Blood sugar screening for prediabetes and type 2 diabetes isn’t something that is front-of-mind for many people, especially young adults and people in good health. But early detection of prediabetes can help you significantly reduce the risk of development of type 2 diabetes. Prediabetes is often asymptomatic, and progression to type 2 diabetes happens in 50% of those with prediabetes. So how do you know when and if you need to be screened?
Determine if you are at risk of developing type 2 diabetes
There are a number of risk factors that determine if you are more likely to develop type 2 diabetes, and are applicable at any age.
- Having a parent, brother, or sister with diabetes;
- Being a member of a high-risk group (Aboriginal, Hispanic, South Asian, Asian, or African descent);
- Having given birth to a baby that weighed more than four kilograms (nine pounds) at birth or having had gestational diabetes (diabetes during pregnancy);
- Having been diagnosed with prediabetes (impaired glucose tolerance or impaired fasting glucose);
- Having high blood pressure;
- Having high cholesterol or other fats in the blood;
- Being overweight, especially if that weight is mostly carried around the middle;
- Having been diagnosed with polycystic ovary syndrome;
- Having been diagnosed with psychiatric disorders: schizophrenia, depression, bipolar disorder;
- Having been diagnosed with obstructive sleep apnea
See more risk factors on the Canadian Diabetes Association website.
If you are at risk, get screened regularly by your doctor
If you have one risk factor, your doctor should screen your blood glucose (sugar) once every three years. Dr. Jan Hux, chief science officer for the Canadian Diabetes Association, says that if you have multiple risk factors, you may want to have your blood glucose tested once a year. For example, if you are a member of a high-risk group, members of your immediate family have type 2 diabetes, and you are overweight with weight being carried around the middle, you should be testing once per year, even if you are otherwise healthy. Those who have no risk factors do not require testing.
Early detection can prevent type 2 diabetes with just five per cent loss of body weight
If you are diagnosed with prediabetes, which is typically considered to be when your blood glucose is “high normal”, there are a number of preventative measures you can take to reduce the risk of progression to type 2 diabetes. The first and most important is lifestyle change, which doesn’t have to be a huge adjustment.
A lifestyle change can be a commitment to exercise more frequently, dietary modifications, or a combination of the two. And it doesn’t take much; a structured lifestyle change that results in a five per cent loss of initial body weight prevents progression to type 2 diabetes by nearly 60 per cent. This is true for any starting body weight.
Dietary changes can include avoiding foods that are high on the glycemic index, substituting refined grains for whole grains, limiting portion sizes and increasing your fruit and vegetable intake.
If you are making a structured lifestyle change that you make an ongoing commitment to, you probably won’t stop at losing five per cent of your body weight – but small steps make a huge difference and the process doesn’t have to be an overwhelming one. This is good news since those who have developed prediabetes may also have some measure of insulin resistance, which can make it harder to lose weight. But the more weight you lose and the better food you eat, the more likely it is that you will lose some of that insulin resistance and the weight will fall off faster.
If prediabetes is indicated, your doctor will usually ask you initially to try lifestyle changes over medication, since diet and exercise only have positive side effects. If your blood glucose doesn’t decrease significantly over time, or you have other conditions such as polycystic ovarian syndrome, your doctor may prescribe metformin or similar medications to help keep your blood glucose levels down.
Lifestyle changes can be difficult
It’s a standard assumption that lifestyle changes are easy. In reality, they can be very difficult. If you live in a neighbourhood that doesn’t have sidewalks or is unsafe at night, it isn’t that simple to just go for a walk. Similarly, if you can’t afford to buy fresh produce on a regular basis due to preventative costs on a fixed income or high produce costs in your area, changing your diet isn’t just a matter of buying more fruits and vegetables. If you face obstacles in making lifestyle changes, talk to your primary health-care provider about ways to overcome these challenges.
The payoff of type 2 diabetes prevention and screening
If you develop type 2 diabetes, there is much more work involved than testing your blood glucose on a daily basis and taking medication. While there are many medications, devices and programs to help the management of type 2 diabetes, it can be overwhelming. But those living with the disease can live active, independent and vital lives. Good management of diabetes early on is quite important as those living with the disease are at higher risk for other medical issues such as heart disease. Screening is the key!
To determine if you are at risk of developing type 2 diabetes, take our short CANRISK questionnaire online.