Prediabetes Risk Factors

5 Signs You Might Be at Risk for Diabetes
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Incredibly, one in four Americans over age 20 has prediabetes -- and most don't even know it. Being prediabetic means that your blood glucose levels are higher than normal but short of being classified as diabetic levels. Studies show that most people with prediabetes go on to develop type 2 diabetes within 10 years, unless they lose weight and make dietary and exercise changes.

Because prediabetes develops gradually over years, it's often said that there are no obvious symptoms. But it's possible to notice certain warning signs of growing insulin resistance, the inability to process the energy in food properly that's a key aspect of prediabetes, says Beth Reardon, director of nutrition for Duke Integrative Medicine at Duke University.

Paying close attention to such warning signs gives you plenty of time to make changes before the situation progresses to type 2 diabetes, she says.

"These symptoms usually occur in tandem with one another; together they create a bigger picture that says insulin resistance is going on," Reardon says. "Some signs can be measured, some we feel, some we can just see."

If you're experiencing the following signs, you should ask your doctor about an insulin response test to measure your insulin and blood sugar levels. If the tests confirm that your body is starting to have trouble managing its glucose, it may be incentive for you to commit to the diet and exercise changes that can help move you away from the path toward diabetes.

What Feeling Tired and Sluggish After Eating Might Mean

Ready to nap right after a big meal? This is a normal response to an influx of carbs (think of that post-Thanksgiving dinner feeling). But if it happens often, your body may be sending a message that your diet is too diabetes-friendly.

After eating, all carbohydrates -- whether in a doughnut or a carrot -- are broken down into the bloodstream as glucose (blood sugar), the body's main energy source. When the blood containing the glucose hits the pancreas, this organ gets the message to release insulin, a hormone it produces to help the cells throughout the body use glucose. Cells have insulin receptors that allow glucose to enter and either be stored as future energy or used right away.

It's a great system. But a diet that's high in simple carbs like sugar, white flour, and sweet beverages -- especially when consumed in large quantities at one sitting -- overwhelms it. According to Reardon, the cells' insulin receptors eventually stop receiving the insulin, which means they can't take in the glucose. The glucose builds up in the blood while the needy cells don't get any. The pancreas, meanwhile, notes the glucose level is still high in the blood that flows through it, and it pumps out still more insulin in response. Net result: You feel sleepy and may find it hard to think, because your brain and body are depleted until the system rights itself.

"Over time, this cycle can cause someone to become chronically insulin resistant. The body simply can't keep up with the demands that all those simple sugars and fats are placing on it," Reardon says.

What helps: Slow your carb load. Choose more complex carbohydrates, such as whole grains (barley, oats, quinoa, spelt, brown rice), vegetables, and whole fruits (not juices) that the body has to work harder to digest. This means blood sugar stays stable longer. Move around right after eating -- take a 15-minute walk; even washing the dishes helps -- rather than plopping in front of the TV. The activity will help your body begin to process the big glucose intake faster and more efficiently. In fact, a Mayo Clinic study presented at the 2011 American Diabetes Association annual meeting reported blood sugar levels rose only half as much after eating in a group that was moderately active after a meal, compared to a control group that ate, then rested.

What Carb Cravings Might Mean

Among the most craved foods: chocolate, chips, and French fries. They're loaded with sugar, salt, and fat -- three substances that taste so good, they light up the reward system of the brain, which begs for more, more, more.

But what happens next in the body can be dangerous, says nutritionist Beth Reardon. Simple carbs such as sugars and white flour break down very quickly, providing a fast hit of energy. Soon, however -- because the insulin-resistant cells essentially ignore this entry of glucose into the blood -- the pancreas overcompensates, releasing more and more insulin to handle the glucose. What follows is a dramatic drop in blood sugar as the extra insulin quickly shuttles the glucose to the cells -- and energy levels plummet. The body is caught in a wave of fatigue. So, naturally, it craves another quick hit of energy to bring blood sugar back up. The brain becomes obsessed with this mission. And before you know it, you're reaching for a pick-me-up guzzle of soda, another handful of pretzels, a second cookie (or three).

People get sucked into a vicious cycle before they realize it, getting hooked on problematic foods they think they're craving -- while gaining weight.

What helps: Kick your food cravings. It's challenging, but one starting place is to avoid triggers that you associate with these foods. Just seeing a fast-food sign or the cookie package in your cupboard can be enough to set off the pleasure system in the brain that fixates on having the craved food.

Instead of quick-hit snacks like candy bars or chips, substitute slower-to-digest choices, like a handful of nuts, a banana, or raw carrots dipped into a tablespoon of peanut butter, which will keep you feeling sated longer. Be persistent: It can take as many as a dozen "successes" in resisting an old craving before your new habit is established.

How Being Overweight Might Put You at Risk for Diabetes

Most prediabetics carry excess weight, says Duke University's Beth Reardon. That fact alone is a major risk factor for diabetes. But especially worrisome is when you try to cut back on calories and still can't see the scale budge. Stubborn weight loss despite best efforts can be the result of mixed messages that our cells are receiving, Reardon says. "The cells are starving because the fuel they need (in the form of glucose) is not being absorbed at the insulin receptor site on the cell. In the face of a perceived fuel shortage, the body will hold tightly onto existing stores of energy -- fat," she says. What little is absorbed also goes straight into storage -- as more fat.

What helps: Incremental change. Don't think, "OMG, I have to lose 50 pounds; I can never do that." Instead, think small. Losing just 5 to 7 percent of body weight prevents or delays diabetes by 60 percent, according to the Diabetes Prevention Program (DPP), a major multicenter research study. People over age 60 see even greater benefits, according to the DPP. Five percent of body weight translates to just 10 pounds for a 200-pound person. A combination of lifestyle changes (especially changes in diet) and medication is often needed to address weight loss in these circumstances.

What It Might Mean if You Look More Like an Apple Than a Pear

Weight gain is weight gain, and all of it risks moving you down the path toward diabetes. But added pounds in one particular area -- the midsection -- are especially associated with insulin resistance and prediabetes.

Weight gain around the waist and abdomen (visceral fat) is considered more dangerous than extra padding in the thighs and rear. So-called "belly fat" is linked to a higher rate of high blood pressure, heart disease, stroke, and dangerous cholesterol levels -- all risk factors for diabetes. Having an apple-shaped middle has also been linked to Alzheimer's disease.

For men, the danger point is considered to be a waist circumference of 40 inches or more; for women, the dangerous measurement is a waist of 35 inches or more.

What helps: Diet, weight loss -- and exercise. The third leg of a diabetes-thwarting approach is moving. It's not true that sit-ups and other abdominal exercises will target belly fat. (Though they do build muscles.) Exercise plays a critical role because when you build muscle, you increase the number of enzymes that are able to metabolize glucose as a fuel source for those cells, nutrition expert Beth Reardon says. Aim for 30 to 60 minutes of moderate exercise (like a brisk walk) most days of the week.

How High Blood Pressure Might Put You at Risk for Diabetes

High blood pressure is linked to many different conditions. But prediabetes may be the cause when it appears in tandem with excess weight gain (especially around the middle), fatigue, and other negative numbers on a medical workup (abnormal cholesterol levels and high triglycerides). Many people with high blood pressure worry about their heart without recognizing that the presence of hypertension -- along with these other signs -- is a neon red sign for prediabetes.

The numbers to beware: blood pressure equal to or higher than 130/85, an HDL "good" cholesterol level below 40 mg/Dl for men and below 50 mg/Dl for women, and triglycerides of 150 mg/Dl.

Blood pressure elevates in part because of inflammation, a damaging cascade of events in the body that high insulin levels contribute to. "Blood becomes stickier and more viscous, and blood clotting factors increase, making it more difficult for the body to move the blood around," Duke University's Beth Reardon says. "Insulin also has an effect on the pliability of blood vessels, making them less elastic and therefore less able to respond to changes in pressure. This, in combination with blood that doesn't flow as easily, results in elevated blood pressure."

What helps: Losing weight slowly through dietary changes and increased exercise.

Paula Spencer Scott

Paula Spencer Scott is the author of Surviving Alzheimer's: Practical Tips and Soul-Saving Wisdom for Caregivers and much of the Alzheimer's and caregiving content on Caring. See full bio

9 months, said...

Pharmaceutical companies have been trying to shut these doctors down simply for revealing the truth about diabetes. Scientific studies have proven that type 2 diabetes can be reversed naturally - but this information has been hidden and suppressed for decades. Diabetics can normalize blood sugar, and be taken off all medication and insulin injections completely naturally. Learn about their diabetes busting methods Watch the video here:

almost 2 years, said...

This is the exact natural remedy I followed to get rid of Chronic Fatigue Syndrome naturally ( ). You'll be absolutely thrilled with the step-by-step plan that guides you through the ultimate solution to get rid of Chronic Fatigue Syndrome, that you'll only have one regret -- and that is this: Not having had this valuable resource years ago!

almost 2 years, said...

Hello i would like to know if anyone has experienced getting extremely sleepy, tired, brain fog, pain in their muscle, stomach pain nausea, after eating or during? I don't hve to finish the meal bfore i am out. I eat healthy, drink lots water, i do know it's getting much worse. I just don't know what it is i am dealing with. PLEASE HELP. SINCERELY RACHEALL

about 2 years, said...

I know I am at risk for diabetes because my mother developed it later in life, in her 40's. I will be 50 in a couple months and I DO have the tiredness after eating, and none of the other signs listed, but, I am also going though menopause, have not has a 'cycle' in 18 months.. Now, I think, it may me something more than just, the diabetes possibility going on because usually most women gain weight during menopause, and I just keep losing (yes I know that is also a sign of diabetes.) So I am a little confused as to which it could be more related to.

over 3 years, said...

sources of data. eg, in the next to last paragraph author lists several numbers to watch out for, but no reference for where she got them from, and as you know, danger ranges often differ depending on who you're reading. otherwise very good!

over 4 years, said...

I feel sleepy after eating, and this is GOOD info! I'll continue to shift away from sweet foods and fats, and go ahead and take that walk after a meal!

over 4 years, said...

One other thing to consider is if you take a statin drug for cholesterol, it may be increasing your blood sugar levels. After several years of taking a statin, I had blood work showing that I was prediabetic, 108, I believe. I then saw a popular TV doctor who had on two other doctors. One of whom said he prescribes statins to less than 1 to 2% of his female patients and that there are studies showing a correlation between the use of statins and increases in blood sugar. I quit taking the statin and my blood sugar dropped to a healthy level, in the 80s. If you are female, take a statin and develop high blood sugar, I recommend talking to your doctor about this.

over 4 years, said...

Learned some new facts, especially about the connection between insulin and high blood pressure. The author gives some very practical advice to help turn things around.

almost 5 years, said...

want to know more

almost 5 years, said...

O here we go again with these articles. Although I agree with some of it, I don't agree with not resting after a meal as digestion adds a lot of work to your heart and dying from a heart attack, although it can be one way to avoid becoming diabetic, it's probably not one most of us would favor.

almost 5 years, said...

I have to agree with the comment on "portion control". I do not know what type my uncle was diagnosed as but, several years ago he was diagnosed as diabetic. As a result he was not allowed to work because his job is driving special needs children to school. So, in order to have control of HIS life and be able to work HE took control of the diabetes through diet and exercise. He was on meds and off of work for less than 4 months. He checks himself regularly and goes to doctor regularly and has not needed meds since. I UNDERSTAND that not all diabetics can keep things this controlled but, he caught it soon enough because of physicals for his job and has been able to control it HIS way.

almost 5 years, said...

Maybe you should mention portion control, and all foods in moderation. I have been type 2 diabetic for 14 years but off all meds and controlling it by diet and exercise (losing weight sure did help)

almost 5 years, said...

When I saw the author write about "simple carbs" and "complex carbs," the warning bells went off. These terms aren't accurate. Look into the science of the glycemic index. Foods that rank high on the glycemic index like white bread, white flour, white potatoes (without skin), white rice, and cake flour (among others) cause your blood sugar to spike, and are therefore best avoided or at least drastically reduced. Sugar is not classified as high on the glycemic index (though too much sugar is bad for you for other reasons). Meat and vegetables tend to be low on the index, but fatty meats can be bad for other reasons. *** Diabetics and those at risk, seek out a doctor knowledgeable about diabetes and the glycemic index. This article has some potentially dangerous mis-information.***

almost 5 years, said...

It's the first time I've seen/heard of a list of diabetes symptoms! the only thing I've heard previously is my AC level, which requires blood testing (shudder!). This article is gratifying to me especially, because it proves to me that I am indeed moving closer to diabetes, and need to be much more cautious with my diet, and I particularly need to exercise MUCH more! Thank you!!

almost 5 years, said...

Very helpful and informative article. I recognized myself in some parts. When I have to French fry or sugar urge, I will drink a glass of water afterwards. I also decreased my intake of juices to about 2 to 3 oz to eliminate that sugar intake.

almost 5 years, said...

On Page 5, you made wording errors with the desired values of HDL and Triglycerides: Those are MINIMUM values for "good" Cholesterol, and a maxmimum value for Triglycerides. Perhaps it would have been helpful to say that "Triglycerides" are another name for fat molecules. (I.e., "High Tryglycerides" means that you have a lot of fat molecules floating around in your blood.)

almost 5 years, said...

I have had diabetes, and still do, but I had a gastric bypass and I have loss a considerably amount of weight. I am so glad but I was left with a bad neurapady in my feet and my kidneys is felling, all because I didn't take care of myself had no knowledge of the diease. so please pray for me that I will be blessed with a kidney. and they fibne a cure for the nerves in my feet.