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So you ve just met with your doctor to review your lab work.

Although everything l
ooks good, your blood sugar is slightly elevated to a level that s considered prediabetic. You weren t quite prepared for this news, and several questions immediat
ely pop into your head. What does this mean? Do I need to start taking medicatio
With diagnoses of type 2 diabetes surging in
years, I have this conversation in my office
an Diabetes Association estimates 86 million
e-diabetic. Studies suggest up to 11 percent
diabetes each year. Fortunately, we know how

the United States over the past 10

several times each week. The Americ
Americans over the age of 20 are pr
of them graduate to a diagnosis of
to delay or prevent diabetes from d

Coping strategies for pre-diabetes

Many studies have looked at the benefits of diet, exercise, and medication in pr
eventing diabetes. While medications such as metformin can be used to treat prediabetes, they don t fix the long term problem they only seem to DELAY progression t
o diabetes for a few years.
The only way to truly prevent an eventual diagnosis of diabetes in which your body
is no longer using sugar properly is to change your lifestyle. In fact, losing fi
ve percent to 10 percent of your body weight will drastically cut your risk of d
iabetes by double the amount of medication alone.
And don t forget the power of regular exercise. One study showed a daily walking p
rogram lowered average blood sugars, even if the patients did not lose weight.
Here s how you can prevent pre-diabetes from progressing to diabetes:
Change your diet in a way that leads to a sustainable lifestyle change. LG Healt
h s Diabetes and Nutrition Center has an excellent class designed specifically for
people with pre-diabetes. Formal education can help you get started and set re
alistic goals. Since insurances typically do not pay for this service, it s offere
d at a significantly reduced rate.
Get 30 minutes of exercise most days of the week. Start slow, five or 10 minutes
daily, and work your way up. Walking, swimming, bicycling are good choices to g
et you moving.
Consider a trial of a medication such as metformin.
Consider joining a diabetes online community for education and motivation.
Follow up regularly with your doctor to monitor your progress and watch for othe
r health problems related to pre-diabetes.
Find out your risk
Taking an online risk profiler is one way to estimate your risk of getting diabe
tes. If you re age 45 or older, you should be screened for pre-diabetes. If you re y
ounger, you should be screened if you have a family history of diabetes or a his
tory of diabetes during pregnancy; you don t exercise regularly; you re overweight;
you have high cholesterol or high blood pressure, or you re of African American or
Hispanic descent.
Screening for pre-diabetes involves a fasting blood test to see how your body is
using sugar. If you re diagnosed with pre-diabetes, your doctor should follow you
r blood sugar yearly to check that it hasn t progressed to diabetes.
James M. Kelly, MD is a family physician who practices at Lincoln Family Medicin
e in Ephrata, Pa. He is a graduate of Brody School of Medicine at East Carolina
University and completed his residency at Lancaster General Hospital. He special
izes in diabetes care and is a member of the American Diabetes Association.

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