Before Type 2 Diabetes is diagnosed, there are warning signs that the body is struggling with balancing blood sugars. Often diagnosed as "prediabetes," these warning signs can be subtle, but they can last for years before a diabetes diagnosis is official. The earlier we can pick up on these signs, the sooner we can take action and hopefully prevent diabetes (and all it's serious health complications!). Prediabetes is often overlooked or downplayed, but I'm here to tell you it's the best time for action. Let's get into the basics of prediabetes including the science and how to diagnose, risk factors of prediabetes, signs and symptoms of "insulin resistance" and what you can do today to maintain healthy blood sugars for tomorrow.
Insulin resistance
Prediabetes involves some degree of insulin resistance. So what does it mean to be insulin resistant? Let's start with the science of glucose regulation to better understand where things go wrong when you are "resistant." Insulin is a hormone made by the pancreas and its job is to transport glucose (sugar) from the bloodstream into the cells. It is important for our body to get glucose out of the bloodstream and into the cell for two main reasons:
our cells need glucose for energy
complications occur when we have a build up of glucose in our bloodstream
With insulin resistance, the cells aren't as "responsive" to insulin meaning the insulin doesn't work as well and the body has trouble getting glucose into the cell. This leads to higher levels of glucose in the bloodstream, cells that are not getting enough energy, AND a pancreas working overtime making more insulin to get things back into balance. Over time, this can lead to higher blood sugars, a "stressed out" pancreas, Type 2 Diabetes, and all it's complications. How do we know when our cells are starting to become insulin resistant and how can help them stay "insulin sensitive"? By understanding our risk, staying on top of our numbers, and adopting healthy habits.
Risk Factors for Prediabetes
Even if your current blood sugar levels are within normal range, it's important to know your risk factors for prediabetes. Remember early action is the key for prevention! So if you have one or more of following risk factors, consider taking action for your health:
Genetics: A family history of diabetes can significantly increase your risk.
Race and Ethnicity: Certain groups, such as African Americans, Hispanic/Latino Americans, Native Americans, and Asian Americans, have a higher risk of developing prediabetes.
Weight: Being overweight is a major risk factor. Excess fat, particularly around the abdomen, increases insulin resistance.
Age: The risk of prediabetes increases with age, particularly after the age of 45 (but can be earlier!).
Physical Inactivity: A sedentary lifestyle contributes to insulin resistance.
Poor Nutrition: Diets high in processed foods, sugary beverages, unhealthy fats, and excess carbohydrates contribute to weight gain and blood sugar spikes.
Sleep Disorders: Conditions such as sleep apnea are linked to prediabetes.
Smoking: Using nicotine regularly increases your risk of developing prediabetes.
Diagnosing Prediabetes: Know Your Numbers
Healthcare providers should start screening for prediabetes at 35 years old. Interesting fact: in the past few years, the age of screening was changed to 35 from 40 years old in an effort catch prediabetes earlier (and sadly because more and more people are being diagnosed with Type 2 Diabetes). Here are the most widely recognized criteria for diagnosing prediabetes:
Hemoglobin A1C: A blood test ordered by your primary care provider that reflects your average blood sugars over the past 3 months. Results between 5.7% and 6.4% indicates prediabetes.
Fasting Blood Glucose: A blood test ordered by your primary care provider that measures blood sugar at a moment in time. It's important to fast for at least 8 hours prior to the blood draw. A fasting blood sugar level between 100 mg/dL and 125 mg/dL is considered prediabetes.
Oral Glucose Tolerance Test: A test ordered by your primary care provider in which you drink a sugary drink and have blood tested before and two hours afterwards. A result between 140 mg/dL and 199 mg/dL after two hours indicates prediabetes.
Beyond the Numbers: Other Indicators of Glucose Dysregulation
Even if you aren't "diagnostic" for prediabetes, meaning your A1C, fasting blood glucose or oral glucose tolerance test are within normal limits, your body could still be struggling with balancing blood sugars at times or in response to certain foods. Glucose dysregulation refers to your body's inability to balance blood sugars, which can be sporadic, especially in early stages of insulin resistance. The following is a list of signs and symptoms of insulin resistance:
Random Blood Glucose Over 200 mg/dL: Blood sugar levels that spike above 200 mg/dL can be a red flag, even if your fasting levels are normal.
Elevated Postprandial Blood Glucose: Checking fingerstick blood sugar levels after meals can reveal spikes that might not be apparent with fasting or A1C tests alone and can be an early sign of insulin resistance.
Trending A1C Levels: If your A1C levels are progressively increasing, even if they haven’t yet reached the prediabetes threshold, it’s a sign to pay attention to your blood sugar management.
High Blood Pressure: Excess glucose in the bloodstream cause damage to blood vessel, changing the flow of blood and therefore leading to high blood pressure. If your pressure is increasing, it might be a sign of insulin resistance.
Fatigue: When our cells aren't as responsive to insulin, they don't get all the energy they need from glucose. This can lead to feeling tired often, especially after carb-heavy meals.
Weight Gain: As the cells becomes more resistant, the body makes more insulin to try and balance blood sugars. All that extra insulin can lead to increased fat storage and weight gain, so if your weight is starting to creep up (especially around your midsection) it might be an early sign of insulin resistance.
Taking Action
Prediabetes is a time for action, not to wait and see. Let's be proactive with our health and tackle insulin resistance head on by acknowledging risk factors, paying attention to warning signs, and mostly importantly taking action. Here are just a few of the many ways we can help increase "insulin sensitivity" and decrease insulin resistance:
Routine Medical Care: Regular check-ups with your healthcare provider can help monitor your risk and take early action if needed. Knowing your numbers can help help drive healthy behavior change!
Exercise Regularly: Physical activity helps increase insulin sensitivity. Aim for a mix of aerobic exercises (like walking or cycling) and resistance training (like weightlifting).
Maintain a Healthy Weight: Losing excess weight, particularly around the abdomen, can significantly improve insulin sensitivity.
Eat a Balanced Diet: Focus on whole, unprocessed foods. Include plenty of fiber-rich vegetables, lean proteins, healthy fats, and whole grains. Limit sugary foods and beverages.
Get Enough Sleep: Poor sleep can increase insulin resistance. Aim for 7-9 hours of quality sleep per night.
Manage Stress: Chronic stress can affect blood sugar levels and insulin sensitivity. Practice stress-reducing techniques like mindfulness, meditation, and deep breathing exercises.
Avoid Smoking: Smoking can increase insulin resistance. Quitting smoking can improve your overall health and insulin sensitivity.
Regardless if you have been "officially" diagnosed with prediabetes, or if you've simply identified risk factors and/or signs and symptoms of insulin resistance, the time is now to take action for your health. Many of the same tools that we use to manage Type 2 Diabetes can be used to prevent it. Remember, the earlier we take action to balance our blood sugars, the better chance we can reduce further health complications and increase our overall well-being.
Comments