Prelude to Sugar: Pre-Diabetes
If you got a heads up that you were going to be in a car accident on your way to work one day, would you take a different route? Or would you proceed with caution and hope for the best? Unfortunately some things cannot be predicted so there is no way to prepare for them. But if a person has a chance to prevent a crisis, chances are they would take the necessary measures to do so. Such is the case with a pre-diabetes diagnosis. It serves as a caution sign that a person's health is in danger. Thankfully there are ways to prevent pre-diabetes from progressing to a burdensome lifelong health condition.
What Does Pre-Diabetes Mean?
Pre-diabetes is considered to be an introduction to Type 2 diabetes mellitus. It is a middle ground. A person's blood sugar level is elevated but not quite high enough to be considered diabetes. How long will it take before pre- becomes the real deal? Without interventions pre-diabetes can convert to diabetes over a span of 10 years. Sounds like a long time, but having elevated blood sugar levels for an extended period can damage the circulatory system as well as the heart.
According to the 2010 US Census, 8.3 percent of DC residents reported having diabetes. The DC Department of Health reports that some of the highest numbers of residents living with diabetes come from east of the Anacostia River. In Ward 7, 11 percent of the residents are diabetic, while Ward 8 reports 15 percent. Complications due to diabetes are the sixth leading cause of death. Chances are that many of the residents that have Type 2 diabetes also had pre-diabetes.
The Pre-Diabetic Type
If you an overweight adult, 45 years or older, with a family history of type 2 diabetes, you may be at risk for pre-diabetes. So are people who are African-American and have low levels of LDL (good cholesterol) and high blood pressure. A physician can tell that a person is on the road to diabetes through a blood sugar test. If the test reads between 100 and 125 mg/dL on a fasting blood sugar test, or a reading of 5.7 to 6.4 percent on an A1c, the patients is diagnosed as pre-diabetic.
Sometimes it's hard to tell if a person is at risk for pre-diabetes. And since it doesn't exactly present symptoms, people may have it and not even know. Dr. Ama Tyus, medical director at Nyame Nti Natural Health Solutions in Southeast, says that pre-diabetes doesn’t always have a “look.” “A lot of people have pre-diabetes. It's not just the people who are overweight. You can't always tell by looking at people. I have patients that are in dance companies that are pre-diabetic. It's people who you would think are healthy. It's a really big epidemic that I'm seeing at the clinic.” She says that it is critical that people get screened by their primary care physician for diabetes. Diabetes screenings are covered by insurance as a part of the essential screenings classified under the Affordable Care Act.
Food Insecurity and Exercise Options
Living in a food insecure area also puts people at risk for diabetes. According to DC Hunger Solutions, 3.2 percent of all households in the District of Columbia were food insecure in 2011-13. That is an increase of 1.2 percent from 2010-13 when 12 percent of all households were considered to be food insecure. The rule of thumb for pre-diabetics and diabetics alike is to reduce the dietary sugar and fats and increase the fruits, vegetables, and water intake. But living in a neighborhood where transportation to the nearest farmers’ market or grocery store can be challenging creates a formidable roadblock. Corner stores and carryouts provide tempting and unhealthy solutions for residents living in food deserts.
Access to physical activities is also a factor. Are fitness solutions affordable and convenient? Are exercise classes available at times that fit into a family's schedule? What about childcare? Can anything be done at home to significantly reduce weight? These points are often included in a person's planning when trying to decide how to address this health concern.
Can You Say Reversible?
Fortunately pre-diabetes is a stop on a health journey and not a destination. A diagnosis serves as a wake up call to spring into action. It requires planning. Angela Wright, community health educator at Trusted Health in Northeast, says she works with pre-diabetic clients to change their lifestyle before onset becomes full blown. “The main thing they have to understand is good nutrition. That is about 80 percent of the prevention plan for diabetes. A good diet plan, be active, and if they're overweight, lose a few pounds and continue to take medication as prescribed. We do nutrition consults with our members to emphasize portion control and make sure that they eat regularly. We also make sure that they don't skip meals. Skipping meals will also contribute to diabetes.” Wright uses the My Fitness Pal app with her clients to help monitor eating and activity. Trusted Health also offers cooking classes for members.
Physical activity and stress reduction are critical to fighting diabetes. Losing just 10 percent of body weight can make a difference. Wright recommends that her clients get in at least 150 minutes a week of any exercise that includes cardio. In Wards 7 and 8 fitness options include classes at the Community Wellness Collective in the Anacostia Arts Center, Da GoGo classes offered in many locations (free of charge for Trusted Health Plan members), dance classes at the Northeast Performing Arts Center on Benning Road, and water exercises at the Therapeutic Aquatic Center on G Street in Southeast.
As for stress, Wright recommends handling issues upfront. “Stress plays a big part in diabetes control. We work with members on more than just health issues. If they are worried about having a place to live or employment their health is going to take a back seat. So I emphasize working on their problems as they arise to minimize stress in their lives.”
Pre-diabetes doesn't have to define your health or repress you into a life of fingerpricks and insulin shots. It's an opportunity to press the reset button on health. Heed the warning while there is time and change the route you take for a better health outcome.
Candace Y.A. Montague is the health reporter for Capital Community News.