Pre-diabetes: The Silent Killer

Five very obese fat men on the beachFive obesely fat men on the beach

Understanding Prediabetes, Diabetes, and Obesity

This post will hopefully help individuals understand how excess weight puts them at a higher risk of developing pre-diabetes and diabetes. Most with a weight problem are not aware they are predisposed for pre-diabetes and diabetes until symptoms of type 2 diabetes begin to show. Even then it takes time for the diseased individual to realize they have diabetes. Diabetes is often referred to as the silent killer because it is often too late once it is diagnosed. Pre-diabetes is a prequel to diabetes and is tied to excess abdominal fat.

How does excess abdominal weight affect your health?

Belly girth at high risk for Diabetes Type 2.  

Excess weight or obesity can affect a person’s health in many ways, and many of them are subtle at first. It is not as simple as “X” always causes “Y.” Obesity and the degree of disease involvement are dependent on genetics. Obesity is where excess body fat has accumulated to the extent that it may have an adverse effect on a person’s health. Obesity increases a person’s risk of developing heart disease, hypertension, type 2 diabetes, certain types of cancer, osteoarthritis, stroke and lipid disorders such as high cholesterol. Life Style changes such as proper nutrition, physical activity, healthy sleep habits, stress reduction, and weight loss can delay or prevent the onset of type 2 diabetes. Unfortunately, this is not a menu for you to choose what you want, you need to look at the whole picture.

Since excess weight can affect a person’s health in many ways, it is, therefore, important to be able to evaluate how much excess weight a person has. There are many methods of measurement body fat. The most common used method is calculating the body mass index (BMI). To calculate BMI, you only need a weight and height. BMI is a number calculated by dividing a person’s weight in kilograms by his or her height in meters squared. Body fat can also be measured by impedance scales, calipers, water displacement, and a bod pod. There are others but they less common.

Once you have a measurement, you can classify the weight based on body mass index (BMI).  There are four weight status categories or classifications (underweight, healthy weight, overweight, and obesity). To calculate your BMI and determine your weight status category, but the fundamental concept is that your risk of diabetes type 2 increases with your waistline.  BMI just quantifies this.  

What is pre-diabetes / diabetes?

Diabetes Sugars
Diabetes Sugars

If you have a family history diabetes, you likely have pre-diabetes or at least the gene for it. Type 2 diabetes is genetic and is what we are talking about in this article. Type 1 is likely a viral illness in which a patient’s pancreas can no longer make insulin. Plain and simple, diabetes that we are discussing in this post is a metabolic syndrome in which your body become less and less sensitive to insulin.

Pre-diabetes is the state that occurs when a person’s blood glucose or sugar levels are higher than normal, and it is not high enough for a diagnosis of diabetes. Pre-diabetes can also be referred to as reduced insulin sensitivity, impaired glucose tolerance, or impaired fasting Glucose. The magic number for prediabetes is a blood sugar of 100-126 mg/dl. The key point of pre-diabetes is that it is that the increasing blood sugar is a mark of increasing insulin sensitivity. Individuals with pre-diabetes are at an increased risk of developing type 2 diabetes, heart disease, hypertension, and stroke. An estimated 79 million Americans age 20 years or older have pre-diabetes, and 90 percent do not know they have the condition.

Diabetes is just a blood sugar that about 1 point or higher than the top of the range for pre-diabetes. If you have a fasting blood sugar above 125, you likely have diabetes. It is not that large of a difference, but it is a spectrum of the same illness. The worse your blood sugar, the bigger your risk for the associated diseases.

How can I tell if I am high risk for diabetes?

If you are obese or overweight and over 45 years of age, you are high risk for diabetes. Sure, there are those that have genetic time bombs that will get diabetes type 2 even if they are skinny, but that is rare. I recommend that everyone is checked starting at age 45 and every 3-5 years after that.

Recommendations for Pre-diabetics and Diabetics:  

  1. Lose weight.  Especially, you need to concentrate on weight off your waistline. 
  2. Increase your fiber.  Fiber will slow the absorption of carbohydrates.
  3. Exercise, exercise, exercise!  Increase it moderately with the advice of a medical provider.  It will help lower your insulin resistance and waistline.  

The bottom line: Elevated blood sugar and diabetes are a part of insulin resistance and tied to weight gain. Keep you weight under control and your blood sugar will improve.

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About the Author

I am a family physician who has served in the US Army. In 2016, I found myself overweight, out of shape, and unhealthy, so I made a change to improve my health. This blog is the chronology of my path to better health and what I have learned along the way.

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