Millions of people in the United States have a condition that can easily lead to diabetes, but they don’t even know they’re at risk. The Centers for Disease Control and Prevention estimates that about 79 million people in the United States have prediabetes, a condition in which a person’s blood sugar levels are higher than normal, but not high enough to be diagnosed with diabetes. Without lifestyle changes to improve their health, 15 to 30 percent of people with prediabetes will go on to develop type 2 diabetes within five years. People with prediabetes also have an increased risk of developing other serious health conditions, including heart disease and stroke.
Eileen Kim, MD, is a primary care internist at Kaiser Permanente Oakland Medical Center and Kaiser Permanente’s Northern California primary care diabetes clinical leader. Dr. Kim is also the guest of the upcoming free Health Talks Online webinar “Combating and Preventing Diabetes” on Wednesday, Nov. 6, at 12:30 p.m.
Why is it important to get the word out about prediabetes?
There are usually no symptoms associated with prediabetes, so a lot of people who have the condition don’t know about it. More importantly, they should know that there’s something they can do now that could delay the onset of type 2 diabetes.
Type 2 diabetes can be managed effectively, but it would be better not to get it. Even with the best management, if you live long enough, diabetes puts you at much higher risk for serious complications such as early heart disease, stroke, kidney failure, blindness, amputations and irreversible nerve damage.
How do people find out if they have prediabetes?
They take a blood test for diabetes. People who are overweight or obese, over the age of 45, not physically active, or who have a family history of diabetes are most at risk for prediabetes. People with high blood pressure, high cholesterol, or women who have had gestational diabetes are also at higher risk.
What can someone do to prevent diabetes?
Kaiser Permanente Health Talks Online
- October 2, 2013 — Women’s Health with Nancy Goler, MD
- November 6, 2013 — Combating and Preventing Diabetes with Eileen Kim, MD
- December 4, 2013 — Food and Mood with Nancy Hoffman, MD
- Archive of Past Health Talks »
There was a major clinical research study called the Diabetes Prevention Program that found the most effective intervention for patients with prediabetes is for them to lose a modest amount of weight by eating a healthier diet and increasing their physical activity. The people in the study lost only 5 to 10 percent of their body weight (for someone who weighs 200 pounds that’s as little as 10 pounds), but they realized a 58 percent reduction in the chances of developing type 2 diabetes.
The beauty of this is that people who can make these lifestyle changes also enjoy additional benefits: They feel better, and their blood pressure and cholesterol will also likely improve.
Tell us about your experience with prediabetes and your patients.
Prediabetes comes up every day in my practice. It’s very common. When patients get the diagnosis, it gets their attention, because they know what diabetes is and they don’t want to get it. For some patients, you tell them once, and they’re on it. They can make the necessary lifestyle changes to make a difference. But most patients are like most of us. They live busy, complicated lives, and habits are hard to change. Plus, there’s a lot of high-calorie, low- nutrient food that’s readily available; so I understand the barriers to change.
The key to making behavioral changes is to set small achievable goals for yourself, and to have a way for you to be held accountable. Start with these these things: Walk 30 minutes a day, make sure half your lunch and dinner plate is filled with vegetables, and find some sort of support — maybe that’s a walking buddy, a weight-loss group, or a supportive friend.
I’ve seen patients start walking, start making small changes to their diet, and over time they can lose a little bit of weight and slow their progression to type 2 diabetes. I‘ve seen lots of patients succeed.