Bulletin #4368, Diabetes, Carbohydrates and You: Preventing Diabetes with Pre-Diabetes Screening

Developed by the UMaine Cooperative Extension Diabetes Education Committee, including Nellie Hedstrom, nutrition specialist, UMaine Cooperative Extension; Patricia Pierson, Extension educator, UMaine Cooperative Extension; Susan Henner, Extension nutrition aide, UMaine Cooperative Extension; Cheryl Paul, Extension nutrition aide, UMaine Cooperative Extension; Lucinda Hale, Diabetes Prevention & Control Program, Maine Department of Human Services.

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Pre-diabetes is a condition affecting nearly 57 million Americans. Pre-diabetes sharply raises the risk of developing type 2 diabetes, and increases the risk of heart disease by 50 percent.

Pre-diabetes is a condition where the amount of sugar in the bloodstream is higher than normal, but not high enough to be considered diabetic. It may be called pre-diabetes, impaired glucose tolerance or impaired fasting glucose. It is now possible to be screened for pre-diabetes.

Historically, impaired glucose tolerance was not recognized until diabetes developed. Today, it is known that lifestyle changes can prevent or forestall the onset of diabetes for years.

What Is Diabetes?

Diabetes is a condition in which the body either does not make the hormone insulin or does not use it properly. There are two types of diabetes, type 1 and type 2. Type 1 diabetes usually occurs in children or young adults. With this disease, the pancreas, the organ that makes insulin, stops working and the person must take injections of insulin to stay alive. In type 2 diabetes, the body either does not make enough insulin or cannot use it properly. Insulin helps the body to turn the food we eat into energy. If insulin is not present or not working properly, high blood sugar or diabetes results.

The American Diabetes Association estimates that type 1 diabetes accounts for five to ten percent of all cases in this country, and the remaining 90–95 percent are type 2. A person may have type 2 diabetes for several years and not know it because symptoms may not be present. This can delay necessary medical attention.

The biggest concern with diabetes is the complications that can develop. If diabetes is not carefully controlled, it can cause damage to the blood vessels. Over time, this can result in heart disease, stroke, blindness, kidney disease/failure, loss of circulation in the feet and legs, and even death.

What Can I Do?

The good news is that we can help head off type 2 diabetes, perhaps for life. Research shows that the development of type 2 diabetes can be prevented or delayed through lifestyle improvements. These include cutting fat and calories in your diet, losing as little as 10–15 pounds, and exercising regularly — for instance, walking 30 minutes per day, five days per week. Many people who have made these changes in their diet and exercise patterns have “turned back the clock,” and returned high blood sugar levels to blood sugar levels in the normal range.

Ask Your Doctor for Pre-Diabetes Screening

You can request a screening for pre-diabetes. Your physician will conduct a fasting blood glucose test or glucose tolerance test. If you are overweight (with a Body Mass Index of at least 25) and 45 years of age or older, it is especially important to ask to be screened. Screening is also recommended if you have one or more of the following risk factors:

Family history of diabetes
HDL cholesterol level < 35 mg/dl and/or triglycerides > 250 mg/dl
High blood pressure (≥ 140/90 mmHg or on therapy for hypertension)
History of gestational diabetes or giving birth to a baby over 9 pounds
Physical inactivity
Belonging to a minority group such as African-American, American Indian, Hispanic American/Latino, or Asian American/Pacific Islander. These groups have been shown to be at increased risk for type 2 diabetes.

Now that we know we can prevent or delay the onset of diabetes, it is critical to find the people with pre-diabetes who can benefit from a more active lifestyle and better food choices. Type 2 diabetes is much more manageable than it ever has been in the past. However, if you develop the disease you must monitor everything you eat to ensure that your blood sugar stays at a safe level. If you can prevent or forestall diabetes with basic lifestyle changes, life will be simpler.

Information in this publication is provided purely for educational purposes. No responsibility is assumed for any problems associated with the use of products or services mentioned. No endorsement of products or companies is intended, nor is criticism of unnamed products or companies implied.

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