Glucose levels and pre-diabetes

Do you know your fasting blood glucose level? If so, do you understand what is at stake when it rises? If your fasting blood glucose rises above 100 mg/dl, you have what medical professionals call pre-diabetes. Your risk of developing diabetes increases, and your chance of developing heart disease and stroke goes up, too.

The good news is that you can help control and possibly reverse pre-diabetes by making some basic lifestyle changes. HealthySteps encourages you to take control of your health by actively monitoring your blood glucose level and taking appropriate action if it rises above normal.

What is pre-diabetes?

When blood glucose levels are high, but not high enough to be called diabetes, it is called pre-diabetes. According to the American Diabetes Association (ADA) many individuals with pre-diabetes develop type 2 diabetes within 10 years. But it is important to know that the progression from pre-diabetes to diabetes is not inevitable. Pre-diabetes can be seen as a chance to improve your health.

What is diabetes?

Diabetes is a group of diseases marked by high levels of blood glucose resulting from defects in insulin production, insulin action, or both. Diabetes can lead to serious health consequences and premature death.

How many Americans have pre-diabetes and diabetes?

It is estimated that 79 million adults aged 20 and older have pre-diabetes and 25.8 million Americans have diabetes — 8.3% of the U.S. population.

The number of people diagnosed with diabetes each year has risen from 1.5 million in 1958 to 18.8 million in 2010, an increase of epidemic proportions.

How many deaths are linked to diabetes?

Diabetes is the seventh leading cause of death listed on U.S. death certificates. The overall risk for death among people with diabetes is about double that of people without diabetes.

What is the prevalence of diabetes by type?

  • Type 1 (previously called insulin-dependent or juvenile-onset) diabetes accounts for approximately 5 percent of all diagnosed cases of diabetes in adults.
  • Type 2 (previously called non-insulin-dependent or adult-onset) diabetes accounts for 90-95% of all diagnosed cases of diabetes in adults. Type 2 diabetes is increasingly being diagnosed in children and adolescents.

Women who have had gestational diabetes (occurs in 2-10% of pregnancies) have a 35-60% percent chance of developing type 1 or type 2 diabetes — mostly type 2 — over the 10-20 years following their pregnancy.

Where can I check my fasting blood glucose level?

Your fasting glucose level can be checked at your doctor’s office. A free biometric screening is also offered each year to benefit-eligible employees as part of the HealthySteps program.

If the progression from pre-diabetes to diabetes is not inevitable, how can I alter the progression?

Studies have shown that people can prevent or delay pre-diabetes from progressing to diabetes by losing weight and increasing physical activity. People with diabetes can also take steps to control the disease and lower the risk of complications.

Studies (1) show that with intensive diet and exercise, individuals can reduce their risk of developing diabetes by 58 percent. This finding was true across all participating ethnic groups and for both men and women. Lifestyle changes worked particularly well for participants aged 60 and older, reducing their risk by 71 percent. About 5 percent of the lifestyle intervention group developed diabetes each year during the study period, compared with 11 percent of those in the placebo group.

Taking the generic oral diabetes drug metformin ((Glucophage) also reduced the risk of developing diabetes, although less dramatically (by approximately 31 percent) than the lifestyle/diet/exercise regimen. Metformin was effective for both men and women, but it was least effective in people aged 45 and older. Metformin was most effective in people 25 to 44 years old and in those with a body mass index of 35 or higher, meaning they were at least 60 pounds overweight. About 7.8 percent of the metformin group developed diabetes each year during the study, compared with 11 percent of the group
(1) The Diabetes Prevention Program (DPP) was a major multicenter clinical research study aimed at discovering whether modest weight loss through dietary changes and increased physical activity or treatment with the oral diabetes drug metformin (Glucophage) could prevent or delay the onset of type 2 diabetes in study participants. The researchers published their findings in the February 7, 2002, issue of the New England Journal of Medicine.

Other statistics quoted in this article are from the National Diabetes Education Program (NIH and CDC) and the American Diabetes Association.

Are you at risk? Take this quick risk assessment.

Want to learn more? View the Health Improvement Program’s pre-diabetes resource