ElderCare Q&A

What is pre-diabetes?

Almost 21 million people in the U.S. have diabetes. Diabetes is a medical condition in which your body doesn't make enough insulin or has a reduced response to insulin. Diabetes causes your blood sugar to be too high because insulin is needed to use sugar properly. Your blood always has some glucose in it because your body needs it for energy. But too much glucose in your blood is not good for your health. Most people with diabetes have type 2 --- which used to be called 'adult-onset' diabetes. Type 2 used to be found most often in people over the age of 45, but there are more young people - including children - who have the disease because they are overweight or obese.

According to the National Diabetes Education Program (NDEP), diabetes can lead to heart disease, stroke, vision loss, kidney disease, and nerve damage. The group estimates that roughly one-third of the people who have type 2 diabetes don't even know it. There is a 12 point check list to determine if you are at risk for pre-diabetes or diabetes. There are many factors which increase your risk for diabetes. Being overweight, for example, is a risk factor. The NDEP publishes an at-risk weight loss chart which shows how much weight you should be carrying for your height. People who are African American, Hispanic/Latino, American Indian, Asian American or Pacific Islander are higher at risk for diabetes.

Someone with a family history of diabetes is at risk. Someone with high blood pressure or high cholesterol is at risk. Someone whose fasting blood glucose level is 100 or over is at risk for pre-diabetes, and a level over 126 puts you are risk for diabetes. Your primary care doctor can tell you more about the test for blood sugar levels and weight concerns.

For people on Medicare, a blood glucose screening test is a covered service. If you have any of the diabetes risk factors, you may qualify for this test. Based on the results of the test, you can have up to two blood glucose tests per year, with the full cost paid for by Medicare.

The good news is that according to the NDEP, people at high risk for diabetes can prevent or delay the disease by losing 5% to 7% of their weight. For a person who weighs 200 pounds, that means losing 10 to 14 pounds. NDEP recommends at least 30 minutes of moderate intensity physical exercise five days a week, and a diet that emphasizes foods which are low in fat and calories. The three most important food recommendations are: 1) take in fewer calories each day than you burn; 2) eat foods with less saturated and trans fats; and 3) eat smaller portions.

The NDEP urges you to keep a daily log of your food and exercise routine as a way to remain motivated to drop weight and eat healthier. They provide a daily log form that helps you measure fat grams and calories, and exercise time. Some of the more interesting tips for healthier eating habits include: 1) make less food seem like more by serving your meals on smaller plates; 2) don't rush through your meal: it take about 20 minutes for your stomach to tell your brain that you are full; 3) take a lunch to work so you can have more control over what you eat; and 4) drive a different route to work to avoid passing by the fast food restaurants or the donut shop.

The key to losing weight and preventing pre-diabetes and diabetes is to make lifelong changes. The NDEP says not to rely on quick fixes or 'crash diets'. For more information on Medicare diabetes coverage, go to www.medicare.gov/health/diabetes.asp. To learn more about diabetes prevention, go to http://ndep.nih.gov/diabetes/prev/prevention.htm