Diabetes, more especially type 2 diabetes, is emerging as one of the 21st century’s most difficult medical issues. It is also anticipated that 380 million individuals globally will receive a diabetes diagnosis by 2025. Diabetes management and treatment are increasingly important because it is a risk factor for many other diseases and chronic health conditions, including stroke, kidney disease, cardiovascular disease, and blindness, to name a few. However, many people are thought to be in a precursor stage known as prediabetes before they go on to develop type 2 diabetes. People with this illness have blood sugar levels that are higher than normal but not high enough to be classified as type 2 diabetes. However, a significant risk factor for type 2 diabetes is prediabetes. The statistics of those who have prediabetes provide a clear picture when it comes to scaling this issue: more than one in three persons in the U.S. S. along with the U. K. have been identified as prediabetic. Therefore, if prediabetes is considered an early warning sign of type 2 diabetes, people can take steps to reverse the course of this condition and it is possible to reverse this condition with significant lifestyle changes.
On our May podcast, “In Conversation: Can diet and exercise help reverse prediabetes?” Dr. Thomas Barber, an associate clinical professor at Warwick Medical School and consultant endocrinologist at University Hospitals Coventry and Warwickshire, joined Dr. Hilary Guite and me. Additionally, Healthline Media and Medical News Today Managing Editor Angela Chao shared her personal story of reversing her diagnosis of prediabetes and the lifestyle changes she made to maintain it. In Angela’s instance, few medical professionals would have thought that her blood sugar levels were concerning. She is not thin, young, and energetic like most people with prediabetes or those at risk of getting diabetes. She did, however, admit that at the time she led a fairly sedentary lifestyle. She said that because my readings were so low on the spectrum, I don’t even think my primary care physician at the time talked to me about it beyond providing the range and the diagnosis. She did, however, add that some doctors and her medical friends seemed concerned about the changes to the cutoff point for readings that qualified as prediabetes.
According to Dr. Barber, the diagnosis of diabetes and prediabetes was previously made using fasting glucose readings or a conventional glucose tolerance test. In this test, participants were given 75 grams of a sugar-filled beverage, and their blood sugar levels were monitored for the following two hours. Additionally, the definition of prediabetes is constantly changing and may vary from nation to nation. Definitions vary amongst societies and prestigious organizations. According to Dr. Barber, the first thing to really keep in mind is that there is a continuum involved when discussing diabetes or prediabetes. Should we choose the U. S. along with the U. K. For instance, there are variations in the thresholds and units of measurement applied when diagnosing prediabetes. As you point out, there are various units, which makes it a little confusing. However, in essence, in the U. K. for glucose, we use millimoles per liter, and in the U.S. S. milligrams per deciliter, to be exact. We typically use millimoles per mole in clinical settings now, and we have for a while, according to Dr. Barber. He went on, “I think that further complicating matters is the hemoglobin A1C, which has two different percentage units, one that we have historically used and the other that is now replaced by millimoles per mole.
According to Dr. Barber, glucose is a continuous variable rather than a discrete measure. He clarified that while everyone can agree on what is elevated and what is normal, there are kind of disagreements about everything in between. The World Health Organization approved hemoglobin A1C as a test for diabetes a few years ago. While additional glucose readings can be useful, Dr. Barber stated that medical professionals do primarily rely on A1C in current clinical practice. With regard to prediabetes in the U.S. K. this is predicated on an A1C of 39 to 47 mmol per mol; according to him, 39 is equal to an A1C of 5 points 7 percent. Anything that raises the hemoglobin A1C level above 48 millimoles per mole, or 6.5% of the baseline, is considered diabetes by definition. According to him, in order to diagnose type 2 diabetes, we should ideally have at least two of those readings that are elevated. When Angela was diagnosed, her A1C was 5 points8 percent, and anything above 5 points7 was considered prediabetes. Dr. Barber reminded us that, in the United States, Angela’s readings would not have been regarded as prediabetes and that, in recent years, the diagnostic criteria for diabetes have gradually decreased. K. at the time, since the values were extremely near to normal and not quite below the cut-off.
Usually, prediabetes shows no symptoms at all. On the other hand, some people may occasionally have frequent thirst, wake up in the middle of the night to urinate, experience blood sugar spikes, or have energy crashes. Prediabetes is frequently asymptomatic, so many people who are diagnosed with it may have had it for months or even years. Furthermore, it can easily go unreported unless people are tested for it, according to Dr. Barber. In describing her personal experience, Angela said, “I definitely didn’t have a wide range of symptoms.”. On the other hand, I was definitely already drinking water on a regular basis. I therefore found it difficult to determine whether anything was changing. Low blood sugar, particularly if she went for prolonged periods without eating, was something she did notice prior to the diagnosis. Over the years, she said, there has been a consistent pattern of significant fluctuations in her blood sugar levels, which she could feel physically. She can, however, fast trouble-free for more than 16 hours now because of certain lifestyle adjustments. Sugar surges and falls may be considered preemptive indicators of diabetes.
According to Dr. Dot Barber, prediabetes is a general term that can refer to either elevated fasting glucose or elevated postprandial glucose. Dr. Dot Barber stated that fluctuations in blood sugar levels, or glycemia, were often observed in the context of insulin resistance. Glucose levels tend to rise a little higher than they should, he explained, because the beta cells can’t produce enough insulin, for example, or the insulin isn’t as effective after a meal. He explained that without careful monitoring of blood sugar levels throughout the day, people might not physically notice these changes. “I guess the difference really is that most of the time, in the context of prediabetes, we’re not aware of this,” he said. It makes perfect sense that as you lead a healthier lifestyle, lose weight, and reverse prediabetes, your blood sugar levels will stabilize. He mentioned Angela’s description of the changes she saw and said that the insulin becomes more effective and can handle the fluctuations in glycemia better.
Obesity, having a high body mass index, and being overweight are some of the most well-known risk factors for type 2 diabetes. Additionally, as we age, our vulnerability increases. And the reason for that is that as we age, the beta cells and insulin’s receptors can no longer function as well, and insulin itself becomes slightly less effective. Accordingly, as we age, our chance of having prediabetes and diabetes rises, according to Dr. Barber. Dr. Barber added that eating a diet heavy in high-glycemic foods and sugary drinks, as well as stress, can all raise risk. Conversely, he asserted that a diet low in simple carbohydrates and high in fiber can delay the onset of dysglycemia. Genetics and ethnic origin are other factors to consider. Dr. Dot Barber presented the results of a recent study she and her colleagues carried out in the U. K. which revealed that, at a BMI of 23.9%, individuals of South Asian ethnicity had the same risk of developing diabetes as did white people at 30.
In contrast, Angela’s risk was increased by her family history. My mother, a retired medical doctor, had warned me since I was a teenager about the slight family history of type 2 diabetes on my father’s side. She also mentioned that everyone on that side of the family was thin and had no weight problems. Dr. According to Barber, diabetes is frequently attributed to lifestyle decisions, but many people are unaware that it is a hereditary disorder. According to him, patients with a strong family history may not always exhibit the characteristics of type 2 diabetes, such as being middle-aged, male, obese, and having a large abdomen. That’s the idea that most people with type 2 diabetes have of the typical person. And, he added, as you say, Angela doesn’t conform to any of those stereotypes of what that entails. Dr. Barber also emphasized that having a genetic predisposition to diabetes at birth can result in dysglycemia even in the absence of those other factors. More than 40 genes and gene mutations have been found to increase your risk of developing type 2 diabetes. Additionally, he stated that even though each effect is relatively weak on its own, adding them all together can have a cumulative effect. Through a combination of intermittent fasting, a balanced diet with an increased amount of lower-glycemic index foods and complex carbohydrates, and a sig, Angela was able to reverse her diabetes.
She advised against strict dieting, keto, and quick, drastic changes that aren’t long-term. Dr. Barber acknowledged that while this approach obviously worked for Angela, not many people would be able to make such drastic life changes and may find it challenging. According to Dr. Barber, there is evidence to suggest that intensive lifestyle treatments that prioritize diet, physical activity, weight loss, and other related factors can effectively prevent or postpone the onset of type 2 diabetes. In my opinion, it serves as a kind of early warning system that indicates when a person needs to make a lifestyle change. He added that it must be beneficial if it inspires or motivates people to alter their way of life.
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