As America continues to battle the obesity epidemic, there’s another condition lurking in the shadows: prediabetes. While weight is not the only risk factor in prediabetes and diabetes, it does play an integral role.

Dr. Tyler Feldman, Board Certified Family Physician and Diabetologist Fellow with the Franciscan Physician Network, discusses the causes, diagnostic process, and treatment options for those potentially facing a prediabetes future.

What Is Prediabetes?

When a person is in a prediabetic state, their blood sugar is elevated – but not to the extent of what is categorized as diabetes. Dr. Feldman describes it as being in “limbo.”

“In type-2 diabetes and prediabetes, there is resistance to insulin. Your body is trying to pump out more insulin from the pancreas, and the pancreas gets burned out a bit. Eventually, it can’t pump out enough insulin to offset the sugar in the blood,” he explains. “The supply does not meet the demand.”

Risk Factors

As mentioned, weight is the biggest risk factor in prediabetes development – particularly in those who hold more weight in their midsection. However, other factors contribute as well, including:

• Age
• Genetics
• Hypertension

Dr. Feldman reinforces the importance of regular medical checkups, as individuals may be at risk and not realize it. “Really, everyone is at risk. You talk to three people in a room, and at least one person you talked to you probably has prediabetes. Its occurrence is about 34% of the U.S. population right now.”

Screening Tools

Various screening tools can help identify prediabetes. A fasting blood sugar test measures blood sugar after a period of abstaining from food and non-water drink. If that comes back at 100 or higher, a confirmatory test is ordered – especially if a person is taking certain medications (e.g. prednisone) that may have altered the results.

Another common test is the hemoglobin A1C, which monitors average blood sugar over three months. While some may balk at undergoing either of these assessments, Dr. Feldman urges their worth. “Think of it as an investment. You pay a little money to get screened for diabetes, but you’ll probably save a lot more money if you don’t develop it.”

Consequences of Leaving Prediabetes Risk Unmitigated

Diabetes can be controlled with medication, but there are still potential consequences of the disease. Once diagnosed with diabetes, one-third of people will progress to kidney disease. There is a two- to threefold higher risk of heart attack and stroke.

Blindness and nerve damage in the extremities are both also highly possible. In fact, diabetes is one of the leading causes of lower limb amputation in the U.S. “If you can’t feel your feet, and you step on something sharp, it can lead to an infection and then sometimes amputation,” warns Dr. Feldman.

“All of these things are really scary – and your quality of life can really be lowered if you’re diagnosed with diabetes, so you want to catch it early,” he adds.

Treatment Options

Dr. Feldman says one of the most effective “prescriptions” against prediabetes and eventual diabetes is “easy to prescribe, but hard to fulfill.” Data shows that diet and exercise is a significant influence. The Diabetes Prevention Program Study followed thousands of prediabetic individuals and found that there was a 58% reduction in converting to diabetes (over three years) when they adhered to moderate intensity exercise 150 minutes a week and a healthy diet.

The medication Metformin has been proven effective as a preventative drug, but exercise and weight loss still does more than Metformin by itself.

“We can manage diseases and try to prolong quality of life and longevity, but it’s a lot more satisfying and will lead to a better quality of life for the patient if we can actually prevent the disease entirely. You can really reverse the pathologic processes of metabolic syndrome and insulin resistance by exercising and by portion sizing, dieting; you know, these are very doable things,” assures Dr. Feldman.

**To listen to an in-depth conversation on this topic with Dr. Tyler Feldman, Board Certified Family Physician and Diabetologist Fellow with the Franciscan Physician Network, follow this link: https://radiomd.com/franciscan/item/44692