UW Neighborhood Clinics
Being unaware of symptoms is also common for 79 million Americans with “prediabetes.” Without their knowledge, they are at a health crossroads. While they are likely to develop Type 2 diabetes over time, they can delay or prevent its onset with small lifestyle changes.
Savor a few treats, but only on an actual holiday, to avoid end-of-year weight gain.
Diabetes is characterized by high blood glucose levels. Its potential complications include kidney failure, blindness, limb amputation, heart attack, stroke and, for men, impotence. Type 1 diabetes occurs when the pancreas no longer produces insulin, a key hormone for moving glucose from the blood to the body’s cells. This autoimmune form of the disease accounts for about 5 percent of diagnosed cases and develops most often in children and young adults.
Type 2 diabetes, the most common form of the disease, is caused by insulin resistance. The pancreas produces insulin, but the body’s cells do not respond adequately. Before people develop Type 2 diabetes, they almost always have prediabetes. For this reason, the American Diabetes Association recommends that people who are overweight and age 45 or older should be checked for prediabetes during their next routine medical visit.
Your health care professional may recommend testing at an earlier age if you are overweight and have other risk factors for Type 2 diabetes, such as family history, high blood pressure, low HDL cholesterol or high triglycerides. In the United States, 25 percent of people over 65 have diabetes, and the Hispanic (non-Cuban), Asian, American Indian and African-American communities also have higher rates of the disease. For women, gestational diabetes and giving birth to a baby weighing more than 9 pounds are additional risk factors.Being checked for prediabetes involves either a fasting plasma glucose test or an oral glucose tolerance test. Both require an overnight fast. In the first, your blood glucose is measured in the morning before eating. In the second, your blood glucose is checked both after fasting and two hours after drinking a glucose-rich drink.
These tests report blood glucose levels on a scale for normal, prediabetic and diabetic. Due to the health risks associated with prediabetes, treatment is recommended for any results above normal. You will receive counseling about cardiovascular risk factors such as tobacco use, high blood pressure and high cholesterol.
You will also learn that it is not too late to prevent diabetes. Research shows that even losing 10 pounds is beneficial, and this goal can be achieved through diet and moderate exercise, such as walking 30 minutes a day, five days a week.
During the winter holiday season, diabetes prevention is particularly timely. A 2000 study by the National Institutes of Health (NIH) indicated that the average weight gain between Thanksgiving and New Year’s Day is a little over a pound. While this finding was actually less than the researchers expected, they also learned that the weight is typically not lost later in the year. Rather, it accumulates from year to year, leading the researchers to suspect that holiday overeating is a major contributor to obesity and the increase in diabetes in the United States.
Because preventing weight gain is easier than losing weight, I remind patients that only Thanksgiving, Christmas and New Year’s Day are holidays. They can maintain a healthy diet by limiting their indulgences to these three days and by being careful about food choices, fat content and portion sizes during the rest of the holiday season.In the NIH study, the researchers also found that people who were more physically active had less holiday weight gain. With this in mind, I encourage my patients to keep walking. This natural form of exercise requires no special equipment or gym membership, and it can help people of all ages “walk away” from the diabetes epidemic.
Victoria Fang, M.D., is a board-certified internal medicine doctor at the UW Neighborhood Clinic – Federal Way. For more information, call (800) 852-8546