According to the American Diabetes Association, nearly 26 million people, or over 8% of Americans, have type II diabetes. Of these, 7 million remain undiagnosed. And, the ADA says another 79 million Americans – 1 in 4 of us – are prediabetic, meaning that without significant diet and lifestyle changes, there could be more than 100 million diabetics in the US in the foreseeable future. Given these statistics, there’s a good chance that prediabetes is of concern to you or someone you care about, and knowing more about it is, or will be, important to you.
One difficulty in detecting type II diabetes and prediabetes is that the warning signs are usually imperceptible. The classic diabetes symptoms of unquenchable thirst, excessive hunger, and weight loss usually only occur in type I Diabetes, while most people find out about the more common type II diabetes from blood tests ordered by their doctor or health-care professional. Unfortunately, patients aren’t told when their blood work indicates that they may be on a path towards diabetes, and they only find out once they are already diabetic.
What are the signs that your body may be on a path to developing blood sugar problems? The first, and most obvious, warning sign is an expanding waistline. We’ve all grown accustomed to the stories in the news about America’s growing belt size, and there is real reason for concern: A waist circumference (measured at the level of the belly button) of greater than 40 inches in men, and 35 inches in women, is one clear warning sign for prediabetes.
There are two blood tests your doctor is likely to check to see if you have a diabetic tendency. If either or both of your fasting blood sugar or hemoglobin A1C are elevated (greater than 100 mg/dL and 6.0%, respectively) your blood sugar may not be under ideal control. Both of these tests give insight into whether your body is processing glucose efficiently, which is the hallmark of both diabetes and prediabetes.
In addition to these more obvious signs, there are other findings that your doctor may not realize are indicators of inadequate blood sugar metabolism. Remember, just one or two of these signs by themselves are not as important as when several of them are all pointing toward a prediabetic condition.
Fasting triglycerides (TGs) are fats in your blood that are usually measured at the same time as cholesterol. When your TG level is over 150 mg/dL, sluggish glucose metabolism may be to blame. Low HDL cholesterol is another similar indicator, and in many people low HDL and high TGs occur together. In fact, many clinicians use the ratio of TG:HDL cholesterol to look for a prediabetic tendency. A TG:HDL ratio of greater than 4:1 is often associated with other warning signs.
Occasionally, uric acid or liver enzymes (AST and ALT) will also be elevated in prediabetes, but these almost never occur alone.
Finally, if your blood pressure is over 130/90 on more than one occasion, ideally taken when you are relatively relaxed, you should check these other signs to see if that is part of a prediabetic pattern.
It’s essential that you work with your doctor or health-care professional to understand these tests and your risk of diabetes; this isn’t something you can diagnose on your own. By partnering with your whole health-care team, you can take on the diet and lifestyle changes necessary to prevent diabetes.