Pre Diabetes is a precursor to Type 2 Diabetes. Often called Impaired Glucose Tolerance ( IGT) it is characterized by higher than normal glucose (sugar) levels and indicators that your insulin will become resistant.

The American Diabetes Association and US Department of Health and Human Services estimates that 41million Americans (ages 40-74) are unaware they are living as a Prediabetic.

Without proper diet and exercise- those with Pre Diabetes are at risk for developing Type 2 Diabetes within 10 years. However, with a commitment to lifestyle adjustments, Pre Diabetes can be slowed, stopped and in some cases reversed.

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Dr. Shaila Singh explains Type 2 Diabetes

Type 2 Diabetes is the disease process of high sugar or glucose in the blood. The pancreas produced insulin needed to breakdown high blood sugar is unable to do so, and can lead to end organ damage including but not limited to: heart, brain, blood vessels, kidney, nerves and liver.

This differs from Type 1 Diabetes in that, Type 1 patients do not have the ability to secrete their own insulin and have to rely on external medication.

You, on the other hand, have the ability to secrete insulin- you just need to mobilize it.

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Differences between Type1 and Type 2

• Type 2 diabetes is the fifth leading cause of death by disease
• It has a strong genetic link, meaning it tends to run in the families
• It is the leading cause of new cases of blindness in adults ages 40-74 yrs
• It is the leading cause of kidney failure
• Men with diabetes are twice as likely to experience erectile dysfunction
• Adults with diabetes die from heart disease 2-4times more often than adults without diabetes

High Blood Sugar has multiple symptoms that become problematic as the disease progresses

• Excessive Thirst
• Increased urination
• Blurred vision
• Altered mental status like agitation, irritability, lethargy or confusion
• Recurrent infections and or poor wound healing
• Heart attack
• Stroke
• Kidney Failure
• Yeast infections (women)

Doctors use special laboratory tests in diagnosing Type 2 diabetes and managing the blood sugar levels in a known diabetic.

If a patient is having symptoms related to diabetes, a doctor’s visit would include:

• Thorough medical interview
• Physical exam.
• Evaluation of all risk factors, medical problems such as high cholesterol or heart disease
• Evaluation of family history of Diabetes and personal habits life style.

A number of laboratory tests are available to confirm or manage diabetes.

• Fasting Plasma glucose: The patient is asked to not eat or drink for 8-12 hrs and then blood is drawn in a lab and if the results are higher than 128mg/dl probability of diabetes is high. If plasma blood glucose is greater than 100md/dl but less than 128mg/dl then the patient has what is called impaired fasting glucose. This is a pre-diabetic stage and the likelihood of developing diabetes in the near future is high.
• Oral glucose tolerance test: Fasting plasma glucose is drawn and a second blood test is drawn 2 hours after ingesting a sweet drink.
• Hemoglobin A1-C: This test measure how high the blood sugars have been in last 120 days and are used to measure blood sugar control in known diabetics.

High blood sugar over long periods of time, leads to multiple complications of different organs in our body.

• Damage to retina leading to blindness.
• Damage to kidneys leading to kidney failure
• Damage to nerves, leading to diabetic neuropathy, a very painful condition. This also causes non- healing ulcers in the leg and in worse cases leading to gangrene and leg/foot amputations.
• Erectile dysfunction in man.
• Damage to blood vessels accelerating fatty plaque and cholesterol deposits blocking the arteries and causing heart attack and strokes.

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Dr. Shaila Singh breaks down the cause and complications

The foremost treatment of diabetes is to make lifestyle modifications in order to prevent or minimize complications related to it.

Healthy food choices

Highly important in controlling blood sugar levels. Eating a well balanced high fiber, low carbohydrate diet with high protein intake is required It is recommended that most diabetics eat between 200-300 carbohydrates (carbs) per day and balance 1800 – 2000 calorie diet. Initial consult with a dietician can be helpful.

Exercise

The second most important lifestyle change for a diabetic patient is a regime of daily exercise. One can actually prevent and control the progression of diabetes with regular exercise. Exercise does not mean an expensive gym membership. All it takes is to get yourself moving. A simple planned activity for 20-30 mins per day is all that is required. Consult your physician before starting any exercise program. Research has shown that a combination of healthy eating patterns and regular exercise can reduce the risk of developing Type 2 diabetes by 58% and also halt the disease progression in known diabetics.

Medications

With new and advanced research a variety of medications and insulin injections are now available to control high blood sugars in diabetics. Along with lifestyle modifications and medications your physician will be able to manage this very effectively.

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What is insulin?

Insulin is a hormone secreted by the pancreas that your body releases with the primary function being to help metabolize and break down sugar needed for energy.

What does Insulin resistance mean?
Insulin resistance is the insulin in your body saying "No!" What does that mean to you?

If your insulin takes a vacation from breaking down glucose (sugar) in your bloodstream –glucose has nowhere to go and continues to build up until your blood stream is saturated with un-metabolized glucose. This is called high blood sugar.

As a result of an abundant amount of glucose in the blood, the pancreas receives an internal signal to produce more insulin to break down this glucose in effort to meet the rising demands of high blood sugar.

Eventually the pancreatic cells are unable to do this and this is the reason those struggling with obesity become diabetic.

In obese diabetic patients this insulin resistance is what causes a prescription and higher dose of medications. Eventually insulin shots are required to supplement natural insulin deficiency (the resistance). Exercise is helpful in improving this sensitivity to insulin and keeping blood sugars normal.

An estimated 1 in 3 Americans is insulin resistant, with obesity as a predisposing factor leading up to this.

What are the risk factors for Insulin Resistance?

The American Association of Clinical Endocrinologists (AACE) cites the following as risk factors for insulin resistance syndrome.

• Being overweight/obese or having a Body Mass Index above 25
• Leading an physically inactive lifestyle
• Being over the age of 40
• Being of Latin, Hispanic American, African American, Native American, Asian American descent
• History of glucose intolerance or gestational diabetes
• Dark, velvety patches of skin common in skin condition Acanthosis Nigricans (caused by insulin build up)
• Non alcoholic fatty liver disease
• Polycystic Ovary Sydrome (PCOS), found in 1 in10 women.

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