Many people are aware that diabetes and obesity rates are on the rise in the United States. But do you know how many people have prediabetes? Over 84 million adults, or 33.9% of the US population, have prediabetes. This is a condition in which a person’s blood glucose levels are higher than normal, but not high enough to be diagnosed with type 2 diabetes. One condition that goes hand in hand with prediabetes is insulin resistance. Insulin is a hormone made by the pancreas that absorbs glucose in the bloodstream and regulated blood glucose levels. Insulin resistance is when the body is unable to adequately use insulin to absorb the glucose resulting in high blood glucose levels. Preventing prediabetes can help you prevent type 2 diabetes and the long-term complications associated with diabetes including heart disease, kidney disease, and nerve damage.
The direct cause of prediabetes is unknown, however, there are a few conditions associated with this disease including high blood pressure, low levels of HDL cholesterol (the “good” cholesterol), and high triglycerides (a type of fat in your blood). The risk factors that increase your risk for prediabetes are the same risk factors for developing type 2 diabetes. These include:
- Family history: risk increases if a parent or sibling has diabetes.
- Weight: weight is one of the primary risk factors as it is greatly associated with insulin resistance. For people who are overweight, aim to lose 7% of initial body weight.
- Waist size: increased waist size is also associated with insulin resistance. Men are at risk for insulin resistance with a waist size greater than 40 inches and women, 35 inches.
- Diet: include a variety of nutrient-dense foods including fruits, vegetables, and whole grains. Avoid highly processed foods and saturated fats.
- Lack of exercise: sedentary lifestyles increase risk for prediabetes. The recommended amount of moderate-intensity physical activity is 150 min/week.
- Age: prediabetes and diabetes can develop at any age, however, the risk of prediabetes increase at the age of 45.
- Race: certain races are at greater risk of developing diabetes. These include: African Americans, Hispanics, Native Americans, and Pacific Islanders.
The good news is that you can prevent prediabetes and even reverse it if you already have been diagnosed with the condition. With a lifestyle approach, you are able to use diet and exercise to maintain normal blood glucose levels. Eating well-balanced and nutrient-dense foods as well as increasing physical activity can help prevent or reverse pre-diabetes. Since weight is one of the primary risk factors, using these two approaches can also help you maintain a healthy weight. The American Diabetes Association Standards of Care 2018 recommends losing 7% of initial body weight in people who are overweight.
How do I determine if I have prediabetes?
Talk to your doctor if you are concerned about prediabetes. Testing for the condition is recommended for asymptomatic adults who are overweight or obese (BMI >25) or if over 45 years old.
There are three different tests you can undergo to determine if you have prediabetes.
- Fasting Plasma Glucose (FPG): this test requires a blood glucose test after fasting for at least 8 hours.
- Oral Glucose Tolerance Test (OGTT): this test requires consumption of 75 grams of glucose and taking a blood glucose test 2 hours after.
- A1C test: an A1C is the measure that reflects your average blood glucose levels over a period of 3 months.
Prediabetes is categorized as having an A1C% of 5.7-6.4%, and/or impaired fasting glucose of 100-125 mg/dL, and/or an impaired glucose tolerance during a 75-g oral glucose tolerance test with levels resulting in 140-199 mg/dL.
Remember that prediabetes can be prevented. Don’t delay, and start prevention today. Increase daily physical little by little, even if you just take a walk around the block. Include wholesome foods like fresh fruits and vegetables to balance out your meals. Try to limit highly processed foods with high fat and sugar content. Every little step of progress counts toward getting healthier and preventing prediabetes.
- Diabetes Statistics | NIDDK [Internet]. National Institute of Diabetes and Digestive and Kidney Diseases. [cited 2018 Sep 4]. Available from: https://www.niddk.nih.gov/health-information/health-statistics/diabetes-statistics
- Talmadge K, Philipson L, Reusch J, Hill-Briggs F, Youssef G, Bertha B, et al. AMERICAN DIABETES ASSOCIATION OFFICERS CHAIR OF THE BOARD. :150.
Thank you to dietetic intern Molly Lowery for her contributions to and creation of this post.
How slim your state is may also say something about its diabetes rates. According to the American Diabetes Association, across the US in 2012, 29.1 million Americans or roughly 9.3% of the population had diabetes. But not all diabetes is evenly distributed throughout the country.
New research, published as part of the Gallup-Healthways State of American Well-being series recently examined the new cases of diabetes across the US.
The states with the lowest incidence of diabetes in the United States (with less than 8% of the population with diabetes) are:
- Rhode Island
The states reporting the highest number of people with diabetes (with more than 16% of the population with diabetes) are:
- West Virginia
What’s not surprising is that diabetes rates correlate with obesity rates. As weight increases, the body’s ability to use the insulin it produces diminishes. Losing weight causes fat cells to shrink, which in turn improve the body’s ability to utilize insulin and lowers diabetes risk.
For more information about diabetes and minimizing risk, visit the American Diabetes Association. And for some cool interactive tools that track diabetes on different devices, check out the US Diabetes Surveillance System.