Prediabetes, Type 2 diabetes widely seen here

Health experts say lifestyle changes can reverse most risks

by Kate Evans

Prediabetes — a serious health condition where blood sugar levels are higher than normal, but not high enough yet to be diagnosed as Type 2 diabetes —  puts people at a higher risk of developing Type 2 diabetes, heart disease and stroke.

Diabetes and the conditions leading up to it are common here. Most prediabetes and diabetes can be reversed with lifestyle changes, say the doctors and nutritionists who help people navigate them.

Some 96 million adults in the United States — more than 1 in 3 –have prediabetes. Eight out of 10 of them don’t know they have the condition, according to the Centers for Disease Control and Prevention. Nearly 1 in 5 adolescents aged 12–18 years and 1 in 4 young adults aged 19–34 years have prediabetes, stated the 2019 CDC Diabetes Report Card.

The pancreas makes the hormone insulin which allows the body to let blood sugar into the cells to use it as energy.

For those who have diabetes or prediabetes, the body doesn’t make enough insulin or can’t use the insulin as well as it should. Too much blood sugar stays in the bloodstream, which can cause heart disease, vision loss and kidney disease.

Glucose levels

Area physician Dr. Matthew Hahn said that prediabetes is where a person’s fasting glucose (blood sugar) falls between normal and diabetic.  A normal fasting blood sugar runs up to 100 and anything over 125 is diabetes.  From 100 to 125 is considered prediabetes or impaired fasting glucose.

Hahn said that if prediabetes progresses that it can become Type 2 diabetes.  He’s seen a lot of prediabetes in his medical practice.

Hahn recommends screening blood sugar levels on many patients.  Often prediabetes is found then or in other common labwork.  Hemoglobin A1c is another fasting glucose test that measures the blood sugar average over the last two to three months.

Many times patients have no symptoms of prediabetes, he said.

“Often the labwork is how we find it out,” Hahn noted.

Some risk factors for prediabetes are cardiovascular such as weight, diet and lack of exercise, Hahn said.

Other risk factors include genetic predisposition and family history.  The risk factors for prediabetes are all the same as for Type 2 diabetes-lifestyle, amounts and types of food and being overweight and obese.

Hahn said his practice in Hancock sees prediabetes in all ages — young and old.

“It’s one of the most common things we see in primary care,” he said.

Complications, treatment

   The complications of prediabetes are also the same as those of diabetes, Hahn said.  They include eyesight issues, heart disease, kidney disease, nerve function and being more prone to serious infections.

Hahn said that the cost of prediabetes and diabetes has a profound effect on what gets spent on health care in the United States.

“Lifestyle changes could reverse prediabetes in almost everyone as long as people make those changes,” Hahn stressed.

Medication can be used, but lifestyle changes are most recommended.

Dr. Hahn advised that the treatment of prediabetes involved eating healthy-mostly plant foods, eating less food overall and getting some physical activity every day.  He said there’s developing research that low sugar and low carbohydrate eating can help people with prediabetes and diabetes.

Pediatric prediabetes

Local pediatrician Dr. Pam Quarantillo said that they do see children with prediabetic conditions and Type 2 diabetes in relation to obesity, which is the number one risk factor.

“That’s when we start looking for it,” Quarantillo said of prediabetes.

Weight is a big concern, she said.  Prevention of prediabetes and Type 2 diabetes involves healthy eating and exercise.  Kids aren’t getting as much exercise as before with computers, video games and cell phones, Quarantillo said.

If parents have a concern about whether their child is at risk of prediabetes or Type 2 diabetes, they should see their primary care provider and have their child get a good physical exam with bloodwork done later, Quarantillo said.

Most researchers would agree that kids and adults are consuming way too many carbohydrates and sugars.  Generally decreasing carbs will help with treatment of both prediabetes and diabetes, Dr. Quarantillo said.

Nutrition is key

Stacy Schultz is a diabetes educator and has worked at War Memorial Hospital for 35 years.  She said that prediabetes is very similar to the check engine light coming on in your vehicle.  It’s a sign that you need to do something to get prediabetes under control or you’re going to become diabetic.

Studies show that COVID-19 is really hard on the pancreas Beta cells.  Shultz said a lot of people that weren’t on insulin before had to go on insulin after having COVID.  People with prediabetes ended up diabetic and if they had diabetes, it worsened it.

Type 2 diabetes is directly related to food and lack of exercise.

Schultz noted that you can eat whatever you want, but you have to limit it.  There are a certain amount of carbohydrates that you should have a day.  Some take in two to three times more.

She teaches the 80/20 rule –80% of the time is having the right foods and exercising. The 20% is when you can splurge, she said.

“Food is available everywhere you go.  Holidays are all food-related. We’re overeating all the time,” Schultz said.

She recommended having a plan for days you overeat like going for a walk after eating.

Cutting out soda may help with losing weight.  Soda is meant to be a dessert, not a regular fluid that you drink all the time, Schultz said.  Walking after each meal can help control diabetes.

Schultz likes to teach people that food is supposed to energize you when you eat.

“A sure sign you’re overeating is when you want to nap after you eat.  Eat enough to get you to lunch or dinner, not enough to get you through the whole week,” she stressed.

Food recommendations

A certain amount of carbohydrates, good snacks like peanuts or popcorn and limited amounts of pizza, potatoes and rice are fine — just don’t eat them all the time, Schultz said.  Having pizza five days a week or loading up on carbs all the time isn’t good.

Diabetes is preventable for the most part, Schultz noted.  She recommends people have a little protein, a little carbohydrates and a little fat at every meal.  Eat at regular times.

Other tips include using herbs and spices instead of condiments like ketchup, she said.  Eat fresh fruits and vegetables and fresh meats.  Try a salad or steak and veggies for breakfast instead of high-carb entries like pancakes, waffles and yogurt.

Schultz urged parents to not load up their kids with sugary drinks.  They should be drinking water.  Get your kids outside to exercise, said Schultz.

Get active every day

The recommendation for physical activity is 150 minutes of exercise a week and 30 minutes of exercise a day.  People can start out walking 300 steps if they’re not active and work their way up to 700 steps and more.

“You need 30 minutes of exercise five to seven days a week,” she emphasized.

Schultz recommended using a Fitbit, health app or a cell phone to keep track of physical activity and blood sugar. Her Fitbit tells her when she hasn’t gotten 250 steps an hour. She’ll walk up and down the hall for 500 steps.   A Fitbit tracks your sleep, heart rate and how many steps a day you take.

Mostly reversible

When diagnosed with prediabetes and diabetes, people have to get control of it, Schultz said.  A lot of prediabetes and Type 2 diabetes is reversible.  There are clear signs that prediabetes has moved to Type 2 diabetes — increased thirst, frequent urination, excess hunger, fatigue and blurred vision.

Uncontrolled diabetes attacks a person’s body everywhere – their heart and kidneys, for eample. Cuts won’t heal properly and diabetes can put people at a very high risk of amputations, Schultz said.

Sometimes diabetes hits all at once.  It’s 30 years of you ignoring that check engine light, Schultz said.  The stress it puts on families is incredible.  There’s the loss of income from illness, health spiraling downward, dialysis and having a heart attack or leg amputation.  By then it’s too late.

When diabetes is uncontrolled, people don’t feel like moving or doing anything, Schultz said.    They feel better when it’s controlled. Diabetes can be controlled and people can change the future of their health, she noted.

Schultz advised people to see a good doctor if they feel they have diabetes or prediabetes.  There are medications that can control it.  Diet and exercise have to be part of that plan.   Set health goals every month.

“Your health is one of the most important things in life and it’s one of the best decisions you can make to improve your health in any way you can,” Schultz said.