It’s nice to be thought of as sweet, but a lot of people these days are a little too sweet. Blood sugar (aka blood glucose) can be toxic to your tissues, and both roller-coaster blood sugar levels and chronic high readings are signs that your body isn’t functioning the way it should. Over time, blood glucose that isn’t absorbed and used as energy can damage your body.
That’s why blood sugar may be one of the most important markers for long-term health, and the easiest to ignore. Sure, you hear lots about it. Most folks know that type 2 diabetes is an epidemic in our society. Approximately 29 million Americans have it and more than 3,800 more are diagnosed daily, according to the American Diabetes Association; each of them is a candidate-by default for the potential side effects of chronic high blood sugar: heart disease, stroke, nerve and eye problems, and kidney disease. But here’s an interesting exercise: Take that 29 million…and triple it. That’s the number of people who have high blood sugar that is not quite high enough for them to be diagnosed as diabetic. This is prediabetes, this is 1 in 3 American adults, and it’s a health alert that you or someone close to you may have right now. And here’s the kicker: 9 out of 10 prediabetics don’t even know it.
Blood sugar by the numbers
If you take a fasting glucose test…
Less than 100 mg/dl = Normal
100 mg/dl – 125 mg/dl = Prediabetes
125 mg/dl or higher = Diabetes
If you take a hemoglobin A1C test…
Less than 5.7% = Normal
5.7% - 6.5% = Prediabetes
6.5% or higher = Diabetes
The Centers of Disease Control (CDC) offers a prediabetes self-test here.
The other silent killer
“Diabetes attacks every single cell in the body,” says Florence Comite, MD, an endocrinologist and founder of the Comite Center for Precision Medicine in New York City. “That’s why I’m so focused on it as a doctor. I hate the disease.” Prediabetes doesn’t get the same attention because it’s a sneakier condition. Diabetes may come with symptoms like blurred vision, thirst, frequent urination, and nerve pain in the hands, arms, feet, or legs. Pre? People often feel just fine, or their symptoms may be subtle enough to be mistaken for other things.
The result is a risky ignorance, because “it may take a year or two, or a decade or two, but inevitably many prediabetics will become diabetic,” says Comite, who routinely discovers previously hidden pre- and diabetic conditions in her patients. The CDC estimates that up to 30 percent of prediabetics will develop full-blown type 2 within five years.
Here are some warning signs. If any sound familiar, a simple blood test from your doctor may be a smart idea:
Your parents have it.
Has anyone in your family been diagnosed with diabetes? Have your grandparents, parents, or siblings gained weight as they aged, especially around their middles, which can put you at greater risk? “Genetics is one of the biggest determining factors,” Comite says. “Get the information from your relatives when you’re young and don’t be afraid to look ahead.”
You’ve gained weight.
This is common, especially as you age, even if you follow a healthy lifestyle. Part of the problem? A drop in free testosterone, which Comite says is especially damaging for women because they don’t think about T. “Women have a fraction of the free testosterone men have,” she says. “As we hit our 30s, we start losing 1 to 3 percent a year, just like men. That’s why we sometimes see thickening around our waists as we age. We lose our ability to keep lean muscle in place and lean muscle helps burn the energy from the food we eat. The less lean muscle we have, the less effectively we may burn energy and fat.” (Comite also notes that oral contraceptives may contribute to lower testosterone levels.)
You get jittery when you don’t eat.
A few hours after your last meal, your blood sugar could drop while your insulin remains high. The insulin has no blood sugar to work with, so you may feel jittery or light-headed. “This is a sign of reactive hypoglycemia, and for some can be a very early indicator of diabetes,” Comite says.
You don’t heal quickly.
High blood sugar may damage nerves, which could affect circulation and slow your body’s healing process and immune response. Maybe a cut doesn’t heal as fast as it should, or a cold or cough doesn’t go away when everyone else’s seems to get better in a few days. Women might notice chronic urinary tract or yeast infections.
You had blood sugar issues while pregnant.
“If you had even a borderline response, much less a positive response, to a glucose tolerance test while pregnant, you’re absolutely, unequivocally at risk of being a diabetic now or later,” Comite says. “Pay close attention to that the moment you know.”
If you have blood sugar issues, some basic lifestyle changes could go a long way to help you prevent or delay the onset of type 2 diabetes, and possibly reverse prediabetes. According to the American Diabetes Association, research has found that you may lower your risk of developing type 2 diabetes by up to 58 percent by doing the following:
- Lose 5 to 7 percent of your body weight (a 7 percent loss for someone currently weighing 180 is about 13 pounds).
- Do moderate exercise (like brisk walking) 30 minutes a day, five times a week. Comite also recommends strength training a few times a week to help maintain muscle mass.
A weight-loss intervention plan could help you even more. A 2015 study in the American Journal of Public Health found that a weight-management plan—WW, specifically—was successful in delivering lifestyle changes that contribute to prevention of type 2 diabetes. The study included 225 people with prediabetes; 112 of them followed the WW Program and 113 received individual-based advice using a National Diabetes Education Program. After six months, the people on WW had lost more weight than the group following the National Diabetes Education Program (5.5 percent of body weight lost versus less than 1 percent). The WW group also had significantly greater improvement in HDL cholesterol levels as well as A1C, a marker for diabetes.
Managing blood sugar means
A company called Metabolon has developed an initial blood test to assist physicians in analyzing metabolites (molecules involved in metabolism) for signs of inherited metabolic disorders long before they manifest. The test can identify hundreds of metabolites from one blood draw.
Medical firms like Dexcom and Sano have developed minimally invasive blood sugar monitoring systems—testing fluid in the skin, for example— that send real-time data to your smartphone. Talk to your physician to see if this could be an option for you.
Comite compares the future of blood sugar management to what happened with the financial industry. “You can take a picture of a check and never have to visit a bank,” she says. “Soon your medical data will be transmitted to your doctor and your medication can be delivered to you.”