Diagnosing and managing prediabetes

Kay Reed is a tall, lean, fit-looking woman who just turned seventy. She’s an avid hiker and has enough energy to keep up with her four grandchildren, two of whom live in Tucson.  She loves her grandkids more than anything, and the feeling is mutual. Grandma Kay plans to be around for a long time and watch them grow up.

She appears to be the picture of clean living and excellent health, which is, for the most part, true. What you can’t tell by looking at Kay is that she is prediabetic. How did Kay find out? And what does this mean for her?

For starters, there’s family history to consider.

Kay’s paternal grandfather had adult onset diabetes, also known as type-two diabetes. He developed type-two diabetes before the era of insulin replacement. which probably contributed to an earlier-than-expected death. A person with type-two diabetes has a pancreas that produces little or no insulin, leading to dangerously high blood-sugar levels.

This type of diabetes differs from type-one diabetes, which typically starts in youth, which is why it used to be known as “juvenile diabetes”.  In type-one diabetes, the pancreas makes no insulin, and blood sugar must be monitored daily, and regular injections of insulin are required to maintain a healthy blood level.

Kay’s father had adult onset diabetes as well, but he was able to keep his blood sugar in check through the use of various medications, and did not need to take insulin. He lived to be 90, but his cause of death was likely partially related to complications from diabetes.

Because of her family history, Kay thought it was smart to check some bloodwork done to see if she too was prediabetic. So she requested an A1C test to check her glycohemoglobin. This is different than a regular blood sugar test in that it shows a person’s blood sugar levels over a period of several months, rather than simply what one’s current glucose level is. As blood sugar levels can vary throughout time, even in a matter of hour, this test gives a much clearer picture of a person’s glucose levels.

Sure enough, the test results showed a sustained increase in glucose levels over an extended period, and Kay is now clinically prediabetic. She will continue to get regular glycohemoglobin tests to track her blood sugar, and to see if her lifestyle changes are helping her stay as healthy as possible.

So what changes has this already healthy woman made? She already ate little junk food, and mainly consumed whole grains, vegetables, fruit, and some fish. Now, she avoids white flour, refined sugar, animal fat, and tries to get more exercise. “I’ve always tried to eat healthfully, but this has made me even more conscious about my diet. I’m a bit stricter with myself. Also, I know that a daily walk will really help me keep my blood sugar under control.”

“Interestingly, I don’t crave sweets as much as I used to, but I do love a little piece of dark chocolate every day.”