Q: I was informed last week by my doctor that I have prediabetes. I have a parent and two siblings who have diabetes, but I’ve not heard the term “prediabetes” before. What does it mean?

A: It is now well recognized that persons don’t become diabetic without warning. Instead, they pass through a stage of the disease called prediabetes, in which blood sugar levels are above normal but not high enough to be considered diabetes. This stage may last for years.

Risk factors for prediabetes include: being 45 years of age or older; being overweight or obese; having a family history of type 2 diabetes; having high blood pressure; being physically active fewer than three times a week; having had diabetes during pregnancy, which cleared after delivery; giving birth to a baby weighing 9 pounds or more, and being of any ethnic background other than Caucasian.

The CDC has estimated that one-third of U.S. adults have prediabetes, which equates to over 240,000 people in Michigan alone, and that only about 1 in 10 actually know they have it. Nearly one-third of people with prediabetes will become frankly diabetic within five years. Detecting the disease process at this stage is crucial to motivating those affected to take steps to avoid the progression described above.

Prediabetes is most easily diagnosed by a blood glucose (sugar) test that is drawn two hours after completing a normal meal (in medical parlance, a two-hour “postprandial” test). An abnormal test then allows for interventions that have been well shown to prevent progression to diabetes, not to mention the numerous adverse effects of diabetes, such as blindness, kidney failure, heart attacks, neuropathy that causes burning pain in the hands, feet and lower legs, and small blood vessel disease that often leads to gangrene and foot/leg amputations.

Two lifestyle changes are crucial to this prevention — losing weight (as little as 7% of current body weight [14 pounds if you weigh 200 pounds]), and beginning increased physical activity (30 minutes of moderate activity five days a week, usually brisk walking).

To learn more, visit the American Diabetes Association’s website at www.diabetes.org/diabetes- basics/diagnosis/. I want to thank Jennifer S. for this question.

To learn more about this and other topics, visit the American Academy of Family Physicians’ website at familydoctor.org.

If you have a topic you would like to hear more about, message me at paulmdake@gmail.com.

Dr. Paul Dake, a Newberry native, is a retired family physician. He lives in Pinconning, Michigan.