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What is Prediabetes and How Can I Treat It

Leah Haak-Beck, a registered dietitian with Pullman Regional Hospital, explains what prediabetes is and how it can be treated.
What is Prediabetes and How Can I Treat It
Featuring:
Leah Haak-Beck, RDN
Leah Haak Beck has been fascinated with nutrition and food for most of her life.  Building on her innate curiosity for food and science, Leah enjoys working with patients to optimize health through evidence-based nutrition practices. She is passionate about food and community, and is fulfilled by collaborating with patients to apply individualized wellness strategies in a meaningful way.
Transcription:

Introduction: With a relentless focus on excellence in healthcare, Pullman Regional Hospital presents the Health Podcast.

Alyne Ellis: What is prediabetes? And is it reversible? Let's find out with Leah Haak-Beck, a Registered Dietician Nutritionist at Pullman Regional Hospital. Welcome Leah. So nice to talk to you today.

Leah Haak-Beck: Yes. Thanks for having me today. I'm excited to talk about pre-diabetes.

Host: Well, let's begin with what is prediabetes? I know that I've got friends who've got it. And I'm very curious.

Leah Haak-Beck: Yes, of course. So people with prediabetes have higher blood sugars than normal, but they're not quite high enough to be considered for a diabetes diagnosis. Prediabetes is really closely related to type two diabetes. Many of the contributing factors are the same, but what's really important to recognize is that if action isn't taken while you have prediabetes, many people will actually go on to develop type two diabetes as the disease progresses.

Host: How common is prediabetes in the United States?

Leah Haak-Beck: It's actually more common than you might think. According to the American Diabetes Association, one in three adults has pre-diabetes. So that's pretty significant, but what the kicker is, most people, according to the American Diabetes Association, 85% of adults don't even know that they have it.

Host: So, before we talk about perhaps any symptoms involving it, what are the risk factors for developing prediabetes?

Leah Haak-Beck: Yeah. So the risk factors for developing pre-diabetes are very similar, if not exactly the same as for developing type two diabetes, just because they're so closely related. Some of the most common ones that people may know already is having a larger body size or being overweight, having more fat storage around your middle or having a larger waist size, poor diet quality, not being physically active and having a family history of type two diabetes or prediabetes. Some that are maybe less known would be that some people of color are more likely to develop prediabetes or diabetes. We're not really sure why at this point, but it is something to keep in mind. Also, women who have a history of gestational diabetes or PCOS are more at risk, and then people who smoke or who have obstructive sleep apnea. So there's actually quite a few risk factors to be watching out for.

Host: And what about age? As we age, does our risk go up?

Leah Haak-Beck: Yes. The risk for developing type two diabetes or prediabetes actually increases around age 45. So it's important to make sure that you're getting screened around this age, or if you have some of those risk factors that I talked about earlier.

Host: And continue to be screened too, not just one.

Leah Haak-Beck: Yes, absolutely

Host: So, what about signs and symptoms. You mentioned that most people don't know they have it. So I'm assuming there are no signs and symptoms or is that true?

Leah Haak-Beck: Yeah, for many people, they actually don't have any symptoms or they're so mild that they may not even notice. And so this is why many people don't know that they have it. And once the person starts to develop symptoms, this may actually mean that the disease has progressed to a diabetes diagnosis. Some of those symptoms that some people may experience at the prediabetes state would be increased thirst and urination, blurred vision, excessive hunger, or fatigue.

Host: Also, while you are in that state of pre-diabetes, I know that it can be doing you harm even before it gets to the diabetes stage. And maybe you could talk a little bit about that.

Leah Haak-Beck: Yes, of course. So having higher than normal blood sugars is harmful, no matter at what stage you're at. So there's risk for damaging tissues when the blood sugar is high, we want to make sure that we're managing it as soon as we can. So if you're diagnosed sooner, you can help reduce the risk of poor outcomes from your prediabetes or diabetes.

Host: So, for example, it could damage your eyes and you might not notice it particularly, but that damage may not be reversible. Is that correct?

Leah Haak-Beck: It's possible. Yeah. We see most of these poor outcomes in folks who have a diabetes diagnosis and more commonly when the disease is more progressed or the blood sugars are really quite high. Prediabetes, we don't see as many complications, but they are starting. The damage is starting to be done. Prediabetes and diabetes are progressive diseases. So by the time you have a diabetes diagnosis that high blood sugar has been doing some damage to your body,

Host: So how do you get tested for prediabetes?

Leah Haak-Beck: You would want to make sure that you're seeing your healthcare provider regularly. And usually it involves some sort of blood test. There's different ways that your doctor can do that. There's one called a fasting blood sugar. There's one called an A1C or a glucose tolerance test. I see A1C being used most commonly as this gives us a picture of what a person's blood sugar has been doing on average over about three months. So it really gives us some good insights as to what's been going on.

Host: Those tests are diagnosed with a blood test. Is that correct?

Leah Haak-Beck: Correct.

Host: Is prediabetes reversible?

Leah Haak-Beck: Yes. So because we're at the beginning, part of the disease progression, it is possible to lower your A1C back down to that normal amount. It's important to remember though, that there are no quick fixes when it comes to prediabetes or preventing that diabetes progression. Lifestyle changes are going to be the most important thing that can help you with that. And it's important that they're sustainable. So going on a crash diet or doing crazy exercise for one month is not necessarily going to reverse anything, especially not long-term, because if you go back to old habits or some of those risk factors that you can control, like your diet quality and activity level, if you go back to maybe some old habits for a long amount of time, those blood sugars could kind of creep back up

Host: For an example of a diet change. I know they're far more than what I'm about to give you, but that would be not having nearly as much sugar for example, and not as many carbohydrates, which I believe can convert to sugar, is that correct?

Leah Haak-Beck:

You know, nutrition is really tricky and very individualized for each person. So there are some kind of blanket statements we could make, but I think it's really important to consider that everybody's different and everybody is going to manage their diet or nutrition in a different way. I would actually recommend if you do have a prediabetes diagnosis to ask for a referral for a dietitian, that way you can have somebody on your team to help you work through what some of these changes could be for you that are going to work for you personally

Host: And besides diet and exercise. Is there anything else that can help with this condition?

Leah Haak-Beck: Diet and exercise are really the main things that we know make a really, really big impact on those blood sugars with prediabetes. However, there are some other changes you can make. For example, if you're a smoker, you can quit smoking. Working on your cardiovascular risk factors. So prediabetes and diabetes are closely related to heart disease or cardiovascular disease. So if you've got high blood pressure or high cholesterol, something like that, you can work on those as well. Some people may need to take a medication, but that would be up to them and their provider. It really is different for each person.

Host: Leah, thanks so much for your time and all your helpful information. That's Leah Haak-Beck, a registered dietician nutritionist at Pullman Regional Hospital. To learn more about this subject and the providers and services at Pullman Regional Hospital go online to pullmanregional.org. If you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is the Health Podcast from Pullman Regional Hospital. I'm Alyne Ellis. Thanks for listening.