Q: My doctor told me that my fasting blood glucose was 117, I need to lose 100 pounds, I should eat more healthfully, and I should start exercising. Then he walked out of the office without giving me a prescription. How can I prevent diabetes?
A: A fasting blood glucose of 100-125 mg/dl likely means you have pre-diabetes. Your blood glucose is higher than normal but not high enough to diagnose diabetes. There is a silver lining. Research shows that if you follow a healthful eating plan (especially limiting how much fat you eat and getting plenty of fiber), be active about 30 minutes five days a week, and lose just 5-7 percent of your starting body weight, you can delay or prevent the onset of type 2 diabetes without going on a medication.
It is worth noting that research in people with pre-diabetes has shown that several of the blood-glucose-lowering medications are effective in delaying or preventing type 2 diabetes. At this point, none of the medications approved by the U.S. Food and Drug Administration for treating type 2 are approved for treating pre-diabetes.
Keep in mind that pre-diabetes and type 2 are progressive. Over time, about 70 percent of people with pre-diabetes develop type 2, particularly if they don't make healthful lifestyle modifications. Most people with type 2 diabetes require some blood-glucose-lowering medication.
Your main goal should be to control your weight and blood glucose. If you do need to take blood-glucose-lowering medicine, take it without shame or guilt.
To learn more about diabetes and to get the support you will need to achieve your goals, find health-care providers who know about diabetes. Also request a referral from your provider to a diabetes education program. Find a diabetes education program in your area through the American Diabetes Association.
Jeannette Jordan, M.S., R.D., CDE, is the American Dietetic Association's national spokesperson for African-American nutrition issues and oversees nutrition education at the Medical University of South Carolina.