The last time you felt sluggish, had an unexplained increased appetite, or noticed constant thirst, did prediabetes ever cross your mind? Based on the numbers, the answer is likely no. A prediabetes diagnosis is common in the United States — far too common. In fact, 84 million adults — more than one third of the population — have prediabetes and are at risk of developing type 2 diabetes. The unnerving part is 90% are unaware they even have it, according to the Centers for Disease Control and Prevention.
Ready for the good news? With some simple awareness and proactive measures, you can shed a prediabetes label. We’ll provide what you need to know to prevent prediabetes from becoming type 2 diabetes and explain why the health and financial incentives are equally as important.
What is Prediabetes?
Prediabetes is when your blood sugar is higher than normal but not enough to receive a type 2 diabetes diagnosis. Think of it as somewhere between normal and high blood sugar levels.
As a refresher, there are two types of diabetes. Type 1 diabetes occurs when you’re unable to make insulin, a hormone made by your pancreas that your body uses to produce energy by helping glucose reach your cells. Type 2 diabetes is when your body is insulin resistant. An inability to make insulin, or the inability to properly use it, causes glucose to stay in the blood, thus an increase in blood sugar levels.
In general, type 1 diabetes starts early in your childhood or early adulthood. Your immune system attacks insulin cells, weakening them to a point where you’re unable to produce insulin. Type 1 diabetes is most commonly viewed as hereditary.
Conversely, type 2 diabetes develops over time and may not occur until later in life. The condition becomes problematic when your body can’t process and use insulin efficiently. Risk factors include unhealthy habits, including obesity and lack of exercise.
With prediabetes, blood sugar levels are higher than normal because your cells have trouble responding to insulin, which, in turn, triggers your pancreas to produce more insulin.
How to Determine if You Have Prediabetes
The difficult part is prediabetes can stay hidden, with years passing until doctors detect it. That’s why it’s important to get your blood sugar tested if you are overweight and don’t exercise much, have high cholesterol, are over the age of 45, or have immediate family ties to type 2 diabetes.
Additional risk factors include gestational diabetes during pregnancy or polycystic ovary syndrome. Race is also a contributor, as African Americans, Native Americans, Latinos, and Pacific Islanders are more susceptible to develop prediabetes.
However, some of the common signs and symptoms to keep an eye on are an increased appetite, constant thirst, frequent urination, blurry vision, or if you lack energy and are often tired.
Three types of blood tests exist to determine if you have prediabetes. A fasting plasma glucose test requires you to fast for eight hours. With this test, blood sugar levels less than 100 mg/dl are normal. Any figures above that would draw reason for concern. Prediabetes is diagnosed when blood sugar levels are between 100-125 mg/dl. Anything above 126 mg/dl is diabetes.
There is also an oral glucose tolerance test, which requires you to drink a sugary solution and take a blood test two hours later. Blood sugar levels less than 140 mg/dl are normal, prediabetes ranges from 140-199 mg/dl, and a positive diabetes test is confirmed with levels higher than 200 mg/dl.
Additionally, your doctor can perform a hemoglobin A1c test, which displays your blood sugar levels averaged out over a two- to three-month period. Blood sugar levels less than 5.6% are normal, prediabetes ranges from 5.7% to 6.4%, and diabetes is diagnosed at 6.5% or higher.
Tips to Prevent Diabetes
A prediabetes diagnosis isn’t a grim diagnosis by any means. The first step is to adopt a healthy lifestyle so your prediabetes doesn’t develop into type 2 diabetes. The National Diabetes Prevention Program has a Lifestyle Change Program to help you prepare healthy meals, deal with stress and triggers, and add activity to your life. Losing 5% to 7% of your weight can make a drastic difference. That’s equal to 10-14 pounds for a 200-pound person.
For starters, you can alter your diet and introduce daily exercise to your routine. How much? As little as 150 minutes of exercise a week can help you lose weight and lower your risk of diabetes. You don’t have to run a marathon, either. Brisk walking five times a week can do the trick.
As for diet, shop on the peripheral of the grocery store to load up on fresh fruit, vegetables, poultry, and fish. Ditch the processed foods you find on the inner aisles and stick to whole grains (think brown rice instead of white rice) when choosing carbohydrates. Avoid sugary drinks like soda, lemonade, and juices packed with sugar and instead choose water, coffee, or unsweetened tea.
If you’re a smoker, quitting can help control prediabetes. It’s also beneficial to treat other conditions that can increase your risk of diabetes, like high blood pressure and high cholesterol.
Proactive Measures Have Financial Benefits
The cost of living with diabetes is staggering. The disease sets the United States back $327 billion in annual costs, according to 2017 research from the American Diabetes Association. If you have diabetes, expect to pay 2.3 times more in healthcare costs. Data shows $1 out of every $7 in healthcare goes to diabetes and complications.
The moral of the story? Getting ahead of prediabetes has significant financial benefits.
In fact, medication may not be the best suitor to combat prediabetes. Studies show an active lifestyle is preferred over solely relying on medicine to help halt prediabetes in its tracks. Those who participated in the Diabetes Prevention Program run by the CDC found losing weight, even small amounts, reduced odds of developing type 2 diabetes by 58%, compared to 31% for people who took metformin.
Metformin is one of the most popular drugs out there to help combat type 2 diabetes. It keeps blood sugar levels at bay by decreasing the amount of glucose produced by the liver. This is the preferred drug used by doctors because weight gain or low blood sugar aren’t common side effects. While insulin is the most common treatment for type 1 diabetes, it’s also an option for type 2 diabetes patients with higher A1C tests.
A constant reliance on medication will add up. A daily dosage of metformin is two 500-mg oral tablets, meaning a 30-day supply will set you back $12.50-$18.32 per month, on average, according to drugs.com. Brand name versions cost even more. A hundred tablets of Glucophage will set you back $112.58, or about $67.8 per month. Extended-release tablets, like Fortamet, run $2,211 for 60 tablets.
Type 2 diabetes can increase the risk for heart attacks and strokes, so you may incur extra costs in the event your doctor puts you on a blood thinner like Plavix (clopidogrel). You take tablets once a day and, with an average cost of $10.68 per pill ($0.45 for generic), this can add up to anywhere from $13 to $200 a month in extra costs.
You may need to use other medications if blood sugar levels don’t improve after several months. The drugs below are add ons to work in conjunction with metformin to reduce symptoms. All in all, the financial implications are hundreds of dollars per month. We outlined how much certain add ons would run, including cheaper generic versions, when applicable. You can use our drug pricing feature to compare pharmacy and prescription prices in your area.
If metformin isn’t successful, your doctor may first turn to sulfonylureas to help increase insulin production by the pancreas. You take this oral tablet once or twice a day.
Taken orally two to four times a day, this medication works in a similar fashion as sulfonylureas by increasing insulin production from the pancreas.
You take these three times a day in order to limit blood sugar increases after meals. The medicine helps your body digest carbohydrates to delay glucose absorption. They aren’t as effective as metformin or sulfonylurea when lowering glucose levels.
- Glyset — $296.20 for 100 25 mg tablets / miglitol — $154.07 for 100 25 mg tablets
- Precose — $107.23 for 100 25 mg tablets / acarbose — $73.17 for 100 25 mg tablets
This oral medication makes your glucose usage more efficient by targeting your muscles, fat, and liver. Other medicines like insulin or sulfonylureas may be better choices since the side effects aren’t as major.
Dipeptidyl Peptidase 4 Inhibitors
Taken orally, these medications blocks DPP-4, an enzyme that destroys incretin. Our body needs this hormone to produce and release more insulin.
- Nesina — $412.01 for 30 6.25 mg tablets
- Tradjenta — $464.86 for 30 5 mg tablets
- Onglyza — $448.49 for 30 2.5 mg tablets
- Januvia — $480.55 for 30 25 mg tablets
By blocking kidney proteins, these oral medications help lower blood sugar by increasing glucose excretion in your urine.
Also known as incretin mimetics, you inject this medicine to help increase insulin release when needed. It suppresses your appetite and allows for glucagon secretion to decrease the liver’s glucose production.
- Victoza — $651.06 for 6 milliliters
- Ozempic — $815.92 for 1.5 milliliters
- Adlyxin — $656.97 for 6 milliliters
- Trulicity — $802.31 for 2 milliliters
- Byetta— $771.24 for 1.2 milliliters
- Tanzeum — $554.48 for 4 powder for injection
You use this injectable medication as a supplement to insulin to help combat varying levels of blood sugar after meals. It keeps numbers low in many ways, including decreasing the rate in which food passes through your intestines, limits glucose production in the liver, and makes you feel fuller to keep food intake at bay.
Discussing Prediabetes With Your Doctor
Since it pays to get ahead of prediabetes, make sure to discuss with your doctor if you believe you’re at risk. It helps to have an idea of what to discuss ahead of time. Consider asking about the risk factors, whether that’s race-related, familial history, or lifestyle.
If you have concerns, request a prediabetes or type 2 diabetes test. If you meet any of the criteria for prediabetes, have your doctor assist you with a plan of attack moving forward. Make sure they explain your options, as we outlined above, and know you aren’t limited.
You can ask if there are diabetes prevention programs in your area or if they have recommendations for a nutritionist or registered dietitian to help formulate a plan.
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