meaningful difference.

For additional support, The Centers for Disease Control and Prevention sponsors the National Diabetes Prevention Program, which offers structured lifestyle-change classes in person and online across the U.S. (www.cdc.gov/diabetes-prevention). Local hospitals, clinics and community centers also may offer similar programs.

The most important step is awareness. A simple screening test can provide peace of mind or give you the opportunity to take action now and prevent diabetes in the future.

Send your questions or comments to questions@savvysenior.org or to Savvy Senior, P.O. Box 5443, Norman, OK 73070.