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Prediabetes

What is prediabetes?

Prediabetes means that your blood glucose, or blood sugar, levels are higher than normal but not high enough to be called diabetes. Glucose comes from the foods you eat. Too much glucose in your blood can damage your body over time.

If you have prediabetes, you are more likely to develop type 2 diabetes, heart disease, and stroke. But if you make some lifestyle changes now, you may be able to delay or prevent type 2 diabetes.

What causes prediabetes?

Prediabetes usually happens when your body has a problem with insulin. Insulin is a hormone that helps the glucose get into your cells to give them energy. A problem with insulin could be:

  • Insulin resistance, a condition in which the body can't use its insulin properly. It makes it hard for your cells to get glucose from your blood. This can cause your blood sugar levels to rise.
  • Your body can't make enough insulin to keep your blood sugar levels at a healthy level

Researchers think that being overweight and not getting regular physical activity are major factors in causing prediabetes.

Who is at risk for prediabetes?

About 1 out of every 3 adults has prediabetes. It is more common in people who:

  • Are overweight or have obesity
  • Are age 45 or older
  • Have a parent, brother, or sister with diabetes
  • Are African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, Native Hawaiian, or Pacific Islander American
  • Are not physically active
  • Have health conditions such as high blood pressure and high cholesterol
  • Have had gestational diabetes (diabetes in pregnancy)
  • Have a history of heart disease or stroke
  • Have metabolic syndrome
  • Have polycystic ovary syndrome (PCOS)
What are the symptoms of prediabetes?

Most people don't know they have prediabetes because usually there are no symptoms.

Some people with prediabetes may have darkened skin in the armpit or on the back and sides of the neck. They may also have many small skin growths in those same areas.

How is prediabetes diagnosed?

There are a few different blood tests that can diagnose prediabetes. The most common ones are:

  • Fasting plasma glucose (FPG) test, which measures your blood sugar at a single point in time. You need to fast (not eat or drink) for at least 8 hours before the test. The results of the test are given in mg/dL (milligrams per deciliter):
    • A normal level is 99 or below
    • Prediabetes is 100 to 125
    • Type 2 diabetes is 126 and above
  • A1C test, which measures your average blood sugar over the past 3 months. The results of an A1C test are given as a percentage. The higher the percentage, the higher your blood sugar levels have been.
    • A normal level is below 5.7%
    • Prediabetes is between 5.7 to 6.4%
    • Type 2 diabetes is above 6.5%
If I have prediabetes, will I get diabetes?

If you have prediabetes, you may be able to delay or prevent type 2 diabetes through lifestyle changes:

  • Losing weight, if you are overweight
  • Getting regular physical activity
  • Following a healthy, reduced-calorie eating plan

In some cases, your health care provider may also recommend taking diabetes medicines.

Can prediabetes be prevented?

If you are at risk for prediabetes, those same lifestyle changes (losing weight, regular physical activity, and a healthy eating plan) may prevent you from getting it.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

How to Prevent Heart Disease

Heart disease is the leading cause of the death in the United States. It is also a major cause of disability. There are many things that can raise your risk for heart disease. They are called risk factors. Some of them you cannot control, but there are many that you can control. Learning about them can lower your risk of heart disease.

What are the heart disease risk factors that I cannot change?
  • Age. Your risk of heart disease increases as you get older. Men age 45 and older and women age 55 and older have a greater risk.
  • Sex. Some risk factors may affect heart disease risk differently in women than in men. For example, estrogen provides women some protection against heart disease, but diabetes raises the risk of heart disease more in women than in men.
  • Race or ethnicity. Certain groups have higher risks than others. African Americans are more likely than whites to have heart disease, while Hispanic Americans are less likely to have it. Some Asian groups, such as East Asians, have lower rates, but South Asians have higher rates.
  • Family history. You have a greater risk if you have a close family member who had heart disease at an early age.
What can I do to lower my risk of heart disease?

Fortunately, there are many things you can do to reduce your chances of getting heart disease:

  • Control your blood pressure.High blood pressure is a major risk factor for heart disease. It is important to get your blood pressure checked regularly - at least once a year for most adults, and more often if you have high blood pressure. Take steps, including lifestyle changes, to prevent or control high blood pressure.
  • Keep your cholesterol and triglyceride levels under control. High levels of cholesterol can clog your arteries and raise your risk of coronary artery disease and heart attack. Lifestyle changes and medicines (if needed) can lower your cholesterol. Triglycerides are another type of fat in the blood. High levels of triglycerides may also raise the risk of coronary artery disease, especially in women.
  • Stay at a healthy weight. Being overweight or having obesity can increase your risk for heart disease. This is mostly because they are linked to other heart disease risk factors, including high blood cholesterol and triglyceride levels, high blood pressure, and diabetes. Controlling your weight can lower these risks.
  • Eat a healthy diet. Try to limit saturated fats, foods high in sodium, and added sugars. Eat plenty of fresh fruit, vegetables, and whole grains. The DASH diet is an example of an eating plan that can help you to lower your blood pressure and cholesterol, two things that can lower your risk of heart disease.
  • Get regular exercise. Exercise has many benefits, including strengthening your heart and improving your circulation. It can also help you maintain a healthy weight and lower cholesterol and blood pressure. All of these can lower your risk of heart disease.
  • Limit alcohol. Drinking too much alcohol can raise your blood pressure. It also adds extra calories, which may cause weight gain. Both of those raise your risk of heart disease. Men should have no more than two alcoholic drinks per day, and women should not have more than one.
  • Don't smoke. Cigarette smoking raises your blood pressure and puts you at higher risk for heart attack and stroke. If you do not smoke, do not start. If you do smoke, quitting will lower your risk for heart disease. You can talk with your health care provider for help in finding the best way for you to quit.
  • Manage stress.Stress is linked to heart disease in many ways. It can raise your blood pressure. Extreme stress can be a "trigger" for a heart attack. Also, some common ways of coping with stress, such as overeating, heavy drinking, and smoking, are bad for your heart. Some ways to help manage your stress include exercise, listening to music, focusing on something calm or peaceful, and meditating.
  • Manage diabetes. Having diabetes doubles your risk of diabetic heart disease. That is because over time, high blood sugar from diabetes can damage your blood vessels and the nerves that control your heart and blood vessels. So, it is important to get tested for diabetes, and if you have it, to keep it under control.
  • Make sure that you get enough sleep. If you don't get enough sleep, you raise your risk of high blood pressure, obesity, and diabetes. Those three things can raise your risk for heart disease. Most adults need 7 to 9 hours of sleep per night. Make sure that you have good sleep habits. If you have frequent sleep problems, contact your health care provider. One problem, sleep apnea, causes people to briefly stop breathing many times during sleep. This interferes with your ability to get a good rest and can raise your risk of heart disease. If you think you might have it, ask your doctor about having a sleep study. And if you do have sleep apnea, make sure that you get treatment for it.

Eye Care

Your eyes are an important part of your health. Most people rely on their eyes to see and make sense of the world around them. But some eye diseases can lead to vision loss, so it is important to identify and treat eye diseases as early as possible. You should get your eyes checked as often as your health care provider recommends it, or if you have any new vision problems. And just as it is important to keep your body healthy, you also need to keep your eyes healthy.

Eye Care Tips

There are things you can do to help keep your eyes healthy and make sure you are seeing your best:

  • Eat a healthy, balanced diet. Your diet should include plenty or fruits and vegetables, especially deep yellow and green leafy vegetables. Eating fish high in omega-3 fatty acids, such as salmon, tuna, and halibut can also help your eyes.
  • Maintain a healthy weight. Being overweight or having obesity increases your risk of developing diabetes. Having diabetes puts you at higher risk of getting diabetic retinopathy or glaucoma.
  • Get regular exercise. Exercise may help to prevent or control diabetes, high blood pressure, and high cholesterol. These diseases can lead to some eye or vision problems. So if you exercise regularly, you can lower your risk of getting these eye and vision problems.
  • Wear sunglasses.Sun exposure can damage your eyes and raise your risk of cataracts and age-related macular degeneration. Protect your eyes by using sunglasses that block out 99 to 100% of both UV-A and UV-B radiation.
  • Wear protective eye wear. To prevent eye injuries, you need eye protection when playing certain sports, working in jobs such as factory work and construction, and doing repairs or projects in your home.
  • Avoid smoking. Smoking increases the risk of developing age-related eye diseases such as macular degeneration and cataracts and can damage the optic nerve.
  • Know your family medical history. Some eye diseases are inherited, so it is important to find out whether anyone in your family has had them. This can help you determine if you are at higher risk of developing an eye disease.
  • Know your other risk factors. As you get older, you are at higher risk of developing age-related eye diseases and conditions. It is important to know you risk factors because you may be able to lower your risk by changing some behaviors.
  • If you wear contacts, take steps to prevent eye infections. Wash your hands well before you put in or take out your contact lenses. Also follow the instructions on how to properly clean them, and replace them when needed.
  • Give your eyes a rest. If you spend a lot of time using a computer, you can forget to blink your eyes and your eyes can get tired. To reduce eyestrain, try the 20-20-20 rule: Every 20 minutes, look away about 20 feet in front of you for 20 seconds.
Eye Tests and Exams

Everyone needs to have their eyesight tested to check for vision and eye problems. Children usually have vision screening in school or at their health care provider's office during a checkup. Adults may also get vision screenings during their checkups. But many adults need more than a vision screening. They need a comprehensive dilated eye exam.

Getting comprehensive dilated eye exams is especially important because some eye diseases may not have warning signs. The exams are the only way to detect these diseases in their early stages, when they are easier to treat.

The exam includes several tests:

  • A visual field test to measure your side (peripheral) vision. A loss of peripheral vision may be a sign of glaucoma.
  • A visual acuity test, where you read an eye chart about 20 feet away, to check on how well you see at various distances
  • Tonometry, which measures your eye's interior pressure. It helps to detect glaucoma.
  • Dilation, which involves getting eye drops that dilate (widen) your pupils. This allows more light to enter the eye. Your eye care provider examines your eyes using a special magnifying lens. This provides a clear view of important tissues at the back of your eye, including the retina, macula, and optic nerve.

If you have a refractive error and are going to need glasses or contacts, then you will also have a refraction test. When you have this test, you look through a device that has lenses of different strengths to help your eye care professional figure out which lenses will give you the clearest vision.

At what age you should start getting these exams and how often you need them depends on many factors. They include your age, race, and overall health. For example, if you are African American, you are at higher risk of glaucoma and you need to start getting the exams earlier. If you have diabetes, you should get an exam every year. Check with your health care provider about if and when you need these exams.

Islet Cell Transplantation

Islets are cells found in clusters throughout the pancreas. They are made up of several types of cells. One of these is beta cells, which make insulin. Insulin is a hormone that helps the body use glucose for energy. Islet cell transplantation transfers cells from an organ donor into the body of another person. It is an experimental treatment for type 1 diabetes.

In type 1 diabetes, the beta cells of the pancreas no longer make insulin. A person who has type 1 diabetes must take insulin daily to live. Transplanted islet cells, however, can take over the work of the destroyed cells. The beta cells in these islets will begin to make and release insulin. Researchers hope islet transplantation will help people with type 1 diabetes live without daily insulin injections.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Pancreatic Diseases

The pancreas is a gland behind your stomach and in front of your spine. It produces juices that help break down food and hormones that help control blood sugar levels. Problems with the pancreas can lead to many health problems. These include:

  • Pancreatitis, or inflammation of the pancreas: This happens when digestive enzymes start digesting the pancreas itself
  • Pancreatic cancer
  • Cystic fibrosis, a genetic disorder in which thick, sticky mucus can also block tubes in your pancreas

The pancreas also plays a role in diabetes. In type 1 diabetes, the beta cells of the pancreas no longer make insulin because the body's immune system has attacked them. In type 2 diabetes, the pancreas loses the ability to secrete enough insulin in response to meals.

If you are thinking about hospice, palliative care, or home health, please do not hesitate to contact us. We will be happy to answer any questions and even visit your home for a free consultation.


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