Take Control of Prediabetes

Laura Del Guerra, RD, CDE and Julie Walker, Take Control Staff

Your lab results come back, and as you look them over you notice an elevation of your hemoglobin A1c. What is hemoglobin A1c and what exactly does it mean?

Hemoglobin A1c or A1c for short, is a measure of your blood glucose results over the last 90 days. An elevated A1c is a reading over 5.6% so if your A1c is between 5.7 and 6.4%, now is the time to take action. It might be tempting to ignore this seemingly minor elevation. After all, it’s not like you have been diagnosed with diabetes. But prediabetes presents a unique opportunity to make lifestyle changes that will help keep a diagnosis of Type II diabetes at bay.

Many people ignore this seemingly slight elevation in A1c because they don’t feel any symptoms, or think they’ll try a bit harder to eat right and exercise and see how next year’s results look. However, waiting to address these issues is like ignoring a leak in your roof – the longer you wait, the harder and more expensive the repair will be in the future.

Prediabetes occurs when your body starts to have trouble using the hormone insulin. Insulin’s job is to attach to glucose molecules circulating in the blood stream and carry it into the cells to be used as energy. Think of it like this: you eat a meal and as the food digests your blood glucose level starts to rise. The body sends a message to the pancreas to release insulin into the bloodstream to bring the blood glucose level down. Insulin shows up in the bloodstream and starts to attach to glucose molecules BUT some of the insulin molecules are the wrong shape, and instead of attaching to the glucose molecule, they bounce off. The blood glucose level remains high and the body tells the pancreas to make more insulin. At first the pancreas works to make more insulin to overcome this “insulin resistance” but eventually the cells start to wear out, leaving too much glucose in the blood stream. Over time the cells that produce insulin die and there is a mix of insulin resistance and insulin deficiency.

Once you meet the diagnostic criteria for prediabetes, the above process may have been going on for years. Because of this, people with prediabetes are high risk for cardiovascular disease. In fact, insulin resistance doubles your chance of having a heart attack or stroke – and triples the chance that if one of these events occurs it will be deadly. Taking action early is the best way to try to prevent a catastrophic health event. The good news is that small lifestyle changes can have a big impact on improving your health. At Take Control, we specialize in identifying small, simple ways to improve your A1c that works with your existing lifestyle and preferences.

Hopefully you’re convinced and ready to take early action. There are simple things you can do to reverse prediabetes and gain peace of mind. We’ll help you identify goals that will focus on achieving small amounts of weight loss through changes in the way you eat and exercise. Also, if you are a nicotine user, we’ll help you stop.

Losing weight may sound daunting, but it only takes a small amount, between 5 and 10%, to improve your A1c. Our health coaches will work with you over the course of six months to a year. For example, if you weigh 200 pounds, the goal would be to lose between 10 and 20 pounds. Divided by 12 months, it would mean losing a little over a pound a month. Because we customize the goals for each person, the changes you’ll be making to achieve weight loss will be chosen by you; and they will be permanent changes that take time to develop. This will ensure you’re successful in maintaining the weight-loss long term.

The best diet is the one that takes into account your likes and dislikes, cultural preferences, and fits your lifestyle. We’ll get started by taking a look at what you are eating now and suggest improvements in your diet over time that will improve nutrition but won’t compromise taste.

Adding movement or exercise to your life may turn out to be easier than you think. Take Control health coaches will have a conversation with you about what activities you like, don’t like, and have done in the past that you enjoyed. You’ll work with them to identify times of the day, and ways to add exercise that fit into your busy schedule. We’ll remind you how exercise will improve your energy level, mood, sleep quality, while reducing anxiety, stress, and depression. Whatever your age or fitness level, there are ways to add movement into your life that you will enjoy and help you achieve your goals.

It’s important not to rely on just diet or exercise. One study done by the New Mexico School of Medicine showed that people who lost 10% of their weight through diet PLUS exercise saw their insulin resistance improve by 80%. Those who lost weight by diet alone only improved insulin resistance by 38% and those who only engaged in exercise but did not lose much weight, experienced no change in their level of insulin resistance.

The bottom line with prediabetes is that the sooner you take action the better. With a little effort and support, changes are possible. You have an opportunity to reverse this disease before it does any further damage.

We hope you’ll embark on this important journey, and we’re here to make it easier for you!