Prediabetes is often without clear symptoms. Some people who have pre-diabetes may experience some of the symptoms of diabetes. These include frequent urination, fatigue, increased thirst and blurred vision. People who are overweight (BMI of 25 or above) or have a family history of diabetes are definitely in a higher risk category as well as those of African American and Native American descent. People with these risk factors or symptoms should definitely ask their doctor to have a blood test called hemoglobin A1c (HbA1C),glycosylated hemoglobin or glycated hemoglobin test.
The HbA1C test shows how well your diabetes is being controlled. It provides an average of your blood sugar control over a 2-3 month period. The HbA1C test measures what percentage of your hemoglobin or protein in red blood cells that carries oxygen, is coated with sugar (glycated). The higher your A1C level, the more uncontrolled your blood sugar is and the higher your risk of diabetes and complications from diabetes. If your HbA1c is between 5.7%-6.4% you are pre diabetic. If it is 6.5% or above you are considered diabetic. Ideally you want yours to be below 5.4%. Also, you should take into account fasting blood glucose which should be less than 100mg/dl. Those with pre-diabetes are 100mg/dl-125mg/dl and diabetes 126mg/dl or higher on two separate tests.
So, you were diagnosed as pre diabetic, now what? Well, there are several ways in which you can reverse this condition before it progresses. But, before making any health or lifestyle changes definitely check with your physician first. A good idea would be to see a doctor that practices functional or integrative medicine. These physicians can be found all throughout the country. Integrative or functional medicine is a healing-oriented medicine that takes into account the whole person including all aspects of lifestyle i.e. diet, exercise, family history, stress levels and environment. It emphasizes the therapeutic relationship and makes use of all appropriate therapies, both conventional and complementary.
You can find local integrative doctors near you here: ACAM.org.
Losing about 7% of your body weight or 15 pounds if you weigh 200 pounds, is an easy place to start for those overweight. However, things are not always so easy. A recent study from Korea concluded that visceral fat mass, or fat around the organs, acquired using dual-energy X-ray absorptiometry (DXA), has stronger associations with diabetes and pre-diabetes than other measurements. Therefore, fat around the organs or visceral fat, is a better predictor of pre diabetes than adipose fat or fat under the skin which is the fat we can see when looking at a person (or ourselves in the mirror).
Visceral fat is basically excess intra-abdominal tissue accumulation. It is fat that is actually covering the organs including the liver, pancreas and kidneys. A sign of excess visceral fat storage is if you have a belly that sicks out and a large waist. This is most noticeable in overweight and obese people but anyone can have visceral fat and not know it. Visceral fat cells do more than just make your pants tight, they also cause changes in the way your body functions by producing hormones and inflammatory factors leading to heart disease, inflammation, cancer, dementia, strokes, depression and diabetes.
Carrying a high amount of visceral fat is known to be associated with insulin resistance, which can lead to glucose intolerance and type 2 diabetes. Researchers have found that visceral secretes a protein called retinol-binding protein 4 (RBP4) which has been shown to increase resistance to insulin. Storing excess fat around the organs increases production of pro-inflammatory chemicals called cytokines, which leads to inflammation. It also interferes with hormones that help regulate appetite, weight, mood and brain function.
A relatively good indicator of visceral fat is to take a measurement of your waist. Harvard University notes around 10% of our total fat is likely to be stored as visceral fat, therefore if you are carrying higher amounts of body fat than is recommended, it is therefore more likely that you are also storing more visceral fat than is healthy. The most certain way to tell if you are carrying excess visceral fat is with an MRI. MRI's are expensive and do not tell you if you have diabetes so this should be discussed with your physician.
In order to reverse pre diabetes, you must focus on decreasing body fat and improving your insulin sensitivity. In part II, I will discuss ways to do this using four categories for lifestyle change; diet, exercise, vitamins and supplements and stress reduction. Keep an eye out for this life changing blog post coming soon!