Nolan Alexander (Host): Welcome to the Kirby Connections Health Podcast, where we help you nourish your wellness journey with Kirby Medical Center. I'm Nolan Alexander. And on this episode, we'll talk about pre-diabetes with Dr. Lauren Fore, a primary care medical officer and KMG Medical Director. Lauren, thank you so much for joining us. How are you today?

Lauren Fore, MD: I'm doing very well. Thank you for having me.

Host: It's our pleasure. So, let's establish the basics here. What is pre-diabetes?

Lauren Fore, MD: Yes. So, pre-diabetes means that someone's blood sugar levels are higher than normal, but not high enough to be diagnosed as diabetes. It's usually detected through routine blood tests like an A1c or a fasting blood sugar. Pre-diabetes happens when the body begins to develop insulin resistance. Insulin is that hormone that helps move sugar from the bloodstream into the cells where it can be used for energy.

But when the body becomes resistant to insulin, sugar starts to build up in the bloodstream. Pre-diabetes is incredibly common. In fact, about one in three adults has pre-diabetes, and most people don't even realize it. I would say that, in my practice, I am diagnosing at least one new case of pre-diabetes every week.

But the good news is that pre-diabetes is one of the few health conditions where early action can truly make a big difference. With some small lifestyle changes, many people can prevent or delay developing diabetes.

Host: Is it really that common, one in three adults?

Lauren Fore, MD: Yeah, it's incredibly common. It's really surprising how often we're coming across pre-diabetes these days.

Host: So, who's at risk for developing pre-diabetes?

Lauren Fore, MD: Yes, there are some risk factors that make someone more likely to develop pre-diabetes that increases their risk for this. So, these include family history of having diabetes, being overweight, having a sedentary lifestyle. Even having a history of gestational diabetes during pregnancy can increase your risk. There's also some conditions like PCOS or polycystic ovarian syndrome that increases someone's risk of developing pre-diabetes, or just increasing age can.

Host: So, what are the signs and symptoms that people should look out for?

Lauren Fore, MD: The challenge is that most people with prediabetes have no symptoms, which is why routine screening and regular visits with healthcare providers are so important. Without changes, about 15-30% of people with pre-diabetes will go on to develop diabetes within just five years, and that's pretty significant.

Diabetes can then increase the risk of developing complications like heart disease, kidney disease, nerve damage, or even vision problems. But the encouraging part is that pre-diabetes can often be reversed or improved with lifestyle changes. This is really an a window of opportunity to make adjustments that can have long-term benefits.

Host: I do want to ask you about those lifestyle changes. But before I do, Dr. Fore, it just seems like having a regular cadence of visiting a medical provider is so important if there are no signs or symptoms most of the time.

Lauren Fore, MD: Right. That is why it's so important to have those routine appointments and to get that routine wellness lab work. A lot of insurance companies will cover those routine screenings every year, so it's important to take advantage of that.

Host: Oh, that's great. Okay, so there's lifestyle changes. What changes can help with pre-diabetes?

Lauren Fore, MD: Yes. The good news is that small lifestyle changes can make a very big impact when it comes to prediabetes. So, research has shown that losing just 5-7% of body weight can reduce the risk of developing diabetes by more than half. And there are a few areas that really matter.

So, the first is nutrition. It's important to focus on whole balanced foods, so that means increasing vegetables, fiber, lean protein, and whole grains while also trying to cut back on those highly processed foods and sugary drinks. Even small changes like swapping out a soda for water or adding more vegetables to meals can really help improve blood sugar control.

And also, physical activity is very important. Exercise helps your body use insulin more effectively. So, the general recommendation is about 150 minutes of moderate activity every week, and that could be something as simple as a brisk walk for 30 minutes on most days of the week. Strength training is also really important and helpful, because muscle actually helps your body process glucose more efficiently.

Sleep and stress also play an important role in blood sugar regulation. Poor sleep and chronic stress can increase insulin resistance, so really prioritizing rest and stress management can make a difference. I often really like to remind my patients that improving metabolic health doesn't require perfection. It's about consistent small steps.

Host: And with that, it's probably important to get off to a good start, right? And establish some momentum so you can be consistent and maybe have a routine too.

Lauren Fore, MD: Yes, exactly. I always say we're not going to change everything overnight. Start with evaluating where we are, and then we can develop a plan to move forward. Small consistent steps.

Host: That's key, in just about everything we do, especially for what you said and changes for pre-diabetes diagnosis. In addition to that, I'm just curious, are there any medications that can treat pre-diabetes?

Lauren Fore, MD: As far as medications, there are some cases that medications such as metformin may be recommended, particularly for people at higher risk. However, lifestyle changes are really the foundation of treatment. And many people can significantly improve their blood sugar simply through changing healthy habits.

Host: Well, this has been so informative today. Is there anything else that you want to add to the topic of pre-diabetes?

Lauren Fore, MD: Yeah, I would just like to say, I think, the most important thing to remember is that pre-diabetes is not a failure. It's an opportunity. It's a signal from the body that now is a good time to make some changes that can protect your long-term health. So if you've been told that you have pre-diabetes, I would just encourage people to talk to their healthcare provider about the steps that you can take. Because even small changes can lead to really big improvements over time.

Host: I love that frame of mindset. Thank you so much for joining us today.

Lauren Fore, MD: Yeah. Thank you so much for having me.

Host: That was Dr. Lauren Fore. For more information, go to kirbyhealth.org/providers. If you enjoyed this podcast, please share it on your social channels and check out the entire podcast library for topics of interest to you. And this is the Kirby Connections Health Podcast. Thanks for listening.