Pre-diabetic

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Specializes in icu, er, transplant, case management, ps.

I am curious about the term 'pre-diabetic'. How many of you have heard this term used before? What defines a pre-diabetic, in your opinion? What have you been taught about this term, either in continuing education or in your nursing program?

Thank you

Woody:balloons:

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Specializes in Med-Surg.

I think some people are using the term for convenience when they mean "metabolic syndrome" http://www.americanheart.org/presenter.jhtml?identifier=4756

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

I was taught that prediabetes is a condition that involves slightly elevated fasting blood glucose levels that are not high enough to warrant a diagnosis of diabetes. Prediabetes was diagnosed when the pt's fasting blood glucose fell between 110 and 125mg/dL. The parameters have recently been changed to 100 to 125mg/dL for prediabetes. Of course, two fasting blood glucose readings of 126mg/dL or greater will result in a diagnosis of diabetes.

I also read that 60 percent of prediabetics will eventually be diagnosed with diabetes.

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Specializes in Pedatrics, Child Protection.

It's also being used to replace "borderline diabetic". For those who are looming on the brink of diabetes....passed your GTT but have all (or many) other signs/symptoms of diabetes. My family doc described it as the point where you can make changes to your lifestyle to avoid diabetes, or throw it to the wind and enter the world of diabetes management.

I would look at the American/Canadian Diabetes Association website for more info.

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Specializes in Education, FP, LNC, Forensics, ED, OB.

Here is the link to the ADA regarding pre-diabetes:

http://www.diabetes.org/pre-diabetes.jsp

And, the ADA Practice Guidelines for 2008 with screenings for pre-diabetes:

http://www.medscape.com/viewarticle/568031?sssdmh=dm1.330453&src=nldne

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Specializes in Community Health, Med-Surg, Home Health.

Actually, everyone mentioned the things I was about to say. I went to a diabetic seminar for LPNs and this was a big subject. It now influences my reading of glucose values and the direction of my patient teaching.

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Specializes in icu, er, transplant, case management, ps.

Thank you everyone for your responses. I was curious because I have heard the term tossed around on diabetic message boards. To me, someone is either a diabetic or not a diabetic. I understand the blood glucose guideline numbers but I don't think that a lot of my fellow diabetics, who were former prediabetics, really understood the meaning or importance of managing their blood sugars. And there are those that when they do convert, view this conversion as a failure on their part.

I understand the changes that have happened over the years. My PCP is one of the most forward thinking doctors I know. He wants my A1c to be 5.0 to 5.2. And I remember when he thought a 5.9 was super. But I also remember when he put me on an 1800 cal ADA diet when I was first diagnosed. Now we agree on my carbohydrate intake.

Woody:caduceus:

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Specializes in Med/Surg, Geriatrics.

Probably the most exciting aspect of the designation of prediabetes is the understanding that diabetes is now preventable. Very few in the public understand this and if we as nurses could forward that idea, a lot of lives would be saved and a lot of suffering prevented. Previously, people believed that diabetes was a disease that they got and that there was nothing that could be done about it. The people who believed they got it from eating too much sugar were gently redirected. Now it turns that there was a more than a grain of truth in their thinking. As someone with a high risk for diabetes myself, I am always cognizant of my weight, the size of my waist and the foods I eat as well as my activity levels as I struggle NOT to fulfill what I once thought was my destiny.

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Specializes in icu, er, transplant, case management, ps.
Probably the most exciting aspect of the designation of prediabetes is the understanding that diabetes is now preventable. Very few in the public understand this and if we as nurses could forward that idea, a lot of lives would be saved and a lot of suffering prevented. Previously, people believed that diabetes was a disease that they got and that there was nothing that could be done about it. The people who believed they got it from eating too much sugar were gently redirected. Now it turns that there was a more than a grain of truth in their thinking. As someone with a high risk for diabetes myself, I am always cognizant of my weight, the size of my waist and the foods I eat as well as my activity levels as I struggle NOT to fulfill what I once thought was my destiny.

May I ask you a question? If Type 2 is considered the result of eating too much sugar, how does one explain the genetic factor or the steroid impact, or gestional diabetes. I am not looking for an argument but enither my PCP or my endocrinologist blame my developing Type 2. They tell me that my body was influenced by both of my grandfathers and father being Type two. Plus the impact of steroids on my blood sugar and insulin production. I wasn't even put on regular insulin, while on steroids, until 2000. Also, at the time of my diagnoses, I weigh 132 pounds.

Another question, please. Do you get period A1c's done? And have you ever had the insulin antibodes done? I am not trying to say anything about the way you are managing the problem but unless your A1c is 5 or under, according to some, you are hitting the diabetic line.

Woody:hrnsmlys:

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Specializes in Acute Care Psych, DNP Student.

I am pre-diabetic. My most recent fasting bs was 106. My BMI is in the normal category, too. After receiving this diagnosis, I had an 'awakening' of sorts. I looked around at my family of type 2 diabetics and decided to change my lifestyle, drastically.

I do the treadmill or elliptical for 60 minutes six days a week. I lift weights three times a week. I do 20 minutes of yoga every day. I have cut out most simple carbs. I eat lean and healthy. Lots of lean protein, fish, fruits, and veggies.

To me, prediabetes is an early wake up call, if one chooses to pay attention and make changes. I understand that I may one day become diabetic, but I'm going to try to prevent it as long as I can. I think it's great that the medical establishment is looking at the shades of gray on this, and looking towards prevention.

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Specializes in Nursing Professional Development.

My story is pretty much the same as that of Multicollinearity. My fasting blood sugars were 122 and 115 at diagnosis. That was about 18 months ago. It was a wake-up call.

Since then I have eaten a lot better, exercised more than I EVER have, and lost about 35 pounds. I test my BG twice per day. My finger sticks are almost always below 100 now if it's more than 3 hours since my last meal. My cholesteral & triglyceride numbers are also dramatically improved. My doctor is thrilled with my results and so am I.

Having the "official diagnosis" and the blood glucose monitoring has been a life-saver for me -- literally. It has forced me to take it seriously on a daily basis. Had I just been advised that I was at high risk and should "be careful," I doubt I would have been as compliant.

I have been naughty over the holidays, though, and need to get back on track.

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Specializes in Med/Surg, Geriatrics.
May I ask you a question? If Type 2 is considered the result of eating too much sugar, how does one explain the genetic factor or the steroid impact, or gestional diabetes. I am not looking for an argument but enither my PCP or my endocrinologist blame my developing Type 2. They tell me that my body was influenced by both of my grandfathers and father being Type two. Plus the impact of steroids on my blood sugar and insulin production. I wasn't even put on regular insulin, while on steroids, until 2000. Also, at the time of my diagnoses, I weigh 132 pounds.

Another question, please. Do you get period A1c's done? And have you ever had the insulin antibodes done? I am not trying to say anything about the way you are managing the problem but unless your A1c is 5 or under, according to some, you are hitting the diabetic line.

Woody:hrnsmlys:

It's my understanding that there are multiple factors which influence the development of Type 2, genetics being a big part of it. I didn't mean to suggest that diet alone causes type 2 because it doesn't, only that it is a factor which if controlled can help prevent the development of type 2.

But how does diet influence pre-diabetes?

Diet high in sugar and simple carbohydrates------->large amounts of insulin released----------->insulin resistance----------->hyperinsulinemia and pre-diabetes.

So the controllable factors are: diet, weight, fat (in particular around the waist), and activity level. For someone like myself, an African-American female with a strong family history of type 2, two genetic factors which predispose me, I can work on the other factors to decrease my chances of developing the disease.

I haven't had A1cs or insulin antibodies done. Occasionally I will check my lipids and fasting blood sugar and I keep an eye on my weight and blood pressure. I work out but not as often as I should.

I just signed up for a research study that is looking for a new way to diagnose pre-diabetes so I will be getting all of those tests done. I'll get to see if my strategy is working. I hope so, by the time my mother and my aunts were my age they were already on insulin so I think I'm already a little ahead of the game. We'll see.

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