A New Way To Prevent Type 2 Diabetes
Got prediabetes? Here's the proven way to keep it from progressing.
Prevention Magazine
By Sara Altshul
November 11, 2013
It can be hard to know what to make of a diagnosis of prediabetes, the usually symptomless elevated blood sugar that can be a precursor to diabetes. "Here's the wrong reaction: 'Whew, at least I don't have diabetes,' " says Matt Longjohn, MD, MPH, senior director of chronic disease prevention for YMCA USA. "Your reaction should really be 'Wow-I need to do something about this right now.' "
If you take action right away your chances of preventing the full-blown disease are excellent. But if you ignore your condition, you could end up with diabetes sooner than you think—and for the rest of your life, says Dr. Longjohn. Not convinced? Here's an attitude adjuster: For every 100 people diagnosed with prediabetes today, 10 to 15 will have diabetes next year.
You don't have to be one of them. There's now a proven way to keep prediabetes from escalating into diabetes itself. Multiple studies have confirmed that joining a coach-led weight loss program can prevent nearly 60% of people with prediabetes from developing diabetes. That number rises to 71% for those over 60, says I Dr. Longjohn.
There are two major programs like this rolling out nationwide, one from the YMCA and the other from the Diabetes Prevention Support Center at the University of Pittsburgh. The aim of both the YMCA's Diabetes Prevention Program and the University of Pittsburgh's Group Life Balance Program is to help you reduce your body weight by 5 to 7% and increase physical activity to 150 minutes a week. Often, when you've been diagnosed with prediabetes, that's all it takes to keep diabetes at bay. Both programs emphasize education and self-help to assist you in making enduring changes.
"The GLB Program is an evidence-based, behavioral-lifestyle intervention, and it gives you not only the information but also the tools to help you make healthy choices for the rest of your life," says M. Kaye Kramer, director of the Diabetes Prevention Support Center at the University of Pittsburgh. The yearlong program of group meetings teaches you how to develop and stick with healthy eating habits and helps you to become more physically active. The program also helps you identify and change behavior that may interfere with a healthy lifestyle and works with you on managing stress (which can raise blood sugar).
Participants in the Y's Diabetes Prevention Program meet in groups for 16 weekly 1-hour sessions—not necessarily at a Y—where a specially trained lifestyle coach helps participants focus on behavior changes such as eating more healthfully and getting active. After those initial sessions, the group continues to meet monthly for a year for added support.
That kind of group support—a crucial component of both plans—may be what really makes these programs work. "The secret sauce is that when people with similar health concerns come together for motivation and education, they end up holding each other accountable for their progress and finding solutions to common challenges," says Dr. Longjohn.
In some locations, the programs are offered free of charge, but those that do come with a price tag may be covered by insurance. The Y currently has about 400 program locations throughout the United States, while the GLB Program is available in 50 locations in 20 states and in several sites in Canada.
To find a prevention program near you, visit ymca.net/diabetes-prevention or diabetesprevention.pitt.edu.
The perils of high blood sugar
Here's why it's so important to take control of your prediabetes: When you eat, the carbohydrates in your food are turned into glucose (sugar), which circulates in your bloodstream. Insulin, a hormone that's produced in your pancreas, lets your cells absorb the glucose from your blood and use it for the energy they need to function.
If you have type 2 diabetes, your body doesn't respond as well to insulin, so the unused sugar builds up in your bloodstream. When you have prediabetes, you're not fully reacting to your insulin, but your blood sugar levels aren't as high (100 to 125 mg/dl or an A1C, a measurement of blood sugar over time, of 5.7 to 6.4) as they would be if you had full-fledged diabetes (126 mg/dl or above or an A1C of 6.5 or above).
High blood sugar is dangerous because it harms your blood vessels by lowering your level of nitric oxide, which keeps blood vessels open and supple. The result is narrowing, stiffening blood vessels, which can lead to high blood pressure and blood vessel damage—and may eventually cause heart disease, as well as affect your vision, your kidneys, and your ability to heal.
The damage to your blood vessels starts well before your blood sugar reaches the level at which type 2 diabetes is diagnosed. That's why docs are so keen on recognizing and treating prediabetes early—so you can stop or slow possible problems down the road.