Prediabetes

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy

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The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.

Have you ever listened to John Mellencamp? In his song “Cherry Bomb” there is a line that goes, “…Seventeen has turned 35. I’m surprised we’re still living!...” I remember being younger than 17 when that song came out. I am now older than 35. I have been feeling old lately and wondering about what will happen to my health. So I was concerned when I read about a condition that seemed to have my name written all over it. It was called Prediabetes.

Prediabetes means your blood sugar is higher than normal, but you aren’t diabetic yet. So what are the numbers for prediabetes? The Canadian Diabetes Association 2008 Clinical Practice Guidelines are a little wishy-washy. In fact they call prediabetes a “practical and convenient term for impaired fasting glucose (IFG) and impaired glucose tolerance (IGT).” They say if your fasting blood sugar is between 6.1 and 7.0 you have prediabetes. But right in the guidelines they admit there isn’t really any world wide consensus on the numbers. You might be at risk for diabetes all the way from a fasting blood sugar of 5.6 to 7.0. If your fasting blood sugar is greater than 7.0, you have actual diabetes.

What else puts you at risk for getting diabetes? You are at risk for type 2 diabetes if you are over 40 years old, you have a parent or sibling with type 2 diabetes, you had diabetes when you were pregnant or you are overweight, especially around your middle.

So as a male approaching 40, who has too many chocolate easter eggs around my middle, am I headed towards prediabetes? Maybe. Should I be afraid? That is a little harder to nail down. We know that risks of things like heart attacks, strokes, eye problems and kidney problems increase as your blood sugar goes up from 5.6 to 7. That is the zone of prediabetes plus that grey area from 5.6 to 6.0. But it isn’t clear whether the risk is from my sugar going up or from other things that may be going on at the same time like high blood pressure, high cholesterol and high triglycerides.

I have to say I don’t really like the term “prediabetes”. We used to tell people they were “border-line diabetics” and I still have customers tell me they have a “touch of diabetes”. These terms led to a lot of confusion. People who believe they are “border-line diabetics” don’t seem to like taking their medications because they don’t really have “full blown” diabetes. “Border-line” diabetics seem to be less likely to follow their diabetic meal plans. I have been known to tell people that being “border-line diabetic” is like being a little bit pregnant. You either are diabetic or you are not. I guess the point of prediabetes is that if you have it, you are at greater risk of developing diabetes. I guess it’s like saying if you don’t use birth control you are at greater risk of developing pregnancy.

So what can I do if I have prediabetes? Don’t panic. You don’t have diabetes. Not everyone with prediabetes will get diabetes. If you have been told you have prediabetes, maybe it is time to look at your lifestyle. Two studies, the Finnish Diabetes Prevention Study and the Diabetes Prevention Program showed that a low calorie diet with reduced fat intake and 150 minutes of exercise per week reduced the number of people who went from prediabetes to diabetes by 58% over four years. The part I found interesting was the people in the study didn’t necessarily lose a lot of weight. So you shouldn’t give up on your healthy eating and exercise program just because you don’t lose fifty pounds. Eating well and exercise are good for you even if the weight loss is modest.

As always if you have any questions or concerns about these or other products, ask your pharmacist.