Diabetes Prevention and Management

Prediabetes indicates a condition that occurs when a person’s blood glucose is higher than normal but not high enough for a diagnosis of diabetes mellitus type 2 (DM-2). Many people seemingly destined to develop DM-2 spend many years in a state of prediabetes, which has been termed “America’s largest healthcare epidemic.”

No one wants DM-2. It has a serious impact on both your length of life and your quality of life. Long term complications of DM-2 start to emerge as early as 5 years after being diagnosed and within 20 years you will be battling complications from many body systems. Most of the complications are related to damage to blood vessels. It more than doubles your risk of getting cardiovascular disease (angina, heart attacks, stroke and peripheral vascular disease), the large blood vessels. Diabetes also damages the small blood vessels, including the ones in the eyes, kidneys and feet. In the US, it is the leading cause of blindness, the third leading cause of heart attack, the leading cause of kidney failure leading to dialysis and the most common cause of leg amputations as a result of poor circulation and gangrene.


The First Sign: Insulin Resistance:

Normally, your body makes insulin, which “escorts” glucose (the type of sugar in your blood) inside the cells. There, your body turns glucose into energy. There are many theories about what causes insulin resistance but, simply put; it is the result of repetitive sugar and starch exposure throughout our lives. Over time, our body desensitizes itself to both insulin and sugar. As a result, insulin and its companion sugar cannot enter the cells as they used to. This leads to elevated levels of both glucose and insulin in our blood.

Insulin resistance is easy to test for and is a routine part of our wellness panels. It is a direct result of poor lifestyle choices that place us one step closer to DM-2. If you are overweight, eat a lot of sugary and starchy foods, or don’t exercise, your insulin resistance will worsen.


Second Chance: Prediabetes (Metabolic Syndrome)

If insulin resistance is not treated, then over time, glucose will build up in your blood. When fasting glucose (sugar) is high (greater than 85), but not high enough to be diabetes (greater than 125), you could have prediabetes. This is important to recognize because we start to damage our blood vessels at this early stage. In addition, triglycerides and cholesterol start to become more difficult to control and the rising sugars are paralleled by escalating insulin levels. It is noteworthy that insulin is the most powerful fat generator in our body and that excess fat accelerates the rate insulin resistance progresses.

If detected at this stage, it is not too late to reverse your tracks and reduce your blood sugar, cholesterol, triglycerides and insulin levels. Lifestyle changes are never simple. But relatively simple changes in your eating habits, weight (especially body fat), and regular exercise can restore everything back to healthy levels. Diabetes is just around the corner if you fail to treat at this point.


Diabetes: It’s still not too late:

Over time, high blood sugars damage your nervous system and blood vessels. This leads to a cascade of problems which will limit your quality and length of life. Keeping your blood sugars under good control significantly reduces this risk. Lifestyle changes such as weight reduction, better eating habits, and regular exercise can control your sugars or at least significantly reduce your reliance on medicines to control your sugars.


Detection and Management:

Early detection and appropriate lifestyle modification is obviously the best management. Our baseline wellness panels will detect insulin resistance at very early stages and may even pick up diabetes that you did not know about. In addition to detection and monitoring through blood work, it is also important to test for the consequences of high blood sugars which are mostly related to damage to small and large blood vessels. Tests looking for problems in the function of your blood vessels and potential blockages in the circulation supplying your extremities (legs) and kidneys are routinely done in our office. Additionally, diabetics that are not followed by an ophthalmologist may get a retinal scan looking for early disease in your eyes. These scans are interpreted by a diabetic eye specialist in Houston. Other tests we use on a regular basis in our office include exercise stress tests, EKG’s, and echocardiograms. Urine can be examined for early detection of kidney disease, and the nervous system can easily be tested by a painless test called ANSAR.


Clearly, lifestyle changes are mandatory if you want to avoid or reduce your chances of damage. Diabetes affects every cell in your body, and it responds well to repairing nutrition to every cell in your body. Once your baseline labs are reviewed with you, “a prescription for change” is outlined and explained. Some take this prescription and are able to make changes on their own. Lifestyle changes are not easy and can take as long as 3-5 years. It involves “re-programming the brain” to make healthier choices. We offer the assistance of our Lifestyle Coach program to those who feel the need for assistance and ongoing teaching, motivation, and accountability. Regardless, regular monitoring (every 3 to 6 months) to review your progress is recommended. The changes in our body associated with high sugars are mostly reversible if caught early enough, and so we prefer not to look at these problems in terms of “control” by medicines, but rather, we encourage a “fix” through better choices and a healthier lifestyle.