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Published on August 20, 2015

Do you have pre-diabetes? 3 tests you can take to find outDo you have pre-diabetes? 3 tests you can take to find out

More than 29 million Americans have diabetes. But another 86 million—about one in three of us—have pre-diabetes.

And most of (about nine in 10) don’t even know it.

“The difference is you still can do something about it,” explained Debbie Allietta, a registered nurse and diabetes educator for the Visiting Nurse Association of Cape Cod, part of Cape Cod Healthcare.

“Pre-diabetes means your blood sugar is higher than normal,” she said. But it can return to normal if you are motivated to make lifestyle changes, such as weight loss, exercise and a better diet with fewer carbohydrates.

“Your blood sugar can return to a normal range and you may never go on to Type 2 diabetes.”

Blood Testing

One of the most common tests is the Fasting Plasma Glucose, or FPG. It checks fasting blood glucose levels after patients don’t eat or drink anything but water for at least eight hours.

If your results are 126 milligrams per one tenth of a liter or higher, you have diabetes. Pre-diabetes clocks in at 100 to 125 milligrams per deciliter. A normal reading is 70 to 99 milligrams per tenth of a liter.

The Oral Glucose Tolerance test is similar. After fasting for eight hours, you consume a sugary drink and get measured again two hours later.  Those results look like this:

  • Normal: below 140 mg/dL
  • Pre-diabetes: 140-199 mg/dL
  • Diabetes: 200 mg/dL or above

A third test called Hemoglobin A1c, or HbA1c, does not require fasting. It provides your average blood sugar levels over the previous two to three months. Your results may be read as follows:

  • Normal: below 5.7%
  • Pre-diabetes: 5.7%-6.4%
  • Diabetes: 6.5% or above

Even if you’ve been diagnosed with pre-diabetes, your system may already have gone through some changes. That makes early detection and treatment all the more critical, Allietta said.

“What we know about diabetes is that it is a progressive disease,” she said. “The pancreas over time will continue to fail.”

The pancreas produces insulin, a hormone that helps move sugar in the cells of your body so they can be used for energy.  Beta cells in the pancreas produce and secrete that insulin.

“It is estimated that a person at diagnosis already has lost about 50 percent of the beta cell function. And every subsequent year will register a loss of another 4 percent,” explained Allietta.  “That means that by 10 years, you can lose 90 percent of your pancreas’ function.”

If your test indicates pre-diabetes, you should have it repeated for accuracy. If you do have pre-diabetes, you will need to be retested every year.

Experts recommend that people with pre-diabetes reduce their body weight by 5 percent to 7 percent, and engage in modest physical activity for at least 150 minutes each week.

In addition to exercising, you doctor will encourage you to eat more fruits and vegetables and whole grain foods, and to decrease the amount of carbohydrates you consume at one time. You should also limit your intake of sugar-sweetened drinks.

If you already drink alcohol, limit your drinking to moderate amounts of alcohol: two drink per day for men and one for  women. Some studies have shown a benefit for people who drink moderately.

In some cases, medications commonly used to treat diabetes may be prescribed to prevent people from developing diabetes.

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