Pre-Diabetes and Sugar   Frank Barnhill M.D.
 

Pre-diabetes is the new medical condition everyone is currently reading about and hearing about in the news. Pre-diabetes is an “early detectable condition” involving metabolic changes in our body occurring just before a person develops diabetes mellitus or “sugar diabetes”.

It is one of the newest of the endocrine “pre” disease states found to effect humans and quite a few doctors don’t even know of its existence. (Many of us have been treating it for at least ten years, even though it was only recently recognized as a serious disorder.)

Currently in excess of 6 % of the general population (2 million people in the United States) develop diabetes mellitus or sugar diabetes each year.

Diabetes Mellitus is the leading cause of kidney failure and accounts for about 7 to 8% of all legal blindness. Diabetes likewise doubles your risk of a stroke or heart attack and can cause nerve and small blood vessel damage in your feet.

It accounts for millions of hours of lost wages in the form of missed work and can lead to early disability in an otherwise healthy person.

Newly diagnosed diabetics spend over 200 million dollars on medical care each year.

What’s this about spending so much money on a little disease like sugar?

Diabetics require or may require:

All of this adds up to millions and millions of healthcare dollars spent each year on just one disease! (And it appears to be worsening!)

By detecting pre-diabetes, doctors have an opportunity to either delay or prevent a person’s progression to full blown medication requiring diabetes. Hopefully, this will save a lot of pain and suffering as all of those things discussed above may be avoided or put off into the distant future when a cure for diabetes is more likely. In addition, just think of the health care dollars you and your family would save by not developing diabetes.

As we get older, the part of our pancreas responsible for making insulin (Islet Cells) begins to loose its ability to make insulin sufficient enough to keep our blood sugars in the normal range of about 90 to 110. As this failure worsens, our bodies struggle to maintain normal blood sugars by temporally forcing the pancreas to secrete or put out more insulin. This just tends to make the situation worse, as eventually the pancreas just seems to “run out of insulin” and full blown diabetes results!

How is Pre-diabetes diagnosed?

The diagnosis requires blood testing.

You have pre-diabetes if your fasting (have not eaten for eight hours) blood sugar level is between 101 and 126 on two separate occasions.

Key Note: Unfortunately, a lot of doctors don’t understand the need for testing fasting blood sugars on two separate days!

Key Note Two: Over the counter and prescription medications, conditions such as stress and sudden illnesses and a multitude of other factors must be considered before labeling someone as “pre-diabetic”. So, a single blood sugar reading should not be used to make the diagnosis!

Early in pre-diabetes as your body struggles to secrete more insulin when insulin supplies and the ability to make insulin is dwindling, hypoglycemia or low blood sugars (a glucose of 60 to 70) can occur. So, needless to say, if your doctor checks your blood sugar at the wrong time and under the wrong conditions, he will incorrectly diagnose hypoglycemia instead of pre-diabetes.

Abnormal fluctuations in your blood sugar can cause:
mild irritability

Mild fatigue

Poor concentration

Sleepiness

Mild headache

Blurry vision

Poor infection resistance and healing

As we discussed above, your doctor will check two fasting blood sugars on two separate days and if your blood sugar is between 101 and 126, then you will be diagnosed as having pre-diabetes.

To see if a person is in what I cal “late stage pre-diabetes”, I often advise a three hour glucose tolerance test. This test requires you to drink a very sweet cola type drink that will raise your blood sugar rapidly. Blood and urine samples are then taken hourly and the results compared to normal to make a diagnosis. How your body handles this large “sugar load” will determine whether you are just pre-diabetic or truly in early diabetes.

Key Note Three: The most effective therapy for pre-diabetes involves you making “Lifestyle changes”.

Here are the things specialists agree you should do:

Stop smoking and using tobacco products.

Avoid excessive alcohol

Lose weight until you are at your ideal body weight or lower and keep it there

Exercise at least one hour five times a week

Eat a healthy low fat low sugar diet concentrating on complex carbohydrate intake

It’s often been quoted that by age 45 years, 2 to 3% of us will develop diabetes and by age 75 years the number will be closer to 20%. Hopefully, as we learn more about this “pre-disease state”, we can change these statistics dramatically and help improve the quality and life expectancy of millions of people.

Sideline information: Adult onset or type II Diabetes Mellitus or the type of diabetes that usually follows pre-diabetes is usually caused by muscle, bone, nerve and other parts of the body becoming resistant to insulin, despite the fact that excess insulin is found in the bloodstream. We now know that children can develop Type II Diabetes under certain conditions (very overweight, Black race). Therefore, it’s very important to diagnose pre-diabetes at as early a stage as possible. With proper treatment, we may be able to delay or prevent progression to the full blown disease in children who could require treatment for over fifty years!

Dr. Frank

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