Ep 2: Catching Prediabetes Early: Recognizing Symptoms and Early Detection

[00:00:00] Oscar Camejo: I was about 268 pounds and I felt myself being tired a lot. Just going up and down steps was a struggle.

[00:00:10] Dr. Bayo Curry-Winchell: Some people like Oscar Camejo may notice something's wrong before they are diagnosed with prediabetes.

[00:00:16] Oscar Camejo: It just felt weird, you know, when your body is off.

[00:00:20] Dr. Bayo Curry-Winchell: But most people live for years with prediabetes before realizing they have it.

Early diagnosis is key to managing prediabetes and preventing type 2. And that's what we'll talk about in this second episode of the Preventing Type 2 Diabetes Podcast. We'll learn how prediabetes is diagnosed and hear from people like Jessica about how they coped with their diagnosis. 

[00:00:45] Jessica Patrick: It's something that makes you very mindful of how you live your life.

[00:00:52] Dr. Bayo Curry-Winchell: This is the Preventing Type 2 Diabetes Podcast. I'm your host, Dr. BCW. The Preventing Type 2 Diabetes Podcast is a production of Mission Based Media and was made possible with the support from the American Pharmacists Association Foundation. This series is for educational purposes only. It is not a substitute for formal medical advice, diagnosis, or treatment. So please, if you have questions about your health, talk to a qualified healthcare provider. 

In episode one, registered nurse and certified diabetes care and education specialist Adrienne Maye explained that prediabetes is the stage before type 2 diabetes. 

[00:01:35] Adrienna Maye: With prediabetes, your blood sugars are elevated, but not high enough for you to have the diagnosis of type 2 diabetes. I always tell people it's the bridge. You're at one end of the bridge, but if you cross over, you're at type 2 diabetes. 

[00:01:50] Dr. Bayo Curry-Winchell: The CDC estimated that about 96 million adults in the U. S. had prediabetes in 2019. That's about one third of the U. S. population. Oftentimes, people with prediabetes won't even know they have it.

[00:02:06] Ryan Aiazzi: Prediabetes doesn't have a lot of symptoms. 

[00:02:09] Dr. Bayo Curry-Winchell: This is family nurse practitioner Ryan Aiazzi. We met him in the last episode.

[00:02:15] Ryan Aiazzi: I have had some patients complain of fatigue or in some of my male patients, maybe some decreased libido. They're very subtle things that you wouldn't necessarily pinpoint, aha, that's diabetes right away.

[00:02:28] Dr. Bayo Curry-Winchell: Oscar Camejo is the host of the Beating Diabetes Lifestyle Podcast.

[00:02:34] Oscar Camejo: I live here in Atlanta, Georgia. My story began with me being diagnosed with prediabetes in 2018. 

[00:02:44] Dr. Bayo Curry-Winchell: Oscar was 268 pounds and constantly feeling sluggish and tired. 

[00:02:49] Oscar Camejo: I remember actually feeling some chest pain and it was just felt weird, you know, when your body is off. So I decided to go to the doctor. 

[00:03:01] Dr. Bayo Curry-Winchell: Initially, Oscar's doctors thought he had a heart problem, not prediabetes, and it wasn't until they took blood work that he learned his blood sugar and cholesterol were high. 

[00:03:11] Oscar Camejo: I was given a one sheet document that said, hey, start eating better and try to exercise so you can prevent getting type 2 diabetes.

[00:03:22] Dr. Bayo Curry-Winchell: Unfortunately for many people, this is about all the information they get. Oscar got one sheet from his physician telling him he needed to make some really big life changes, but there are actually lots of great resources that can help people figure out what they need to change and how they need to change it. We'll get into some of those resources throughout this series, and you can find links on our website at healthunmuted.com/resources. 

In some ways, Oscar was lucky to notice his symptoms, seek help, and receive a diagnosis of prediabetes early. For many other people, they may not develop symptoms or receive a diagnosis for a long period of time. And that loss of time means that you could be getting closer and closer to crossing that bridge to a diagnosis of type 2 diabetes. 

[00:04:13] Ryan Aiazzi: As your body becomes closer to diabetic, you start to get maybe a little bit of tingling here and there in the fingers or the toes, which is known as neuropathy. A lot of times they'll notice some weight gain that is harder and harder to get off.

[00:04:27] Dr. Bayo Curry-Winchell: It's common for people with prediabetes to experience the kinds of symptoms that are associated with the diagnosis of type 1 diabetes or type 2 diabetes.

[00:04:37] Ryan Aiazzi: Increased hunger and eating more, more frequent need to urinate, and increased thirst and wanting to drink water more often or other beverages. 

[00:04:48] Dr. Bayo Curry-Winchell: So let's say you and your health care provider suspect you may have prediabetes. To confirm a diagnosis, your health care provider will most likely order a blood test called a hemoglobin A1C test. Here's Grace Silverio, a registered nurse and diabetes educator. 

[00:05:05] Grace Silverio: A hemoglobin A1C is a lab test, so you have to go get some blood drawn in order to check to see over the course of three months how much glucose is actually still in the blood.

[00:05:16] Dr. Bayo Curry-Winchell: You'll also hear hemoglobin A1C described sometimes as just A1C or HbA1C. And remember that glucose just means sugar. 

[00:05:28] Ryan Aiazzi: And the lab can do a quick calculation and say, yep, based on how much glucose we see attached to your red blood cell, your A1C is this.

[00:05:36] Dr. Bayo Curry-Winchell: Red blood cells are the cells that carry oxygen from the lungs around the body.

Your healthcare provider will take a small blood sample from your finger or arm. You don't need to do anything special to prepare for the test. Then it's time to read the results. 

[00:05:51] Grace Silverio: In my experience as an educator, when someone gets their hemoglobin A1C result, it's like this report card. 

[00:05:59] Dr. Bayo Curry-Winchell: A score of 5.7% or below is considered normal.

[00:06:04] Grace Silverio: So for prediabetes, the hemoglobin A1C diagnosis is 5.7 to 6.4%.

[00:06:12] Dr. Bayo Curry-Winchell: In other words, if between 5.7% and 6.4% of the hemoglobin protein in your red blood cells is coated with sugar, you may be diagnosed with prediabetes. 

[00:06:25] Grace Silverio: 6.5% or greater than you are considered to be diagnosed with diabetes.

[00:06:31] Dr. Bayo Curry-Winchell: Your healthcare provider may also use your A1C level to keep track of your risk of developing type 2 diabetes and other complications.

[00:06:39] Ryan Aiazzi: I like to measure it as a way to gauge where someone is at on their path. We have some people who hang out in the prediabetic range, they're very healthy people, they eat healthy, they exercise, but their A1C is always at a 5.7, 5.8, regardless of what they do, but they never progress. Some people, if I check their A1C and they're at a 5.8 and then I check it a few months later and it's a 6.0, and then a few months later, it's a 6.2, that gives me a lot of great information on, hey, we need to intervene now before this turns into something more serious.

[00:07:13] Dr. Bayo Curry-Winchell: Another test that can be used to diagnose prediabetes is a fasting blood sugar test. A fasting blood sugar test, also known as a fasting plasma glucose test, or FPG, is like a snapshot of your blood sugar levels after you've gone without food for a stretch, usually overnight. Your healthcare provider can explain more about these different tests and which is best for your situation.

If you or someone you care about are diagnosed with prediabetes, it can feel overwhelming. For Jessica, who has a family history of diabetes, it seemed to her almost inevitable that she would have it too.

[00:07:54] Jessica Patrick: It almost seems like because of my genetic predisposition that this is something that I would be marching towards without an opportunity to scale it back, without stopping it, and then you see that your A1C is inching up and you are getting closer to the point of becoming diabetic and you get that prediabetes diagnosis, it's very scary. 

[00:08:17] Dr. Bayo Curry-Winchell: And because her family didn't openly talk about diabetes, Jessica found herself at a bit of a loss when she was diagnosed with prediabetes.

[00:08:26] Jessica Patrick: It's not that I didn't take it seriously. It's just that I didn't know how to attack it in the way that I do now.

[00:08:33] Dr. Bayo Curry-Winchell: Jessica, like many other people who struggle with their weight, also sometimes felt stigmatized and judged for things that fell out of her control. And while it's true that some lifestyle factors contribute to prediabetes and type 2 diabetes, Ryan reminds his patients that they shouldn't blame themselves and that other factors could be contributing.

[00:08:54] Ryan Aiazzi: Your past doesn't define you, what you do going forward defines you. This is something that we can help manage. So the light at the end of the tunnel is not a train.

[00:09:03] Dr. Bayo Curry-Winchell: So, if you or someone you love has recently been diagnosed with prediabetes, here's a little guide to help you. 

Firstly, registered nurse Adrienne Maye says you shouldn't be afraid to ask questions.

[00:09:16] Adrienne Maye: I think that the most important questions that a patient should ask their provider is, first of all, explain this to me. You say, I have this diagnosis. What does this mean? Well, if they say your A1C is 9.5, what does that mean? 

[00:09:34] Dr. Bayo Curry-Winchell: Secondly, your support network is also really important, as Jessica and Oscar have found.

[00:09:40] Jessica Patrick: We live in a time where you don't have to think of your health struggles as taboo and the more open you are and the more you are willing to talk to others who are in similar situations, the more you can garner from that to help change your lifestyle and move towards a healthier one. 

[00:09:59] Oscar Camejo: And if you are married or you have a partner or what have you, you want to be accountable. To them to let them know, hey, I'm working on my health. So I need your help. It's okay if you're struggling to reach out to a friend. 

[00:10:16] Dr. Bayo Curry-Winchell: And if someone in your life isn't being supportive of your new healthy lifestyle choices, Sebastian Beller, who is a lifestyle coach with the American Pharmacists Association Foundation, recommends drawing clear boundaries.

[00:10:29] Sebastian Beller: It is worthwhile to try to have a conversation with those people and let them know that while they're entitled to their own opinions, it's probably not going to be helpful to your progress. And these conversations can be awkward. I've had a few of them myself. It's weird sitting down with your mother and telling her, I don't need you commenting on my health anymore. But when you set those expectations early on, and you tell them that this is what I'm going to be doing, this is what you're going to be seeing, this is the support that I need from you, they're much more likely to give you that support and, at the very least, withhold those opinions that might be not so helpful to your progress.

[00:11:03] Dr. Bayo Curry-Winchell: And thirdly, go easy on yourself. 

[00:11:07] Grace Silverio: It can be overwhelming. It can be a lot. Be kind to yourself.

[00:11:11] Adrienne Maye: Take a deep breath. It's going to be okay. This is an individual walk, individual journey. Once you get everything lined up the best way you can, move forward. It's not going to be perfect. You're not going to get it right every time, but just do it. It's your journey and just stick with it. 

[00:11:30] Dr. Bayo Curry-Winchell: In the next episode: 

[00:11:32] Rebecca Lindstedt: Carbohydrates raise your blood sugar if you eat too much, or you might go a little low if you don't eat enough. 

[00:11:38] Dr. Bayo Curry-Winchell: We talk about food choices. Does a prediabetes diagnosis mean the end of your favorite foods? 

For now, if you want to learn more about how prediabetes is diagnosed, you can head to our website at healthunmuted.com/resources, where you can find links to the National Diabetes Prevention Program, lifestyle change programs, and other resources that can help reduce the risk of type 2 diabetes. 

I'm Dr. BCW, and this is the Preventing Type 2 Diabetes Podcast. This show is part of the Health UNMUTED Audio Library by Mission Based Media and was created with support from the American Pharmacists Association Foundation. To listen and learn more, visit healthunmuted.com and share it with someone you care about.