All about borderline diabetes (prediabetes)

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A person with borderline diabetes, or prediabetes, has blood sugar levels that are higher than normal but not yet high enough for a diagnosis of type 2 diabetes.

Borderline diabetes is a condition that may lead to type 2 diabetes. According to the American Diabetes Association, an estimated 10 to 23 percent of people with borderline diabetes will go on to develop type 2 diabetes within 5 years.

Doctors may also refer to borderline diabetes as:

This article looks at how to recognize risk factors for prediabetes, how to manage the condition, and how to prevent type 2 diabetes from developing.

Symptoms

Prediabetes does not have clear symptoms. Some people may not be aware that they have it until:

  • a doctor tests blood glucose and blood pressure levels
  • prediabetes has progressed to type 2 diabetes
  • a complication occurs, such as a heart attack

If a person’s blood sugar level remains high, they may begin to develop some symptoms of type 2 diabetes. Symptoms include frequent urination and increased thirst.

Most people will not know they have prediabetes until they receive testing.

Causes and risk factors

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), a range of other conditions can increase the risk of prediabetes, including:

Other risk factors include:

  • not getting enough exercise
  • having a family history of type 2 diabetes.

According to the American Heart Association, the following lifestyle factors may also be a risk for prediabetes in some people:

  • raised stress levels
  • smoking
  • drinking too much alcohol

Regularly consuming high-sugar drinks may also increase the risk.

One 2017 review found that people who regularly drink sugary beverages face an increased risk of metabolic diseases, such as high blood pressure and high levels of blood glucose and fats.

These metabolic conditions can lead to prediabetes and diabetes.

People who lead an inactive lifestyle are at higher risk of taking in too many calories without burning them through exercise.

Other people who may be at risk of developing prediabetes include those with polycystic ovary syndrome (PCOS) and those who have experienced instances of high blood sugar levels in the past.

Anyone with any of these risk factors may benefit from a prediabetes screening to identify whether they have the condition.

Diagnosis

A doctor typically diagnoses prediabetes with a blood test, particularly a glucose tolerance test. A glucose tolerance test measures how quickly the body can process the sugar in the blood in a 2-hour period.

Other tests include measuring blood sugar levels after a person has not eaten for a specific period. This is called a fasting blood test.

The doctor may also use an A1C test. This involves measuring the average blood sugar levels over 2–3 months. People do not need to fast or take any special liquids or medications for this test, and it gives reliable results.

According to the American Diabetes Association, a doctor will diagnose prediabetes when test results show the following measurements:

  • fasting blood sugar levels of 100–125 milligrams per deciliter (mg/dl)
  • glucose tolerance levels of 140–199 mg/dl
  • an A1C test result of 5.7–6.4 percent

A doctor will often re-test these levels to confirm that the readings are not due to one-off spikes in blood sugar.

Blood glucose monitors for home use are available for purchase online.

Who should seek screening?

The NIDDK recommend that people with the following risk factors should undergo a prediabetes screening:

  • an age of 45 years or over
  • obesity or overweight, or a body mass index (BMI) over 25
  • a waist circumference larger than 40 inches in males or over 35 inches in females
  • a close relative with diabetes
  • a condition that increases insulin resistance, including PCOS, acanthosis nigricans, and nonalcoholic steatohepatitis
  • an ethnic background that places an individual at high risk of diabetes, including people who are African-American, Asian-American, Latino, Native American, or a Pacific Islander
  • a history of gestational diabetes, or diabetes as a result of pregnancy
  • having given birth to an infant weighing over 9 pounds
  • having a disease that harden the arteries
  • recent treatment with glucocorticoids or atypical antipsychotic medications

If a doctor identifies any of these risk factors, they may recommend that the person has a screening for blood glucose levels.

Medical professionals advise repeating screening tests every 1 to 3 years if a person has these risk factors.

The NIDDK has an official resource to check diabetes risk. Click here to take the test.

However, anyone who is concerned that they may have borderline diabetes should visit the doctor for testing and a proper diagnosis.

Treatment

Prediabetes is reversible, but it is often easier to prevent than treat. Lifestyle factors are the primary causes of prediabetes, and making changes in some aspects of life can significantly reduce risk factors.

A balanced, nutritious diet that moderates sugar intake and regular exercise can help reverse borderline diabetes.

According to the American Diabetes Association, diet and nutrition changes should include the following:

  • improving intake of unprocessed high-fiber carbohydrates
  • increasing fruit and vegetable consumption
  • reducing saturated fat and processed meat intake.

Click here to find out more about what to eat with prediabetes.

Exercise is also important. According to a report in Diabetes Care, exercise can help prevent or delay diabetes from developing.

Current guidelines for Americans recommend that adults should:

  • have at least 150–300 minutes of moderate-intensity aerobic activity each week
  • do muscle-strengthening exercises at least twice a week, such as lifting weights or doing push-ups

Examples of moderate exercise are fast dancing and brisk walking.

Regular exercise and a healthful diet not only help reduce the risk of developing diabetes but also protect the heart against future diseases.

Diabetes Prevention Program

The Diabetes Prevention Program (DPP) was a long-term study that aimed to identify practical steps for reducing diabetes risk and reversing prediabetes.

The people who took part in the DPP Lifestyle Change Program aimed to lose 7 percent of their body weight and maintain this loss through dietary changes and activity. After 3 years, the results of the program showed:

  • a 58-percent drop in the risk of developing diabetes regardless of sex or ethnicity, compared with those who took a placebo
  • a 71-percent drop in risk people of developing type 2 diabetes among people aged over 60 years

All the people in the program received motivational support on effective diet and exercise and attended “lifestyle change classes,” for the duration of the study.

Follow-ups took place regularly. After 15 years, people in the DPP Lifestyle Change Program continued to see a delay in the onset of diabetes compared to people who took a medication called metformin or a placebo.

Anyone who developed diabetes during the study received extra medical care. However, diet and exercise remained important in managing symptoms and reducing the risk of complications.

Monitoring borderline diabetes

In addition to lifestyle changes, doctors may recommend other steps for managing the risk of diabetes.

Medical management may include treating related conditions, such as obesity and heart disease.

Managing prediabetes also involves continued monitoring of the risk factors and regular testing of blood sugar levels.

A person can reverse borderline diabetes if they can make and maintain the necessary lifestyle changes.

Takeaway

Borderline diabetes is the stage before type 2 diabetes develops. By this stage, blood sugar, blood pressure, and insulin resistance may start reaching harmful levels.

Prediabetes does not usually cause active symptoms, and most people will not be aware they have the condition until it becomes diabetes and starts causing severe health problems.

It is therefore essential for anyone who is at risk of developing diabetes to receive regular screening. Risk factors include high BMI and waist circumference, an age of more than 45 years, or other cardiovascular diseases.

Prediabetes is often reversible with a sustained exercise program and a balanced, low-sugar diet.

How to Advocate for Yourself and Your Baby During Delivery

Babies are unpredictable. Knowing your rights can help you better prepare for the unpredictable.

After 9 months of nausea, weight gain, back pain, and general discomfort, the day is finally here: delivery day. And, if you’re anything like me, you are more than ready.

I was trying to evict my daughter as soon as she turned 37 weeks.

But before you head to labor and delivery, you should know what your rights are (and aren’t). Because while you may have a well-written birth plan, things change, and it’s important that you know how to advocate for yourself and your baby.

The basics

You have the right to receive full and clear information about the benefits and risks of any medication, treatment, test, or procedure you may receive

Things move quickly in labor and delivery wards, and for good reason. Childbirth can be unpredictable, and most medical professionals act abruptly out of necessity. They simply want to ensure a safe and healthy delivery.

But before receiving any treatment, you can (and should) ask about the risks and results of procedures. It’s your legal right and duty to give permission for care.

You have the right to receive full and clear information about your healthcare professional’s background and qualifications

When it comes to your OB-GYN, transparency isn’t just important, it’s your right.

Ask about their medical training and degree. Inquire how many years of experience they have (and how many babies they’ve delivered), and request any other information which you deem necessary. For example, you can ask how many vaginal and Cesarean births they’ve attended.

You have the right to receive treatment that’s appropriate for your cultural and religious background

This includes refusing certain medical procedures and receiving written correspondence in a language of your choosing.

You have the right to accept or refuse any unnecessary medical test, intervention, or procedure, including continuous fetal monitoring or an episiotomy

While certain birthing situations require intervention — sometimes it’s medically necessary to perform a C-section or monitor your unborn babe — if you’re laboring naturally and there is no fetal or maternal distress, you have the right to accept or refuse any test or procedure.

You have the right to change your mind

If something doesn’t feel right or if you’re having second thoughts, speak up. Period.

The birth process

You have the right to know if you will be induced (and why)

Some pregnancy complications may require you to be induced. In fact, in certain cases, it may be the best way to keep you and your baby healthy.

However, many inductions are unnecessary, and in some cases, can increase your risk of complications.

You have the right to labor in whatever position you choose

Barring any unforeseen problems or medically restrictive devices (such as a catheter), you can — and should — be able to labor in any position.

Some hospitals have various policies in place when it comes to delivery. If you’re planning a hospital delivery, ask about their policies ahead of time.

Newborn care

You have the right to uninterrupted contact with your newborn

There are numerous benefits of skin-to-skin contact, both immediately following birth and in the days and weeks after. As long as you and your baby are healthy, you should be given (and are entitled to) relatively uninterrupted time to bond with your child.

You have the right to breastfeed or bottle feed

While the benefits of breast milk are well-researched and well-known, not everyone can or wants to. (I stopped breastfeeding to resume my regular mental health care regimen.)

Do what is best and right for you.

You have the right to deny unnecessary medical tests or procedures

After your child is born, medical professionals will likely perform a series of tests on your wee one. For example, your newborn will be measured, weighed, given an APGAR test, and blood will be drawn.

However, not all procedures need to be done immediately after birth (or in the hospital). Speak to your OB-GYN or pediatrician in advance to better understand what they recommend doing and when.

You are your own best advocate

You should speak up, ask questions, and remember this is your birth experience and your child.

If something doesn’t seem or feel right, or if you have questions, it’s your right to ask questions and receive answers.

Kimberly Zapata is a mother, writer, and mental health advocate. Her work has appeared on several sites, including the Washington Post, HuffPost, Oprah, Vice, Parents, Health, and Scary Mommy — to name a few. When her nose isn’t buried in work (or a good book), Kimberly spends her free time running Greater Than: Illness, a nonprofit organization that aims to empower children and young adults struggling with mental health conditions. 

2 servings of avocado per week may cut heart disease risk by 16%

  • Researchers examined the relationship between avocado consumption and cardiovascular events. 
  • They found that eating 2 or more servings of avocado per week is linked to 16% fewer cardiovascular events over a 30-year period. One serving is half an avocado, or 80 grams (g).
  • The researchers conclude that replacing certain fat-containing foods with avocado could lower cardiovascular disease risk. 
  • The note however that replacing plant oils with avocado is linked to a 45% higher stroke risk. 

Cardiovascular disease (CVD) is the leading cause of death worldwide. However, it can be prevented through lifestyle factors like diet

The American Heart Association (AHA) recommends limiting 5 to 6% of calories intake from saturated fatty acid (SFA), and replacing SFA and trans-fats with monounsaturated fats (MUFA) and polyunsaturated fats for better heart health. 

Avocados are rich in MUFAs and polyunsaturated fats. Studies have found that their regular consumption reduces triglycerides, low-density lipoprotein (LDL) cholesterol, and total cholesterol level. 

Most studies on avocado consumption have focused on cardiovascular risk factors. Studies investigating the link between avocado consumption and cardiovascular events could improve understanding of the fruit’s health benefits. 

Recently, researchers have investigated the link between avocado consumption and cardiovascular events. 

They found that higher consumption of avocados was linked to a lower risk of CVD and coronary heart disease (CHD). 

“The […] results are significant and strengthen previous findings of avocados’ association with a lower risk of cardiovascular disease [as well as] reducing heart outcomes such as fatal and nonfatal myocardial infarction,” Bhanu Gupta, MD, cardiologist at The University of Kansas Health System, not involved in the study, told Medical News Today.

“Point to be noted: avocado consumption does not lower the risk of stroke in the study. Another point to be noted: avocado is not a replacement for healthy dietary fats such as olive oils, nuts, and other plant oils.” 

– Dr. Gupta

The study was published in the Journal of the American Heart Association (JAHA)Trusted Source

Data analysis

For the study, the researchers used data from the Health Professionals Follow-Up Study (HPFS) and the Nurses’ Health Studies (NHS). Both studies are ongoing and began in 1986 and 1976 to examine the effects of health and lifestyle on the incidence of serious illness in male and female healthcare professionals. 

For the present study, the researchers included 62,225 females and 41,701 males who did not have a history of heart disease, stroke, or cancer. 

The researchers examined their medical records for incidence of myocardial infarction and stroke, dietary surveys taken once every 4 years, and risk factors such as hypertension and type 2 diabetes from self-reports and physician diagnoses. Participants were tracked for 30 years. 

By the end of the study period, the researchers noted 14,274 incident cases of CVD including 9,185 CHD events and 5,290 strokes. 

The researchers noted that males and females with higher avocado intake tended to have higher total energy intake and a healthier diet with more fruits, vegetables, whole grains, nuts, and dairy products such as yogurt and cheese. 

After adjusting for major dietary and lifestyle factors, the researchers found that having two or more servings of avocado per week was linked to a 16% lower CVD risk and 21% lower CHD risk compared to those who did not eat avocados. 

They further found that replacing half a serving per day of mayonnaise, margarine, butter, egg, yogurt, cheese, or processed meats with the same amount of avocado was linked to a 19–31% lower risk of coronary heart disease. 

They reported no significant association between stroke risk and avocado consumption. However, they noted that replacing half a serving per day of plant oils with an equivalent amount of avocado was linked to a 45% higher stroke risk. 

Nutrient-rich food 

When asked to explain what might account for the positive effects of avocado on CVD risk, study first author Lorena Pacheco, Ph.D., MPH, RDN, postdoctoral research fellow at Harvard T.H. Chan School of Public Health, told MNT

“Avocados are a nutrient-rich food item with favorable food compounds including monounsaturated and polyunsaturated fats (healthy fats), vitamins, minerals, soluble fiber, vegetable proteins, phytosterols, and polyphenols. There are potential biological mechanisms by which avocados offer cardioprotective benefits.”

“The primary monounsaturated fatty acid present in avocados is oleic acid – healthy fat – and it is suggested that it helps in reducing hypertension, inflammation, and insulin sensitivity.” 

“Additionally, they contain plant sterols that could have favorable effects on lipid profiles. [Also], the soluble fiber intake in avocados can also lead to a better lipid profile, meaning lower ‘bad cholesterol’ levels,” she explained. 

“They also are a source of vegetable protein,” added Penny M. Kris-Etherton Ph.D., professor of nutritional science at Penn State College of Health and Human Development, not involved in the study. “Collectively, it is very likely that this ‘package’ of heart-health compounds accounts for the findings,” said Dr. Kris-Etherton. 

The researchers concluded that replacing certain fat-containing foods with avocado could lower CVD risk. 

Study limitations

The authors noted some limitations to their findings. As their study was observational, they could not establish causation. 

Shannon Hoos-Thompson, MD, a cardiologist at The University of Kansas Health System, not involved in the study, explained for MNT

“To put the findings in perspective, eating less cardiovascular unhealthy food may be the explanation [rather] than the result being specific to avocado consumption.” 

The authors also noted that their study population was primarily non-Hispanic white nurses and health professionals, so their results may not be generalized to wider demographics. 

“The dietary data were self-reported and have some measurement error,” added Dr. Kris-Etherton. “However, the authors used a repeated measurements dietary assessment method and collected intake data over time, which reduces random measurement error.”

Taking Care of Your Mental Health

Sadness, fear, worry, or other emotions can affect us during or after tough situations, like dealing with the COVID-19 pandemic, the loss of a family member or friend, or experiences related to racism. Dealing with these challenges can weigh heavily on your mental health, and recent data suggest this is the case for many who have sought professional help with their mental health since the pandemic started.

Increases in mental health-related ED visits

Recent research suggests that some racial and ethnic minority groups have been more affected by mental health challenges related to the pandemic. According to a new study published in JAMA Psychiatry, these groups had significant increases in emergency department (ED) visits for new and existing mental disorders during and after a COVID-19 case surge.

  • Asian adults had increases in the number of visits for most of the mental disorders that the study looked at, including a 21% increase in ED visits with depression during a COVID-19 surge.
  • American Indian and Alaska Native adults had increases in the number of ED visits for multiple mental disorders after a COVID-19 surge, including a 42% increase in trauma and stressor-related visits.
  • There was a 24% increase in ED visits for bipolar disorder among Hispanic adults and a 14% increase in trauma and stressor disorder-related visits among Black adults after a surge.

Mental Health Impact of Stress

It’s natural to feel stress, anxiety, grief, and worry during challenging times. Feeling strong emotions or being stressed can have negative effects on your health. Stress can cause the following:

  • Feelings of fear, anger, sadness, worry, numbness, or frustration.
  • Changes in appetite, energy, desires, or interests.
  • Problems concentrating or making decisions.
  • Nightmares or problems sleeping.
  • Physical reactions, such as headaches, body pains, stomach problems, or skin rashes.
  • Worsening of chronic diseases and mental health conditions.
  • Overeating or not eating enough.
  • Increased use of alcohol, illegal drugs (like heroin, cocainemethamphetamine), and misuse of prescription drugs (like opioids).

Healthy Ways to Cope with Stress

Learning to cope with stress in a healthy way will help you, the people you care about, and those around you become more resilient. You can help yourself, others, and your community manage stress in the following ways.

  • Take breaks from news stories, including those on social media. It’s good to be informed, but constant discouraging information can be upsetting. Consider limiting news to just a couple of times a day and disconnecting from your phone, TV, and computer screens for a while.

Take care of your body:

  • Get vaccinated and stay up to date on your COVID-19 vaccines.
  • Eat plenty of fruits and vegetables, lean protein, whole grains, and fat-free or low-fat milk and dairy products. Eating well also means limiting saturated fats, cholesterol, salt, and added sugars.
  • Going to bed at the same time each night and getting up at the same time each morning, including on the weekends, can help you sleep better (adults need 7 or more hours per night).
  • Move more and sit less. Every little bit of physical activity helps. You can start small and build up to 150 minutes a week that can be broken down to smaller amounts such as 20 to 30 minutes a day.
  • Take deep breaths, stretch, or meditate.
  • Limit alcohol intake. Choose not to drink, or drink in moderation (one drink a day for women, two for men) on days that alcohol is consumed.
  • Avoid using prescription drugs in ways other than prescribed, taking someone else’s prescription, or using illegal drugs. Treatment is available and recovery starts with asking for help.
  • Avoid smoking and the use of other tobacco products. People can and do quit smoking for good.
  • Continue with regular health appointments, testing, and screening, especially those for cancer.