Complications from Diabetes: A Lethal Consequence

Diabetes Complications: Learn how to safeguard your health

Few individuals would consciously expose themselves to the dangers of heart disease, stroke, kidney failure, vision loss, limb amputation, or nerve impairment. Nevertheless, if you happen to be among the 30 million or more Americans grappling with Type 2 diabetes, you’ve already significantly elevated your susceptibility to a range of critical health complications.

According to Rick Gillis, MD, an Assistant Professor of Medicine and the Director of the Office of Clinical Informatics at the Medical College of Wisconsin, “If you are dealing with diabetes, your likelihood of experiencing a heart attack and succumbing to it is amplified by six to seven times compared to those without the condition.” Remarkably, the risk of heart attack associated with Type 2 diabetes is on par with that of Coronary Artery Disease.

With Diabetes, It’s the Complications That Kill You

Diabetes mellitus, commonly referred to as diabetes, is actually an assortment of chronic conditions characterized by the improper utilization of blood glucose, the essential sugar utilized for normal bodily functions. Insulin, the hormone responsible for regulating fuel, plays a vital role in storing and effectively utilizing glucose. 

However, individuals with diabetes encounter flaws in insulin production or function, impeding the proper functioning of the system. This results in an inability to use glucose for the energy required for activities, cellular growth, and repair. In the prevalent form of Type 2 diabetes, the resistance of muscle and fat cells to insulin’s effects is the primary issue. Some patients with Type 2 diabetes might require insulin therapy to regulate blood sugar levels.

Between 90% and 95% of the 16.7 million Americans who have received a diabetes diagnosis are afflicted with Type 2 diabetes, as reported by the Centers for Disease Control and Prevention (CDC). Researchers from the US Department of Health and Human Services (HHS) speculate that the actual number of Americans with the condition might be twice that, though approximately half of them are unaware of their affliction. Irrespective of the precise figures, diabetes predisposes millions of Americans to profoundly serious health repercussions unless meticulous management of the disease is practiced.

Facts About Diabetes

Diabetes stands as an enduring condition impacting numerous individuals across the United States. Approximately one out of every ten people in the U.S. grapples with diabetes, while surprisingly, one out of five remains unaware of their condition. 1 Left untreated, diabetes can lead to perilous health consequences, including mortality. Nonetheless, with appropriate diabetes management, individuals can enjoy many years of life.

In times past, prior to the discovery of insulin, those afflicted with diabetes faced shorter lifespans. Today, advancements in treatments have extended the lives of people with diabetes, affording them a higher quality of life. Nonetheless, as of 2021, diabetes still ranked as the seventh principal cause of death in the U.S. The question arises: what precisely triggers complications, and how can they be preempted?

What Is Diabetes?

Diabetes arises when the body’s ability to regulate blood sugar levels falters. There are two distinct types of diabetes: type 1 and type 2. In the case of type 1 diabetes, the production of insulin—essential for controlling blood sugar—is hampered. On the other hand, type 2 diabetes involves inadequate insulin production or utilization, resulting in difficulty maintaining normal blood sugar levels. Both variations of the condition can result in elevated blood sugar levels.

Indications of diabetes include:

  • Increased thirstiness compared to usual
  • Greater frequency of urination
  • Heightened appetite
  • Persistent fatigue
  • Blurred vision
  • Sensations of numbness or tingling in the extremities
  • Slow-healing sores
  • Unexplained weight loss

Diabetes exerts diverse impacts on the body, contributing to a range of complications if not properly addressed. This underscores the importance of seeking treatment, as unmanaged diabetes can give rise to various health issues.

What Are the Consequences of Diabetes?

While diabetes can elevate the likelihood of additional health issues, individuals can also coexist with it over extended periods. Neglected diabetes can pave the way for numerous health ramifications, such as diabetic ketoacidosis, neuropathy, renal disorders, cardiovascular ailments, strokes, and adverse effects on mental well-being. These outcomes predominantly stem from the uncontrolled elevation of blood sugar levels.

Diabetes and Health Complications

Diabetes, whether type 1 or type 2, raises concerns about potential long-term complications. Often, those newly diagnosed may overlook these future risks. However, it’s important to acknowledge that some individuals with type 2 diabetes might have experienced elevated blood sugar levels for years before their diagnosis, potentially causing subtle damage. The good news is that taking proactive steps can delay, prevent, or even reverse certain complications.

Understanding Long-Term Complications and Their Significance

A hallmark of diabetes is elevated blood sugar levels, which can persist unnoticed due to limited noticeable symptoms. Recognizable signs, such as extreme thirst and frequent urination, usually arise when blood sugar levels are exceptionally high. Consequently, individuals may have lived with heightened blood sugar levels for months or years without awareness. While efforts to enhance screening for prediabetes and type 2 diabetes are underway, comprehensive preventative measures are not yet widespread in the United States.

This poses a serious challenge, as prolonged high blood sugar levels inflict damage on blood vessels and nerves, impacting vital organs like the eyes, heart, and kidneys. Although the mechanisms behind this damage are intricate, the excess glucose can be harmful if left untreated.

Anticipating Potential Complications and Taking Action

Diabetes-Related Retinopathy (DR): This condition stems from high blood sugar levels damaging the retina, potentially leading to blindness. Regular comprehensive eye exams by eye care professionals are crucial, as up to 40% of type 2 diabetes patients could have DR.

Peripheral Vascular Disease (PVD) and Neuropathy: These complications, causing reduced blood flow and nerve damage, respectively, may lead to infections, slow healing, and even limb amputations. Effective blood sugar, blood pressure, and cholesterol management, along with foot care, are essential preventive measures.

Heart Disease and Stroke: Elevated risk of these issues is common due to high blood pressure, cholesterol, and blood vessel damage from diabetes. Monitoring these factors and maintaining a healthy lifestyle can mitigate the risk.

Chronic Kidney Disease (CKD): Damage to kidney blood vessels can result in kidney disease, emphasizing the importance of blood sugar, blood pressure, and cholesterol control to prevent or manage CKD.

Depression and Diabetes Stress: Mental well-being is vital. Seeking support and practicing coping skills is essential for managing diabetes effectively.

Facing the Complexities of Diabetes

Although managing diabetes can be intricate, remember that you’re not alone. The diabetes community offers invaluable support and guidance. Seek assistance, involve family, and never hesitate to ask for professional help when needed. With dedication to a healthy lifestyle, medication, and regular medical consultations, you can take charge of your diabetes journey and prevent potential complications.

Dealing With the Fear of Diabetes-Related Complications

Diabetes, a chronic condition, carries the potential for severe health complications, including kidney failure, nerve and eye damage, heart disease, and stroke. The experiences of three individuals shed light on the impact of diabetes-related complications on their lives.

Recognizing the Scope of Complications

While long-term complications aren’t inevitable for individuals with diabetes, understanding how the condition affects the body is crucial. Diabetes raises the risk of complications like kidney failure, nerve damage, vision impairment, heart issues, and amputations. These concerns can be daunting, along with the challenges of managing diabetes itself.

Personal Stories of Coping

Ashley Donahue: Diagnosed with type 2 diabetes, Donahue recalls her partner’s father’s struggles with severe complications, motivating her to take her diagnosis seriously. Although she hasn’t experienced complications yet, she contemplates the impact diabetes might have on her future, especially her plans for motherhood.

Rachael Green: 

Diagnosed with type 1 diabetes at a young age, Chalcraft experienced vision loss due to diabetic retinopathy. The emotional toll of the diagnosis was significant, impacting her daily life and mental health. She emphasizes the importance of a supportive community in coping with diabetes-related complications.

Taylor Long: 

Living with type 1 diabetes for over a decade, Averette witnessed her grandfather’s struggles with complications despite managing his diabetes well. This prompted her commitment to prioritizing her health to avoid similar challenges, even though she acknowledges that complications could still arise.

The Significance of Conversations about Complications

People with diabetes stress the need for open discussions about complications, as these experiences help individuals connect and support each other. Creating awareness around complications ensures that no one feels isolated or uninformed. The diabetes community plays a vital role in fostering understanding and offering encouragement.

Diabetes has the potential for serious complications, but sharing personal stories and coping strategies can provide comfort, support, and the realization that individuals are not alone in their struggles.

Learning to cope with multiple diabetes complications

Managing diabetes can be overwhelming, involving regular blood sugar checks, healthy eating, exercise, medication, and health decisions. Concerns about blood sugar levels, medication costs, and complications like heart disease add to the stress. This can lead to diabetes distress, affecting self-care. Seeking support is crucial:

Strategies to Manage Diabetes Distress

  • Acknowledge feelings: Diabetes-related stress is common. Prolonged distress requires help.
  • Consult healthcare providers: Discuss feelings with doctors, nurses, educators, or psychologists to find solutions.
  • Address stigma: Providers can aid in managing judgments from others about diabetes.
  • Seek financial aid: Inquire about assistance programs for diabetes medication costs.
  • Talk to family/friends: Share feelings and problems honestly, reducing stress.
  • Involve loved ones: Seek their assistance in reminders, monitoring, exercise, meals, and doctor visits.
  • Connect with peers: Engage with fellow diabetics to share experiences, reducing isolation.
  • Manage tasks: Break down diabetes management tasks, handling them one by one.
  • Progress gradually: Approach goals like increased exercise in manageable steps.
  • Enjoy hobbies: Allocate time for activities you love to relieve stress.

Prioritize emotional well-being; seek help if stress affects decision-making or self-care. Friends, family, and healthcare providers can offer the necessary support.

Managing Diabetes Involves Potential Challenges

The complications of type 2 diabetes can lead to various health issues due to high glucose levels damaging blood vessels, nerves, and organs. Even mildly elevated glucose levels can cause long-term damage. Diabetes increases the risk of heart disease and stroke by up to five times due to narrowed blood vessels, potentially leading to angina or claudication. 

Nerve damage can result in tingling, burning pain, numbness, and digestive issues. Diabetic retinopathy can damage the retina, affecting vision. Kidney disease can reduce kidney function, potentially leading to kidney failure. Foot problems can arise from nerve damage and poor circulation, causing ulcers and infections. 

Sexual dysfunction can occur in both men and women with diabetes. Pregnant women with diabetes face an increased risk of miscarriage, stillbirth, and birth defects. Careful management of blood glucose levels is essential to mitigate these complications.

Liver Disease in Diabetes: An Overlooked Complication

The liver is a crucial organ responsible for blood filtration, nutrient production, and medication breakdown. However, factors like alcohol consumption, excess weight (especially abdominal fat), and fat accumulation from fat cells can damage the liver. 

This is often seen in individuals with abnormal blood lipid levels, high blood pressure, and diabetes. Nonalcoholic fatty liver disease (NAFLD) occurs when fat accumulates in the liver, and around 60% of those with type 2 diabetes have this condition. NAFLD can progress to nonalcoholic steatohepatitis (NASH), where liver cells become inflamed and develop fibrosis (thickening and scarring). Advanced NASH can lead to cirrhosis, liver failure, and portal hypertension.

Dr. Kenneth Cusi noted a link between diabetes rates and NAFLD/NASH prevalence. The ADA has recently issued guidelines for diagnosing, managing, and treating NAFLD/NASH, considering them part of diabetes care alongside cardiovascular disease and kidney disease.

Early detection is vital, and the FIB-4 screening test can identify those at risk for liver fibrosis. Lifestyle changes are recommended for treatment, including weight loss, healthy eating, reduced alcohol intake, and increased physical activity. While no specific medications are approved for diabetes-related liver disease, pioglitazone, GLP-1 receptor agonists, and SGLT-2 inhibitors are emerging options.

Ongoing clinical trials aim to find drugs for NAFLD/NASH treatment. Researchers are studying genes associated with risk, potentially leading to personalized treatments. The future holds promise for targeted therapies based on genetic factors.

Heart Failure – Another Overlooked Diabetes Complication

Diabetes-related complications often discussed among healthcare professionals include retinopathy, nephropathy, and atherosclerotic cardiovascular disease. However, a lesser-known yet significant complication is heart failure. Heart failure refers to a condition where the heart’s ability to pump blood is diminished, leading to inadequate blood circulation throughout the body.

This content is the first part of a two-part series focusing on heart failure and its connection to diabetes. It explores the concept of heart failure, its association with diabetes, signs and symptoms, screening methods, and diagnostic tests employed by healthcare professionals.

Understanding Heart Failure:

Distinguishing heart failure from cardiovascular disease, heart attack, and cardiac arrest is crucial. Cardiovascular disease pertains to atherosclerosis, where plaque buildup in arteries obstructs blood flow. A heart attack occurs when blood flow to the heart muscle is blocked, causing damage. Heart failure occurs when the heart cannot pump sufficient blood.

Differentiating Types of Heart Failure:

Heart failure can arise due to coronary artery disease, high blood pressure, previous heart attacks, or structural issues affecting the heart muscle. It occurs in two ways: when the heart muscle becomes stiff (HFpEF) or weaker (HFrEF). Both types have been linked to diabetes and prediabetes. Over 6 million Americans experience heart failure, causing approximately 1 million hospitalizations annually.

Progression and Symptoms of Heart Failure:

Heart failure is typically a chronic condition that worsens over time. Initially, compensatory mechanisms mask symptoms, but as heart failure progresses, individuals may experience shortness of breath, fatigue, reduced exercise tolerance, and fluid buildup in the legs and lungs (congestive heart failure).

Diabetes’s Role in Heart Failure:

Heart failure is a prominent and dangerous complication of diabetes, particularly in type 2 cases. Individuals with diabetes face an increased risk of heart failure, and the shared risk factors between the two conditions exacerbate this connection. Research indicates that higher A1C levels are associated with an elevated risk of heart failure, likely due to the adverse effects of prolonged high blood sugar levels on heart function.

Recognizing and Screening for Heart Failure:

Common symptoms of heart failure include breathlessness, fatigue, swelling, an irregular heartbeat, coughing (sometimes producing pink, foamy mucus), chest pain, a lack of appetite, and confusion. Seeking immediate medical attention is crucial for severe symptoms, especially congestive heart failure. Engaging with healthcare professionals and discussing symptoms is essential for early diagnosis and preventive measures.

Diagnostic Tests:

Healthcare professionals employ various imaging techniques to assess heart function, including echocardiography, x-rays, MRIs, and myocardial perfusion scans. Exercise stress tests, blood tests, and electrocardiograms are also valuable tools for diagnosis. Before ordering tests, a physical examination is conducted to evaluate symptoms, lifestyle factors, and medical history.

In summary, this content provides valuable insights into the relationship between diabetes and heart failure, emphasizing the importance of early detection, communication with healthcare professionals, and understanding the diagnostic process.

How to Keep Your Kidneys Healthy When You Have Diabetes

Having diabetes increases the risk of kidney problems. Discover the steps recommended in the latest ADA Standards of Care to safeguard your kidney health and prevent damage.

Your kidneys are vital for your well-being, responsible for filtering waste and excess fluids as urine, regulating blood pressure, and producing essential hormones. Unfortunately, 20-40% of diabetes patients develop chronic kidney disease (CKD), often due to suboptimal glucose and blood pressure management. Maintaining these factors, along with adopting healthy eating habits and appropriate medications, can significantly support kidney health.

This article, based on the American Diabetes Association’s Standards of Care, offers insights into preserving kidney health and preventing diabetes-related kidney disease:

Understanding Kidney Damage Due to Diabetes:

Prolonged mismanagement of glucose and blood pressure can gradually harm the kidneys’ small blood vessels, impairing waste filtration. Damaged blood vessels result in compromised waste elimination, leading to kidney damage. Factors like smoking, high sodium intake, sedentary lifestyle, obesity, heart disease, and a family history of kidney issues amplify the risk of developing CKD, which also heightens the chances of heart and blood vessel diseases.

Preventing Diabetes-Related Kidney Problems:

Daily actions and regular tests are key to averting diabetes-related complications. Effective glucose and blood pressure management, along with annual checkups, form the foundation of prevention strategies.

Maintaining Glucose Levels:

Managing glucose consistently can reduce CKD risk. Collaborate with diabetes healthcare providers to establish tailored glucose targets. Type 2 diabetes patients may consider SGLT-2 inhibitors after consulting their care providers. These medications enhance glucose excretion in urine, reducing glucose reabsorption by the kidneys. Research indicates that SGLT-2 inhibitors can lower weight, blood pressure, albuminuria, and the estimated glomerular filtration rate (eGFR), while also protecting against heart failure. Patients with high CKD and heart disease risk can explore the new FDA-approved medication Kerendia (finerenone) alongside SGLT-2 inhibitors.

Controlling Blood Pressure:

Maintaining optimal blood pressure is crucial. Monitor blood pressure regularly and adhere to recommended targets. Lifestyle changes are crucial for blood pressure management, and ACE inhibitors and ARBs are effective medications. These drugs also slow CKD progression and reduce heart and blood vessel issues.

Monitoring Protein Intake:

Monitoring protein intake is essential to preventing CKD onset or progression. Aim to consume a maximum of 0.32 grams of protein per pound daily (e.g., 51 grams/day for an average-weight woman). This level slows CKD progression without restricting protein excessively.

Annual Kidney Function Tests:

People with type 2 diabetes or type 1 diabetes for over five years should undergo two annual tests to assess kidney function. The spot urinary albumin-to-creatinine ratio (UACR) measures protein excretion, and the estimated glomerular filtration rate (eGFR) evaluates waste filtration. Elevated UACR or declining eGFR should prompt consultation with a nephrologist or kidney disease specialist.

Chronic Kidney Disease Stages:

Understanding the six stages of CKD is valuable, although the primary goal is prevention. Consulting with a nephrologist when UACR or eGFR values change can improve care quality and delay dialysis.

Options for Kidney Failure Treatment:

In advanced stage 5 CKD, dialysis becomes necessary. Hemodialysis and peritoneal dialysis are options, with advances improving convenience and effectiveness. Kidney transplants are also considered. Prompt action is crucial for managing kidney issues and preventing further deterioration.

Personal Perspective:

A person with type 2 diabetes and CKD emphasizes the importance of regular checkups and early intervention. Despite facing challenges, including a kidney transplant, she advocates for proactive kidney care and overall well-being.

Adhering to the ADA’s Standards of Care can help individuals with diabetes maintain kidney health and reduce the risk of complications. Regular monitoring, lifestyle changes, and informed decision-making are essential for preserving kidney function.

Gradual Emergence of Diabetes, Limited Symptoms

Type 1 diabetes, previously referred to as juvenile-onset or insulin-dependent diabetes, is an autoimmune disorder. In this condition, the body generates antibodies that attack and harm its own cells. It tends to manifest abruptly, accompanied by symptoms such as excessive thirst and increased urination.

Type 2 diabetes, on the other hand, involves a situation where the body may produce some insulin but fails to use it effectively, leading to an unhealthy accumulation of glucose (sugar) in the bloodstream. Unlike Type 1 diabetes, Type 2 develops slowly, often without noticeable symptoms. Typically emerging after the age of 40, Type 2 diabetes is most commonly observed in adults aged 55 or older. Previously referred to as adult-onset or non-insulin-dependent diabetes, the nomenclature was recently revised to provide a more accurate portrayal of the condition. Remarkably, Type 2 diabetes is increasingly being diagnosed among American children and young adults.

The diagnosis and treatment of diabetes patients constitute a primary focus area within Dr. Gillis’ practice. Moreover, he frequently delivers presentations about diabetes to both patients and healthcare professionals.

Standard Blood Testing is essential.

Given the rapid increase in the number of individuals affected by Type 2 diabetes, Dr. Gillis strongly advocates for early and regular screening to detect the disease.

“Starting around the age of 45, it’s crucial for everyone to undergo routine screening for Type 2 diabetes,” he advises, particularly those with a body mass index (BMI) of 25 or higher, men with waist measurements of 40 inches or more, and women with waist measurements of 35 inches or more. As part of their routine health screening, his patients undergo a fasting plasma glucose (FPG) blood test. Additionally, he suggests this test for patients under the age of 45 who are significantly overweight or exhibit at least one of the following risk factors:”

Factors Indicating Diabetes Risk

  • Family history of diabetes
  • Low HDL cholesterol and high triglycerides (measured in a cholesterol blood test)
  • High blood pressure
  • History of gestational diabetes or giving birth to a baby weighing over 9 pounds
  • Belonging to a minority group (African-Americans, American Indians, Hispanic Americans/Latinos, Asian Americans/Pacific Islanders)

Dr. Gillis emphasizes the advantages of the FPG test, noting that it is a cost-effective, user-friendly, and consistent option compared to the older oral glucose tolerance test. He states, “If results fall within the normal range (110 milligrams per deciliter or lower), the test should be repeated every three years unless other risk factors are present. 

Results between 110 and 125 could indicate impaired fasting glucose, a pre-diabetic state that lies between normal metabolic function and diabetes. An FPG result of 126 or higher indicates diabetes; however, for confirmation, the test should be conducted on a different day.”

Obesity a Major Factor Influencing Diabetes

While genetics certainly influence diabetes, researchers at the Medical College are actively investigating the genetic connections between diabetes and heart disease. Nevertheless, the environment also has a significant impact, particularly on Type 2 diabetes, where factors like obesity and a lack of physical activity play a prominent role.

A striking 80% of Americans with Type 2 diabetes are overweight, and the prevalence of obesity in the country is experiencing an alarming surge. The Centers for Disease Control and Prevention (CDC) released a study in January, featured in the Journal of the American Medical Association, revealing a one-year increase in diagnosed diabetes from 7.3% to 7.9% of the population. The report explicitly linked this escalation to a concurrent rise in obesity rates among Americans.

The CDC study, using a body mass index of 30 or higher, estimated that a staggering 44 million Americans are classified as obese. To provide perspective, this equates to an individual who stands at 5 feet 4 inches tall and carries an excess weight of 30 pounds or more.

In April, the U.S. Department of Health and Human Services (HHS) and the American Diabetes Association introduced the term “pre-diabetic” to describe individuals whose blood sugar tests fall within the impaired range. They underscored that with “modest lifestyle improvements,” individuals can postpone or even prevent the onset of Type 2 diabetes. Even after diagnosis, effective care and diligent diabetes management significantly diminish the risk of severe complications.

Dr. Gillis highlights, “Diet and exercise form the foundation of Type 2 diabetes treatment. Shedding just 10% of body weight, often translating to 10 to 20 pounds, can yield considerable improvement for overweight patients.” Additionally, he stresses the importance of consulting a registered dietitian and adhering to a personalized meal plan that supports overall health. 

In his interactions with patients and their families, Dr. Gillis advocates for keeping saturated and polyunsaturated fats below 10% of the diet, limiting protein consumption to 10 to 20% of the diet, and giving precedence to monounsaturated fats (such as olive oil) and complex carbohydrates (found in fruits, vegetables, whole-grain pieces of bread, pasta, and cereals). He also emphasizes transitioning from a sedentary lifestyle to one rich in physical activity, suggesting a gradual start with regular walking for exercise.

Effective Management to Prevent Complications

“Diabetes treatment entails more than simply managing blood sugar levels,” Dr. Gillis underscores. “It’s not diabetes itself that leads to illness and mortality, but rather its complications. Uncontrolled blood sugar levels initially harm the smaller blood vessels, resulting in vision impairment and diminished kidney and nerve function. Over time, larger blood vessels can become obstructed, culminating in strokes and heart attacks. By administering appropriate care, we can prevent or mitigate these outcomes, making it imperative to address these ‘complications’ vigorously.”

Recent studies corroborate the significance of this strategy. The January 2003 edition of The New England Journal of Medicine highlights findings from a study titled “Multifactorial Intervention and Cardiovascular Disease in Patients with Type 2 Diabetes.” This study compared the health outcomes of 80 diabetic patients receiving standard treatment with those of 80 diabetic patients undergoing intensive treatment, which involved behaviour modification and medication targeting:

  • High blood pressure
  • Elevated blood sugar levels
  • Cholesterol
  • Microalbuminuria (an early indicator of kidney damage, detected through protein in urine)

These patients also utilized aspirin as a preventive measure against cardiovascular disease.

The outcomes, following an average duration of 7.8 years, were remarkably significant: the group undergoing intensive treatment experienced notably better results than the conventionally treated group. In fact, the authors observed, “A goal-oriented, long-term, intensified intervention targeting multiple risk factors in type 2 diabetes patients with microalbuminuria reduces the risk of cardiovascular and microvascular events by approximately 50 percent.”

Patients receive strong encouragement to quit smoking, engage in regular exercise, and maintain healthy ranges for cholesterol and blood pressure. In alignment with this, Dr. Gillis promotes regular screenings for high blood pressure and cholesterol concerns and may prescribe medications to manage these conditions. Such medications encompass ACE inhibitors (commonly used to regulate hypertension), statins (used to control cholesterol), and low-dose aspirin.

Beyond insulin, several oral medications are available for patients requiring pharmacological support to regulate blood sugar levels. These include sulfonylureas, which enhance insulin release from the pancreas; metformin (Glucophage) and thiazolidinediones, which heighten tissue responsiveness to insulin; and alpha-glucosidase inhibitors, which delay sugar absorption from the intestines.

How does prediabetes relate to type 2 diabetes and heart disease?

Prediabetes occurs when your blood glucose (sugar) levels are higher than normal but not yet at the diabetes threshold. However, if your blood glucose continues to rise, it can lead to the development of type 2 diabetes. Type 2 diabetes, in turn, increases the risk of heart disease, stroke, nerve damage, kidney failure, and eye issues. Fortunately, there are proactive measures you can take to delay or prevent the onset of both diabetes and heart disease.

How can I postpone or avert prediabetes, type 2 diabetes, and heart disease?

The progression towards type 2 diabetes and heart disease can indeed be postponed or even prevented. This can be achieved through weight loss by adopting a diet lower in calories and fat, as well as increasing physical activity.

A study conducted on individuals with a high risk for type 2 diabetes demonstrated that it’s possible to significantly reduce the risk of developing diabetes. Participants achieved this by consuming fewer calories than usual, increasing their daily physical activity, and shedding excess weight. This was accomplished through the following actions:

  • Achieving weight loss, with an average of 15 pounds lost within the first year of the study
  • Reducing calorie intake
  • Cutting back on foods rich in saturated fat
  • Engaging in approximately 30 minutes of exercise per day, five days a week, often in the form of brisk walking

These strategies yielded positive outcomes for both men and women alike.

Risk Factors for Prediabetes and Diabetes

Your risk for prediabetes and diabetes is elevated if:

  • You are aged 45 or above
  • You belong to African American, Hispanic/Latino, American Indian, Asian American, or Pacific Islander ethnic groups
  • You have a parent, sibling, or other family member with diabetes
  • You are overweight
  • You are physically inactive
  • Do you have high blood pressure or are you on medication for high blood pressure?
  • Your HDL cholesterol is low and/or your triglycerides are high
  • You experienced diabetes during pregnancy
  • You have been diagnosed with polycystic ovary syndrome (PCOS)

How do you know if you have prediabetes?

Prediabetes can go unnoticed. To ascertain your condition, you need a blood test to measure your blood glucose level.

  • If you are 45 years of age or older, ask your healthcare provider to conduct a blood glucose test.
  • Regardless of your age, if you are overweight and possess at least one other risk factor for diabetes, consult your healthcare provider about undergoing testing.

Strategies for Reducing Calories and Fat Intake

Consider alterations to your eating habits. Indicate the strategies you wish to try or record your personalized ideas.

  • Maintain a food log for one or two weeks.
  • Opt for smaller meal portions.
  • Select the smallest serving when dining out or sharing a main dish.
  • Replace regular soft drinks and juice with calorie-free beverages or water.
  • Initiate your meals with leafy vegetables, like a green salad.
  • Compare food labels and opt for items with fewer calories.
  • Utilize baking, broiling, or grilling methods and nonstick cookware.
  • Increase consumption of vegetables and whole-grain foods.
  • Reduce your calorie and saturated fat intake by:

Amplifying Physical Activity

Engage in physical activity! Choose the strategies you will implement to integrate more movement into your routine or formulate your own concepts.

  • Document your activity levels for one or two weeks.
  • Utilize a pedometer to monitor your daily steps. Strive to reach 10,000 steps daily.
  • Partner with a friend or family member for accountability.
  • Dedicate more time to physical activities such as gardening, cycling, playing with your kids or grandkids, or pursuing other enjoyable active pursuits.
  • Incorporate a daily walk into your routine. Aim for 30 minutes of brisk walking at least five days a week, or break it into multiple shorter walks.
  • Initiate strength training by lifting light weights several times a week.
  • Explore new activities like yoga, Pilates, or dance classes.
  • Stand up and move around every 90 minutes if you spend extended periods sitting.
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