DEAR DOCTOR K: I recently had some blood tests done, and my doctor told me I have “prediabetes.” What does this mean? Do I have diabetes or not?
DEAR READER: Diabetes doesn’t usually appear all of a sudden. Many people have a long, slow, invisible lead-in to it called prediabetes. During this period, blood sugar levels are higher than normal. However, they’re not high enough to cause symptoms or to be classified as diabetes. It’s still possible at this stage to prevent the slide into full-blown diabetes. Think of prediabetes as a wake-up call.
Type 2 diabetes is a chronic disease marked by high levels of sugar in the blood. During digestion, carbohydrates are broken down into simple sugars, primarily glucose. Glucose is an important source of energy for the body’s cells. But to provide energy to the cells, glucose needs to leave the blood and get inside the cells.
Insulin, a hormone produced by the pancreas, signals the cells to extract glucose from the blood. When levels of glucose in the blood rise (for example, after a meal), the pancreas produces more insulin. That drives more glucose into the cells.
Type 2 diabetes occurs when your body’s cells do not react efficiently to insulin. As a result, not as much glucose is driven into the cells, and more stays in the blood. As glucose starts to build up in the blood, the pancreas makes extra insulin to maintain a normal blood sugar. The cycle escalates. Finally, the pancreas cannot keep up with the demand for more and more insulin. As a result, blood glucose levels remain elevated.
Diabetes increases the chances of having a heart attack, stroke or other form of cardiovascular disease. It can lead to blindness, kidney disease and loss of feeling in the legs.
Fortunately, you have the opportunity to make changes that could keep you from ever going down that road. I recommend this three-part strategy to help stave off diabetes:
— Modest weight loss.
— Increased physical activity, such as walking 30 minutes a day. Even if it doesn’t help you to lose weight, the regular physical activity will reduce your risk of getting diabetes.
— Choosing a healthy, well-balanced diet that emphasizes fruit, vegetables, whole grains and lean protein.
Not everyone with prediabetes goes on to develop diabetes, but many do. You’ve gotten the warning. Now it’s up to you to respond. If you want to avoid getting diabetes, you can do more to protect yourself than your doctor can do for you. And the solutions are all “natural” — no medicines or medical procedures are necessary.
These lifestyle changes are healthy for everyone, but especially for people like you who are at high risk for getting diabetes. No, it’s not easy to make the changes, but it’s a lot easier than living with the complications of diabetes.
Dr. Anthony L. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.