September 30, 2011

Introduction To Prediabetes – Part 2

Some important reminders for all people, without or with diabetes. First obtain copies of all lab reports and tests preformed by your doctor or hospital. I cannot emphasize how important this is for tracking your health. If you have a family history with type 2 diabetes, this may help you know when to see a doctor and have him/her do the necessary tests. Next, make sure that your doctor is testing you with fasting at least once a year. Also make sure your doctor knows your medical family history.

If you have a family history of type 2 diabetes, on your own, if you can afford it, buy a meter and test strips and develop a routine of blood glucose testing on a consistent basis. To start with I would suggest doing a fasting blood glucose test. If you are under 99 mg/dl, then wait a week and test again. If you are consistently under 90 mg/dl, then I would suggest testing on the same day three or four weeks apart. What you are looking for is trends in fasting blood glucose readings.

After a couple of months if the trend is holding steady (plus or minus 3 to 5 points) then space the time out to two or three months. Just don't forget to test. If you have gained weight, now is the time to lose it with exercise and diet modifications. Start making lifestyle changes now while it may be easier. Read my blog here on the different lifestyle changes, adding weight loss prominently to the list is needed. I downgraded it in my blog and was corrected by one of the commentors.

If the trend starts showing an upward trend, then you may wish to do a few one hour after meal tests as well. If your fasting blood glucose reading is 96 mg/dl (5.3 mmol/L) then you don't want to see more than a meter reading of 125 mg/dl (6.9 mmol/L). If this happens then you may wish to check several times during the day both before and after lunch and dinner. This would be just before you are ready to eat and one hour after eating. If any of the before meal reading are above 99 mg/dl (5.5 mmol/L) and one hour post meal readings (postprandial) readings are above 125 mg/dl (6.9 mmol/L), then please schedule an appointment with your doctor for testing a fasting reading and an oral glucose tolerance test. Get the test and lab reports.

If the readings are in the ranges for prediabetes (see previous blog) and the doctor does not say you have prediabetes, or just that you sugar was a little high, I urge you to consider telling the doctor to check the facts for prediabetes and treat it as such. If the doctor puts you off, consider finding a different doctor if you are able and in an area that you can. Even consider asking for a referral to an endocrinologist if there is one available.

You may need to do some research on the Internet to know if there is one specializing in diabetes that is close enough to you. One site to aid you is this site. Many other sites link back to this site. Just be aware that this may be difficult as there are about 3000 endocrinologists in the US that specialize in diabetes and about 21 million people with diabetes.

Now the lifestyle changes become imperative to avoid further erosion of your health and further damage to your pancreas. Testing becomes even more important and I suggest talking to your doctor about prescribing Metformin (extended release) XR to help while you increase your exercise and reduce your carb intake until you can prove to the doctor that you are able to manage your prediabetes by bringing the blood glucose readings back to the normal range consistently. Then the doctor may allow you to come off the medication. Yes, there are some doctors and pharmacies that will not allow this.

Once you have crossed the line above the normal range, you need to consider that you have prediabetes and treat it as such. Even consistently getting the numbers back in the normal range does not mean that you no longer have prediabetes. All it takes is a few days of mistakes and prediabetes will be back and you will need to work more diligently to maintain the normal numbers again. Continue to look for trends as an increase can indicate that you are having the potential for a type 2 diabetes diagnosis.

If you have the genetic predisposition for diabetes, denial will only make future diabetes management more difficult.


Beth said...

Good post, Bob. Type 2 diabetes runs in my family. My brother, who is 52, does not have diabetes but tests his blood sugars often.

Bob Fenton said...

Beth, Good for your brother! It is good that he is aware and watching for the trends in his blood glucose.

He hopefully will not develop type 2, but by watching what he eats and exercising can delay it for many more years.