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DEAR MAYO CLINIC: I am a 50-year-old woman who has always been relatively healthy. I’m not overweight and I try to eat well, but my doctor told me I am prediabetic. Would it be a good idea to ask about going on medication, or are there other things I can do to avoid getting diabetes?
ANSWER: When you have prediabetes, it means your blood sugar level is higher than normal, but it is not high enough to reach the level of diabetes. For someone in your situation, medication is rarely needed. Lifestyle changes, such as improving your diet, exercising more or losing weight, often can lower blood sugar to a healthier level and help prevent diabetes.
Diabetes happens when you have too much sugar, or glucose, in your blood. To understand diabetes, it’s helpful to understand the hormone insulin. After you eat, your pancreas makes insulin and sends it into your blood. The insulin moves through your blood and works like a key, allowing the sugar from your food to enter your cells. As the sugar goes into your cells, the amount of sugar in your blood goes down. When you have diabetes, this process doesn’t work the way it should. Too much sugar stays in your blood.
There are several kinds of diabetes. The most common is type 2 diabetes. It develops when your body cannot make enough insulin to keep your blood sugar at a healthy level, or when your body’s cells become resistant to insulin.
Doctors can diagnose diabetes using several different tests. One of the most common is the fasting blood glucose test. A sample of your blood is taken after you have not eaten for eight hours and tested for the amount of sugar in it. The normal range is 70 to 100 milligrams per deciliter, or mg/dL. Diabetes is 126 mg/dL or higher. If your blood sugar is between 101 to 125 mg/dL, that’s prediabetes.
Being in the prediabetes range signals that you are at high risk of developing diabetes if something doesn’t change. Among the most significant risk factors for diabetes are excess weight, inactivity and age. Although diabetes can develop at any age, the risk goes up as you get older, especially after age 45. Simply by being 50, your diabetes risk is already elevated. You can’t do anything about your age, but you can make other important changes to lower your risk.
You mention that you are not overweight and you try to eat healthy. Those are two good steps in the right direction. Just because you are not overweight, though, doesn’t mean there isn’t room for improvement. Consider your activity level. Being sedentary on a regular basis can raise your diabetes risk, even if you don’t carry excess weight.
Make regular exercise a priority. It doesn’t have to be a strenuous workout. A brisk walk, a bike ride, an afternoon spent gardening — anything that gets you moving helps. Aim for 30 minutes of moderate exercise each day. If you can’t fit it in all at once, try several 10-minute sessions throughout the day. Choose an activity that’s fun for you, so you are more likely to stick with it.
As you think about ways you can improve your diet, concentrate on foods lower in fat and calories and higher in fiber. Focus on eating fruits, vegetables and whole grains. If you aren’t sure what’s right for you, consider meeting with a dietitian to review your diet and help you make changes.
It’s also important to have your blood sugar checked on a regular basis, so you know if you are making progress. Talk to you doctor about how often you need your blood sugar tested. If you have questions or concerns, please ask about those, too. In many cases, blood sugar that falls in the prediabetes range can be successfully controlled without medication. — Dr. Robert Rizza, Endocrinology, Mayo Clinic, Rochester, Minnesota