This document discusses preventing and treating prediabetes. It notes that 79 million Americans have prediabetes, which occurs when blood sugar levels are higher than normal but not high enough to be diagnosed as diabetes. Having prediabetes increases the risk of developing type 2 diabetes within 10 years if lifestyle changes are not made. The recommended treatment for prediabetes is to lose 7% of body weight through diet and physical activity of 30-60 minutes per day in order to reduce the risk of developing diabetes by 58%. Medications including metformin may also be used to treat prediabetes.

1. Preventing DiabetesPreventing Diabetes
Dany Zayour, MDDany Zayour, MD
Via Christi ClinicVia Christi Clinic
Diabetes and Endocrinology CenterDiabetes and Endocrinology Center

2. Why talk about Diabetes?Why talk about Diabetes?
 26 million americans (11.3%) have diabetes26 million americans (11.3%) have diabetes
 7 million do not know it7 million do not know it
 2 new million cases diagnosed each year2 new million cases diagnosed each year
 79 million americans have prediabetes79 million americans have prediabetes
 37 million (15%) will have diabetes in 201537 million (15%) will have diabetes in 2015
 1 in 3 adults will have diabetes in 20501 in 3 adults will have diabetes in 2050

4. What is prediabetes?What is prediabetes?

5. What is prediabetes?What is prediabetes?
 Blood sugar is higher than normal but not asBlood sugar is higher than normal but not as
high as diabeteshigh as diabetes
 Touch of sugarTouch of sugar
 Mild diabetesMild diabetes
 Prediabetes is likely to progress to diabetes in 10Prediabetes is likely to progress to diabetes in 10
years or lessyears or less
 Already started complicationsAlready started complications

6. How do I know if I have prediabetes?How do I know if I have prediabetes?

7. SymptomsSymptoms
 No signs or symptomsNo signs or symptoms
 Darkened areas of skin called acanthosis nigricansDarkened areas of skin called acanthosis nigricans
 Signs of diabetesSigns of diabetes
 Increased thirstIncreased thirst
 Frequent urinationFrequent urination
 FatigueFatigue
 Blurred visionBlurred vision
 Recurrent infectionRecurrent infection
 Tingling and numbnessTingling and numbness
 Cuts and bruises that are slow to healCuts and bruises that are slow to heal

10. What increases my risk for diabetesWhat increases my risk for diabetes
and should I get tested?and should I get tested?

11. What increases the risk of diabetes?What increases the risk of diabetes?
 Overweight or obese (BMI above 25)Overweight or obese (BMI above 25)
 Extra weight in your bellyExtra weight in your belly
 Not physically activeNot physically active
 SmokingSmoking
 Family history of type 2 diabetesFamily history of type 2 diabetes
 Gestational diabetes or baby more than 9 lbsGestational diabetes or baby more than 9 lbs
 PCOSPCOS
 Sleep fewer than 6 hrs or more than 9 hrs per daySleep fewer than 6 hrs or more than 9 hrs per day
 Race: african american, asian, HispanicRace: african american, asian, Hispanic

12. Are there any blood tests to diagnose prediabetes?Are there any blood tests to diagnose prediabetes?

13. Blood tests to diagnose prediabetesBlood tests to diagnose prediabetes
 Fasting glucoseFasting glucose
 8 hrs fast8 hrs fast
 BS 100-125 mg/dlBS 100-125 mg/dl
 Glucose tolerance testGlucose tolerance test
 Drink sugary solutionDrink sugary solution
 BS 2 hrs after that 140-199BS 2 hrs after that 140-199
 Hemoglobin A1c or HbA1cHemoglobin A1c or HbA1c
 HbA1c 5.7-6.4%HbA1c 5.7-6.4%

14. A1C eAGA1C eAG
%% mg/dlmg/dl
66 126126
6.56.5 140140
77 154154
7.57.5 169169
88 183183
8.58.5 197197
99 212212
9.59.5 226226
1010 240240
HbA1c and average glucose

15. ADA Diagnostic Criteria:ADA Diagnostic Criteria:
Normal, Diabetes, and Pre-diabetesNormal, Diabetes, and Pre-diabetes
Clinical Practice Recommendations 2010Clinical Practice Recommendations 2010
ParameterParameter NormalNormal DiabetesDiabetes Pre-diabetesPre-diabetes MethodMethod
11 Fasting PlasmaFasting Plasma
GlucoseGlucose
(mg/dl)(mg/dl)
<100<100 ≥≥126126 100–125100–125 No caloric intakeNo caloric intake
for at least 8 hfor at least 8 h
22 2-h plasma2-h plasma
glucose onglucose on
OGTT (mg/dl)OGTT (mg/dl)
<140<140 ≥≥200200 140–199140–199 WHO method: 75WHO method: 75
g glucose loadg glucose load
33 RandomRandom
plasma glucoseplasma glucose
(mg/dl)(mg/dl)
<140<140 ≥≥200200 -- with classicwith classic
symptomssymptoms
of hyperglycemiaof hyperglycemia
or crisisor crisis
44 A1CA1C
%%
<5.7<5.7 ≥≥6.56.5 5.7 – 6.45.7 – 6.4 NGSP certifiedNGSP certified
methodmethod
standardized tostandardized to
the DCCT assaythe DCCT assay

16. What is the treatment of prediabetes?What is the treatment of prediabetes?

17. Reducing risk of DiabetesReducing risk of Diabetes
 Losing 7% (5-10%) of body weightLosing 7% (5-10%) of body weight
 Decrease risk by 58%Decrease risk by 58%
 11% per year of prediabetes develop diabetes in11% per year of prediabetes develop diabetes in
the first 3 yearsthe first 3 years

18. DietDiet
 DietDiet
 Low in fatLow in fat
 High in fibersHigh in fibers
 Focus on fruits, vegetables and whole grainsFocus on fruits, vegetables and whole grains
 VarietyVariety

19. Physical activityPhysical activity
 30-60 minutes daily 5 days a week ( there are 1440 min in a day)30-60 minutes daily 5 days a week ( there are 1440 min in a day)
 Brisk daily walkingBrisk daily walking
 Ride your bikeRide your bike
 DancingDancing
 Low impact aerobic classLow impact aerobic class
 SwimmingSwimming
 Exercise while sittingExercise while sitting
 Use stairsUse stairs
 Park away from entrancePark away from entrance

20. MedicationsMedications
 MetforminMetformin
 ActosActos
 AcarboseAcarbose
 GLP-1 agonistsGLP-1 agonists

21. Alternative medicineAlternative medicine
 CinnamonCinnamon
 ChromiumChromium
 GinsengGinseng
 Prickly pear cactusPrickly pear cactus
 SoySoy
 SteviaStevia
 GymnemaGymnema

25. THANK YOUTHANK YOU