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Prediabetes/Type 2

1. How do I know if I do or do not have prediabetes?
2. What are the symptoms of type 2 diabetes?
3. I am type 2 and I am controlling it with exercise and diet. How long can that last?

Didn't find your question? Click here for more expert answers to questions from dLife members.

Q: How do I know if I do or do not have prediabetes?

A: Pre-diabetes is a condition where blood sugars are higher than normal, but not high enough to be diagnosed with diabetes. There are two diagnosis associated with pre-diabetes. One is Impaired Fasting Glucose, where the fasting blood sugar (FBS) is between 100 and 125. A normal fasting blood sugar is less than 100 and a FBS of 126 or higher is a diagnosis of diabetes. Impaired Glucose Tolerance is a blood sugar of 140-199 two hours after a Two hour glucose tolerance test with 75 grams of glucose, usually in the form of a Glucola beverage. A normal response to a glucose challenge would be a two hour blood sugar less than 140. A blood sugar of 200 or higher is a diagnosis of diabetes.

Since pre-diabetes almost always leads to diabetes without modifications in lifestyle (healthy eating, exercise and healthy body weight) the American Diabetes Association recommends that people at risk for diabetes have annual lab work to rule out the development of pre-diabetes or diabetes. Those with a diagnosis of diabetes should have lab work every six months to monitor the progression to diabetes.
If you are overweight (BMI of 25 or higher) and are 45 or older you should consider being test for pre-diabetes. If you are younger than 45 but overweight and you can answer yes to one or more of the following questions you may be at risk for pre-diabetes and diabetes and should consider having lab work completed:

The more items you answer yes to, the higher your risk.

You can reduce your risk of developing diabetes. The Diabetes Prevention Program showed that by losing 7% of your body weight by eating a healthy diet with less than 25% of the calories from fat and by exercising for 30 minutes 5 days per week, a person can reduce their risk of developing diabetes by 58%. There are diabetes prevention programs in the community. I encourage you to sign up and attend a class.

The following links have more information

http://www.dlife.com/dLife/do/ShowContent/prediabetes/

http://diabetes.niddk.nih.gov/dm/pubs/riskfortype2/index.htm#6

– Deborah Greenwood APRN,BC-ADM, MEd, CDE

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Q: What are the symptoms of type 2 diabetes?

A: Type 2 diabetes usually develops gradually over time. If you have annual lab work done that includes a fasting blood sugar, you will know if you have diabetes or not. Most people that are diagnosed with type 2 diabetes have no symptoms. However, the possible symptoms that might occur are:

Many people do not find out they have diabetes until they have complications that bring them to the doctor or hospital, such as blurry vision, numbness or tingling in the feet or heart trouble. It is important to diagnose diabetes early so that you can get treatment to prevent damage to the body. The following link has more information:

http://www.dlife.com/dLife/do/ShowContent/type2_information/diabetes-symptoms/

– Deborah Greenwood APRN,BC-ADM, MEd, CDE

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Q: I am type 2 and I am controlling it with exercise and diet. How long can that last?

A: Diabetes is known to be a progressive illness. There have been studies done that show that about 50% of the people diagnosed with diabetes will need insulin to control their blood sugars in 5 to 10 years. Your ability to control your diabetes with diet and exercise is partly based on the genetics of your body and how much insulin your body makes. Your body may be able to produce insulin longer if you lower the amount of insulin resistance by maintaining a healthy body weight, exercising for a minimum of 30 minutes most days of the week and by following a healthy meal plan.

The most important aspect of diabetes management is lowering the blood sugar as close to normal as possible (minimum A1C of less than 7.) Once diet and exercise can not achieve this goal, then medication should be initiated. Although many people do not wish to take medications, the side effects and potential harm caused by most medication is far less than the harm and potential complications from high blood sugar.

– Deborah Greenwood APRN,BC-ADM, MEd, CDE

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