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TKristen Nichols Heitmanhis is a guest post by Kristen Nichols Heitman, MPH, an epidemiologist in the Rickettsial Zoonoses Branch in the Division of Vector-Borne Diseases in the National Center for Emerging Zoonotic and Infectious Diseases at the Centers for Disease Control and Prevention (CDC). She received a Master of Public Health (MPH) with a concentration in epidemiology from Georgia State University.




Pre diabetes Primer 1

You may know something about diabetes, but do you know what prediabetes is? Before people develop Type 2 Diabetes, they almost always have “prediabetes,” a condition that occurs when your blood sugar level is higher than normal, but not high enough yet to be diagnosed as Type 2 diabetes. Your blood glucose depends on a variety of factors, including food, medication, exercise, hormones, stress and many more. These factors can be extremely difficult to manage and control. Prediabetes increases your risk of Type 2 diabetes, heart disease and stroke. More than one out of three American adults have prediabetes – that’s 89 million people! Diabetes and prediabetes are expensive conditions to treat. Costs in the United States have increased from $174 billion in 2012 to $322 billion per year, which equates to 20 percent of all healthcare dollars in the United States! Here’s what you need to know about prediabetes:

pre diabetes primer 2

Know the risk factors
Certain risk factors indicate a higher risk of developing prediabetes and Type 2 diabetes. You can also take the CDC’s quiz to see if you’re at risk.

  • Age, especially those over 45 years old
  • Being overweight or obese (BMI higher than 25)
  • Storage of more fat around the waist than the hips. You can measure this risk factor by checking if your waist is 40 or more inches if you’re male and 35 inches or more if you’re female.
  • Having a family history of diabetes
  • Having an African American, Hispanic/Latino, American Indian, Asian American or Pacific Islander racial or ethnic background
  • History of diabetes while pregnant (gestational diabetes) or having given birth to a baby weighing nine pounds or more
  • Being physically active less than three times a week

Prediabetes is mostly asymptomatic, so a whopping nine out of ten people with this condition do not know they have it. This is important because without a change in behavior, prediabetes can lead to Type 2 diabetes. Some symptoms associated with prediabetes (and early stages of diabetes) include: being hungrier than normal; weight loss despite eating more; being thirstier than normal, frequent urination and feeling more tired than usual.

Get tested
See your healthcare provider to get your blood sugar tested. It’s a simple blood test and knowing your results is the first step to maintaining your health. Doctors recommend that prediabetes screenings generally begin at age 45, but sometimes sooner if you have other risk factors. Additionally, some employers may offer free health screening events or free at-home testing kits for their employees. Some employers may even offer diabetes management programs.

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Learn how to manage it
If you test positive for prediabetes, the good news is that it can be reversed. Losing weight by eating healthy and being more active can cut your risk of getting Type 2 diabetes in half. Your goal should be to lose 5–7 percent of your body weight, which would be 10 to 14 pounds for a 200-pound person, and get a least 150 minutes each week of physical activity, such as brisk walking.

Without weight loss and moderate physical activity, 15-30 percent of people with prediabetes will develop Type 2 diabetes within just five years. People who have diabetes are at higher risk of serious health complications like blindness, kidney failure, heart disease, stroke and loss of toes, feet or legs. If you can control prediabetes and diabetes, you have a better chance of lowering your risk for other r costly diseases like heart disease, stroke and kidney disease.

How employers can help their workforce
A study by the Diabetes Prevention Program (DPP) showed that healthy lifestyle changes, which included 7 percent weight loss and at least 150 minutes of physical activity per week, reduced the incidence of diabetes by 58 percent compared to people with no changes. Additionally, lifestyle changes were significantly more effective than people taking metformin, the first-line medication used to treat Type 2 diabetes.

More and more employers are offering health or diabetes-related programs based on the results of DPP and having a direct, positive impact on employee health. This will also reduce healthcare costs – an employee with Type 2 diabetes burdens a company with approximately twice the medical costs as one without. Other positive effects of diabetes prevention go beyond the obvious. Research shows that individuals who maintain a significant weight loss experience higher energy levels, more physical mobility, improved mood and greater self-confidence. Increasing employee awareness of prediabetes can also result in increased performance of exercise and weight management behaviors and, most importantly, decreased risk of future diabetes.


The conclusions, findings, and opinions expressed by the author do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors’ affiliated institutions.

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