My Doctor Said I'm Prediabetic. Now What?

Today we have a post from our guest blogger, Heather Wheeler, D.O., who is a board certified family medicine physician at INTEGRIS. She practices at INTEGRIS Family Care Edmond East. Dr. Wheeler graduated from the Oklahoma State University College of Osteopathic Medicine in Tulsa and completed her residency at INTEGRIS Great Plains Family Medicine Residency Program. She can be reached at 405-657-3950.

Hi everyone. I'm Dr. Wheeler. Today I want to talk a little more about diabetes. Lately we've focused a number of blog posts on the topic, because it's an important one to the citizens of Oklahoma.

• Studies show that 12 percent of Oklahomans suffer from type 2 diabetes, which is more than 450,000 people.
• To compare, nationally that number is 10 percent of the population.
• Oklahoma has the seventh highest rate of type 2 diabetes in the U.S.
• Without treatment, type 2 diabetes is a leading cause of kidney failure, non-traumatic lower-limb amputations and blindness in adults.

Next, I want to talk about prediabetes. Perhaps you've been to the doctor and were told you are prediabetic. More than 86 million Americans are, and nine out of 10 don't even know it. Getting diagnosed with prediabetes is a serious wake-up call, but it doesn't have to mean you will definitely get diabetes. There is still time to turn things around! Type 2 diabetes is preventable.

So, what exactly does prediabetes mean? It simply means you are at an increased risk of developing diabetes. Your blood sugar levels are elevated, but it doesn’t mean you have diabetes. Deep breath!

Perhaps you suspect you have prediabetes but don't know for sure? Your physician will give you this diagnosis after you complete lab work. Many people have no symptoms and being told you are prediabetic can be a bit of a shock. But as I said, this does not have to mean diabetes is your destiny.

Maybe you're wondering, "do I need to be tested?"

Here are risk factors -- if  you have any of them, you should get tested.

• Weight: If you’re overweight, and have a body mass index higher than 25, you’re at a high risk for developing prediabetes. Especially if you carry a lot of extra weight in your abdomen, you may develop prediabetes because the extra fat cells can cause your body to become more insulin resistant.
• A sedentary lifestyle: If you don't do much physical activity you are more likely to develop diabetes.
• Family history: If someone in your close family has (or had) it, you are more likely to develop it.
• Age: The older you are, the more at risk you are for developing prediabetes. At age 45, your risk starts to rise, and after age 65, your risk increases exponentially.
• Gestational diabetes: If you developed diabetes while you were pregnant, that increases your risk for developing prediabetes later on.
• Other health problems: High blood pressure (hypertension) and high cholesterol (the “bad” LDL cholesterol) increase your risk of getting diabetes.

If you've just been diagnosed with prediabetes, you may be saying to yourself, "Now what do I do?" Are you feeling scared or alone? Please don’t! There are things you can do right now to take control of your health to prevent full-blown diabetes.

Six actions to take RIGHT NOW if you have prediabetes:

1.Lower your weight. This is the most helpful thing you can do for yourself to prevent diabetes. You might not have to lose as much as you think to make a difference. The American Diabetes Association reports that losing just five to seven percent of your body weight (which is only 10 to 14 pounds for someone who weighs 200 pounds) can reduce your risk of diabetes by more than 50 percent. Weight loss (and physical activity - see below) can improve the body's ability to use insulin and process glucose, which may help someone with prediabetes return to normal glucose levels.

2. Just keep moving! Aim for at least 30 minutes of physical activity each day. This doesn’t mean you have to spend a lot of money on a personal trainer or gym membership. Getting out of the house to walk around the block is a good start. Fun activities like dancing, gardening and swimming are great things to do to be active.

3. Start eating better. Aim for a healthy, well-balanced diet. Sorry, no Sonic drinks or fried foods! Some pointers:

• Avoid juice. Water is your best friend.
• Replace soda and sweetened drinks with zero-calorie beverages such as diet soda, tea or lemonade with a sugar substitute.
• Eat less sugar.
• Try to avoid packaged foods, especially chips and candy.
• Eat more vegetables (especially the less-starchy kinds like spinach, broccoli and green beans) and aim for at least three servings a day.
• Eat more fruit. Aim for 1-3 servings a day.
• Eat more fiber.
• Choose whole grains instead of processed grains (for example, brown rice instead of white rice).
• Go for the low-fat or skim options when choosing yogurt, milk, cheese and salad dressings.
• Make other smart swaps in the kitchen, such as cooking spray instead of butter, milk instead of cream in recipes for soups and sauces, unsweetened applesauce instead of oil or butter when cooking, and grilling or baking your food instead of frying.
• Mind your portion size.

4. Get more sleep. Studies show that not getting enough sleep makes losing weight harder. If you have a sleep deficit it's harder for your body to use insulin effectively and may make type 2 diabetes more likely.

5. Find a support group. Making all these changes is easier if you have people cheering you on and holding you accountable. Join a group where pursuing a healthier lifestyle is a common goal, like Weight Watchers, or attend some free classes and events here at INTEGRIS.

6. Quit smoking. This one is not solely related to prediabetes but I want to include it. Smoking has many, many harmful effects: it has a direct negative effect on your heart and lungs, it raises bad cholesterol, increases blood pressure and much more! Quitting will improve your overall health. There are many resources to help Oklahomans quit smoking so give it a try.

When should you get checked again? Lab testing for type 2 diabetes should be done yearly for continued observation. More frequent lab testing may be recommended by your physician depending on your symptoms. https://doihaveprediabetes.org/.

If you'd like more information about type 2 diabetes, please contact the INTEGRIS Diabetes Education Program at 405-949-6000.