PREDIABETES MANAGEMENT - New 3

The American Diabetes Association (ADA) recommends that diabetes screening for most adults begin at age 45. The ADA advises diabetes screening before age 45 if you're overweight and have additional risk factors for prediabetes or type 2 diabetes.

If you've had gestational diabetes, your health care provider will likely check your blood sugar levels at least once every three years.

There are several blood tests for prediabetes.

Glycated hemoglobin (A1C) test

This test indicates your average blood sugar level for the past 2 to 3 months.

In general:

Below 5.7% is normal
Between 5.7% and 6.4% is diagnosed as prediabetes
6.5% or higher on two separate tests indicates diabetes
Certain conditions can make the A1C test inaccurate — such as if you're pregnant or have an uncommon form of hemoglobin.

Fasting blood sugar test

A blood sample is taken after you haven't eaten for at least eight hours or overnight (fast).

Blood sugar values are expressed in milligrams of sugar per deciliter (mg/dL) or millimoles of sugar per liter (mmol/L) of blood. In general:

Less than 100 mg/dL (5.6 mmol/L) is normal

100 to 125 mg/dL (5.6 to 6.9 mmol/L) is diagnosed as prediabetes

126 mg/dL (7.0 mmol/L) or higher on two separate tests is diagnosed as diabetes

Oral glucose tolerance test

This test is less commonly used than the others, except during pregnancy. You'll need to fast overnight and then drink a sugary liquid at the primary care provider's office or lab testing site. Blood sugar levels are tested periodically for the next two hours.

In general:

Less than 140 mg/dL (7.8 mmol/L) is normal
140 to 199 mg/dL (7.8 to 11.0 mmol/L) is consistent with prediabetes

200 mg/dL (11.1 mmol/L) or higher after two hours suggests diabetesIf you have prediabetes, your health care provider will typically check your blood sugar levels at least once a year.

Children and prediabetes testing

Type 2 diabetes is becoming more common in children and adolescents, likely due to the rise in childhood obesity.

The ADA recommends prediabetes testing for children who are overweight or obese and who have one or more other risk factors for type 2 diabetes, such as:

Family history of type 2 diabetes,
Being of a race or ethnicity associated with an increased risk,
Low birth weight,
Being born to a mother who had gestational diabetes.

The ranges of blood sugar level considered normal, prediabetes and diabetes are the same for children and adults.

Children who have prediabetes should be tested annually for type 2 diabetes — or more often if the child experiences a change in weight or develops signs or symptoms of diabetes, such as increased thirst, increased urination, fatigue or blurred vision.

Treatment

Healthy lifestyle choices can help you bring your blood sugar level back to normal, or at least keep it from rising toward the levels seen in type 2 diabetes.

To prevent prediabetes from progressing to type 2 diabetes, try to:

Eat healthy foods

A diet high in fruits, vegetables, nuts, whole grains and olive oil is associated with a lower risk of prediabetes. Choose foods low in fat and calories and high in fiber. Eat a variety of foods to help you achieve your goals without compromising taste or nutrition.

Be more active

Physical activity helps you control your weight, uses up sugar for energy and helps the body use insulin more effectively. Aim for at least 150 minutes of moderate or 75 minutes of vigorous aerobic activity a week, or a combination of moderate and vigorous exercise.

Lose excess weight

If you're overweight, losing just 5% to 7% of your body weight — about 14 pounds (6.4 kilograms) if you weigh 200 pounds (91 kilograms) — can significantly reduce the risk of type 2 diabetes. To keep your weight in a healthy range, focus on permanent changes to your eating and exercise habits.

Stop smoking

Stopping smoking can improve the way insulin works, improving your blood sugar level.Take medications as needed. If you're at high risk of diabetes, your health care provider might recommend metformin. Medications to control cholesterol and high blood pressure might also be prescribed.

Children and prediabetes treatment

Children with prediabetes should follow the lifestyle changes recommended for adults with type 2 diabetes, including:

Losing weight
Eating fewer refined carbohydrates and fats, and more fiber
Reducing portion sizes
Eating out less often
Spending at least one hour every day in physical activity
Medication generally isn't recommended for children with prediabetes unless lifestyle changes aren't improving blood
sugar levels. If medication is needed, metformin is usually the recommended drug.

Talk to your health care provider if you're considering dietary supplements or other alternative therapies to treat or prevent prediabetes. Some supplements or alternative therapies might be harmful if combined with certain prescription medications. Your health care provider can help you weigh the pros and cons of specific alternative therapies.

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