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Cheat Sheet

Prediabetes For Dummies

From Prediabetes For Dummies by Alan L. Rubin

Prediabetes affects approximately 60 million people in the United States alone. Left untreated, the condition can lead to diabetes and serious long-term health problems. Prediabetes can be stopped and even reversed through changes in diet and exercise. Get healthy by figuring out whether you’re at risk for prediabetes; knowing what blood glucose levels identify prediabetes and diabetes; having other medical tests done to monitor your health; and improving your eating habits.

Getting Screened for Prediabetes

The American Diabetes Association recommends that physicians screen their patients for prediabetes starting at age 45. As long as a screening is normal, you should repeat it at three-year intervals. Screening is especially important for people who answer yes to these questions:

  • Do you have a relative with type 2 diabetes or heart disease?

  • Are you overweight or obese?

  • Do you have high blood pressure?

  • Do you have a sedentary lifestyle?

  • Do you have high levels of triglycerides and/or low levels of HDL cholesterol, both being types of fats measured in a blood test?

  • Do you belong to a higher-risk ethnic group such as African American, Latino, Asian American, or Pacific Islander?

  • Do you have “apple-shaped” rather than “pear-shaped” weight distribution? This means your excess weight is around your stomach rather than your hips.

  • For women who have had children, did you develop diabetes during the pregnancy or have a baby who weighed more than 9 pounds at birth?

  • For women, is there a history of polycystic ovarian syndrome, a condition that may include lack of periods, infertility, and increased hair on the body?

Blood Test Results That Identify Prediabetes

Prediabetes is a silent condition: You likely will not experience any symptoms from it. But allowing prediabetes to develop into diabetes will most definitely lead to symptoms, which is exactly what you want to avoid.

If you’re concerned that you may be at risk for prediabetes, ask your doctor to order a blood test. Two types of blood tests are used: a fasting blood glucose test (which is taken after you fast overnight) and a blood glucose test taken two hours after you consume 75 grams of glucose.

Following are the lab results your doctor will use to determine if your blood glucose is normal, if you have prediabetes, or if you have diabetes.

Normal Prediabetes Diabetes
Fasting blood glucose Less than 100 mg/dl 100–125 mg/dl 126 mg/dl or greater
Blood glucose two hours after eating 75 grams of glucose Less than 140 mg/dl 140–199 mg/dl 200 mg/dl or greater

Prediabetes Testing beyond the Blood Glucose

If you’re at risk for prediabetes, you should have several tests and measurements done in addition to having your blood glucose checked. These measurements can provide a baseline against which you and your doctor can compare future tests, and each one provides key information about your current health:

  • Hemoglobin A1c: This test of a substance found in your red blood cells measures your blood glucose levels for the past three months, which offers you a broader perspective on your blood glucose level. It’s not currently used to diagnose prediabetes or diabetes.

  • Blood pressure: The prevalence of high blood pressure is rising in step with prediabetes and diabetes. That’s because prediabetes and diabetes are rooted in the same problems as high blood pressure: increased weight and a sedentary lifestyle. If you’re diagnosed with prediabetes or diabetes, chances are you need to be concerned about your blood pressure as well.

  • Weight and height: These simple measurements are crucial to know so you can calculate your body mass index — a number that helps you determine whether you are underweight, normal weight, overweight, or obese.

  • Lipid panel: This test shows your total cholesterol, LDL cholesterol, HDL cholesterol, and triglyceride level. Abnormal levels of cholesterol contribute to heart disease, which is a particular concern for people with prediabetes and diabetes. Abnormal lipids (or blood fats) are also strongly associated with the metabolic syndrome — a condition that often goes hand-in-hand with prediabetes and diabetes.

  • C-reactive protein: This test shows evidence of inflammation, which is elevated if you have the metabolic syndrome and may be a precursor of cardiovascular disease.

  • Thyroid-stimulating hormone: This test checks for evidence of thyroid disease, which often accompanies diabetes and tends to be asymptomatic.

How to Prevent and Reverse Prediabetes through Lifestyle Changes

If you get a diagnosis of prediabetes, you need to act immediately to take better control of your health. One of the key ways to prevent full-on diabetes is to get your weight under control. Here are some tips to get you started:

  • Eat according to a schedule to avoid unplanned eating. Eat three meals a day and two or three snacks daily, preferably at the same time each day. The snacks should be low in calories, such as carrot sticks and celery.

  • Find a single place to eat all your food. Find a designated eating place where all you do is eat. Do not eat at your desk (where you do many other things) or on the couch in front of the TV (where you aren’t concentrating on your food).

  • Slow down your eating to make the meal last. Put down your fork or spoon between each bite, and don’t pick it up until you have swallowed the food. Chew each bite for a long time.

  • Use smaller plates and shallow bowls to reduce the size of your portions. You will be amazed at how quickly you feel satisfied with less food.

  • Do nothing but eat when you are eating. No TV watching, Web surfing, talking on the phone, or reading allowed!

  • Keep all excess food in the kitchen. Don’t leave plates of food on your counters. Keep leftovers in opaque containers.

  • Keep a journal. List the foods you’re eating, the amount and type of exercise you’ve done, and what mood you’re in.

  • Get seven to eight hours of sleep nightly. Sufficient sleep reduces appetite.

  • Be a disciplined shopper. At the market, buy from a list, carry only enough money for the food on that list, and avoid aisles containing loose foods other than fruits and vegetables.

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