Life on the Borderline
Sign up for Free Classes on Prediabetes
Learn how to prevent type 2 diabetes at California Pacific Medical Center’s Center for Diabetes Services, which offers a two-class program on prediabetes. For dates and times, call 415.600.0506.
If you are living with diabetes, you may be eligible for Brown & Toland’s Diabetes Management Program.
To learn more about the services available, contact Diabetes Clinical Specialist Barbara Liepman, R.N., via This e-mail address is being protected from spambots. You need JavaScript enabled to view it or 415.972.4430.
For more information on diabetes management classes at CPMC and other Brown & Toland hospital partners, see "Your Health".
Eliza McCaw, M.D.
Internal Medicine
2100 Webster Street, Suite 423
San Francisco, CA 94115
415.923.6566,
Pacific Internal Medicine Associates.
Prediabetes is a warning sign — and an opportunity to improve your health
Right now, 79 million Americans have prediabetes, yet many have no idea. This condition — a blood glucose level that is elevated, but not high enough to be called diabetes — often has no symptoms, but it puts people on the path to type 2 diabetes. Could you be one of them?
A simple fasting blood glucose test can reveal whether your blood sugar might be drifting skyward. While no one wants to hear that they have prediabetes, knowing where you stand can inspire you to make positive changes — and delay or even prevent diabetes.
Even prediabetes puts you at risk of developing health problems. “People with prediabetes have a 1.5-fold risk of cardiovascular disease compared to people with normal blood sugars,” says Barbara Liepman, R.N., M.S., a certified diabetes educator at Brown & Toland Physicians. (People with diabetes, meanwhile, have a two- to fourfold increase of cardiovascular disease.)
“Start by talking to your doctor about any risk factors and make sure that you’re up to date with your yearly physical and labs,” recommends Eliza McCaw, M.D., a Brown & Toland internal medicine physician. If you are overweight, talk to your doctor about getting tested. If you have any diabetes risk factors — such as high blood pressure, low HDL cholesterol and high triglycerides, or a family history of diabetes — you should also be tested, regardless of your age. Women with a prior history of gestational diabetes are also at higher risk. The earlier your prediabetes is recognized, the greater chance you’ll have to prevent coronary artery disease and other vascular complications that are seen in people who have long-standing diabetes.
When speaking of blood sugar, how high is too high? Those with a fasting blood glucose of 126 mg/dL or higher have diabetes, while results between 100 and 125 mg/dL put someone in the prediabetes range. “We define fasting glucose levels less than 100 mg/dL as normal, but there’s some evidence that even people who have values in the upper range of normal may be at increased risk compared to those with low to normal fasting glucose,” says Dr. McCaw.
Another test, the hemoglobin A1C, can gauge your blood glucose control over two to three months. A level between 5.7 and 6.4 percent is considered prediabetic, while a result of 6.5 percent or higher is considered diabetes.
If you are diagnosed with prediabetes (or diabetes), there’s much you can do to bring your numbers down. In fact, a major multicenter clinical trial, the Diabetes Prevention Program study (sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases), showed that just 30 minutes of moderate physical activity per day, combined with a 5 to 10 percent reduction in body weight, helps reduce the risk of diabetes by 58 percent. “People who reduced their weight and increased their activity had less risk of developing diabetes during the course of the study than people who were put on a medication called metformin,” Liepman says.
People with busy schedules may find it tough to make time for exercise, but even making small changes, like taking the stairs instead of the elevator or parking farther away when you’re running errands, can help. So can making healthy changes to your diet. “Moderation is key, so just make sure that most of your diet is fruits, vegetables, whole grains and lean protein,” Dr. McCaw says..Also, try to reduce the amount of refined carbohydrates and sugar in your diet, including sugar in soft drinks and sweetened coffee drinks. As you incorporate healthful changes into your life, write down your goals and track them so you can reward yourself and stay motivated.
Need some help on your journey? Brown & Toland partners with several diabetes education centers in the Bay Area, which offer counseling, tools and strategies for controlling prediabetes and diabetes. Experts say it’s important not to go it alone. As Liepman observes, “People really need a supportive community made up of family, friends and professionals who will cheer them on as they take on the challenges.”
