Prediabetes: What It Is and How You Can Still Prevent Diabetes

No one wants to hear that diagnosis. But, it doesn't necessarily mean diabetes is in your future. Here's how you can control your A1C levels and protect yourself.

After a recent blood test to check my B12 levels, I logged online to my LifeLabs results and found a hazard sign (the site's indicator that something is alarming with your blood test results). I assumed my B12 levels must have dropped again, but on closer inspection, I realized that they were normal. It was only when my eyes landed on "general chemistry" that I saw the reason for the hazard sign. T0 my surprise, the offending level was due to my hemoglobin A1C number. I had no idea what caused this high reading or even what it meant.

A frantic search on WebMD told me that my level of 6.3 meant that I had prediabetes and was teetering on the line of full-blown diabetes, which I'd meet the criteria for if it reached a level of 6.5. I was in shock. But maybe, given my lifestyle, I shouldn't have been.

A work-from-home mom, I admit that I've let my health slide. Between assignments and daily errands, I'd often opt for a quick sandwich, followed by a cookie (or two) to satisfy my sweet tooth. Dinners always had carbs (hello, pasta). And, of course, what's dinner without dessert? But it's not like I never exercised. I'd head out on walks with the dog, go to Zumba every once in a while and sometimes do workout videos in my living room. But, even though the pounds have crept up on me over the years, I still thought I was healthy — until that glaring hazard sign stared back at me, forcing me to face the truth: I wasn't.

My next search opened my eyes to another truth: I wasn't alone. In fact, I was now part of a huge club: It's estimated that more than six million Canadians have prediabetes. Of those, almost 50 percent will go on to develop type 2 diabetes. But they don't have to. Here's a breakdown of what's going on in your body and how you can protect yourself from developing full-blown diabetes.

What is A1C?

Simply put, hemoglobin A1C is a measure of the amount of sugar that sticks to the hemoglobin of red blood cells. Red blood cells live for two or three months, so the A1C level reflects the amount of sugar attached to your red blood cells and how well or poorly your blood sugar levels have been controlled over that three-month span.

What causes A1C to increase?

The scary part of having prediabetes is that, without a blood test, you don't know you're at risk. It's not something you feel, and it doesn't come with any alarming symptoms.

Everyone should get an A1C test, especially if you have a family history of diabetes, have polycystic ovary syndrome (PCOS), have previously suffered gestational diabetes while pregnant or are overweight or obese because you have a higher risk of developing diabetes, says Dr. Natalia Mclnnes, an associate professor at McMaster University who focuses her research on weight loss and remission of type 2 diabetes. Planning to get pregnant? Get your A1C levels checked before you try to conceive — a high level puts your pregnancy and baby at greater risk of complications.

Controlling A1C

Diet can play a big role in controlling your A1C. Dr. Jan Hux, president of Diabetes Canada, says that people can lower their A1C levels by incorporating more fruits, vegetables and whole grains into their diets while cutting back on highly processed foods. She says it's more about adopting a well-balanced philosophy of eating rather than incorporating a diet that may be hard to stick to.

"There are some eating patterns that are recommended for controlling blood sugar levels, such as the Mediterranean and DASH diets," says Dr. Hux. Physical activity is also integral to managing A1C levels. Dr. Hux says that doing 150 minutes of activity that gets your heart rate up each week is key.

Losing weight can also help you reduce your A1C levels. According to Dr. Hux, research conducted by the Centers for Disease Control and Prevention in the U.S., discovered that losing just seven percent of your baseline weight can make a huge difference in your levels.

"In the program, somebody came in at 300 pounds and only went down to 280," she says. "Although they weren't at their desired weight, their risk of diabetes fell by 58 percent. Even a modest change — losing seven percent of one's baseline weight — made a difference, and that's amazing because we have no drug that can make that big of a difference in your health outcome." Dr. Hux notes that how patients lose weight matters, as these findings aren't based on weight lost by any method but specifically by a program of physical activity and healthy eating.

But it's not only overweight people that can get prediabetes. People with a healthy body mass index (BMI) can also reach those levels, especially if they have a family history of the disease or other important risk factors.

Get Tested

Diabetes Canada offers a quick online questionnaire that considers factors like your age, weight, physical activity, ethnicity, family history and eating patterns before calculating your risk of getting prediabetes or diabetes. Of course, a blood test is the only accurate way to know your levels for sure.

Dos and Don'ts of Controlling Your A1C Levels

Dr. Natalia McInnes, an associate professor at Mc Master University who focuses her research on weight loss and remission of type 2 diabetes, recommends these tips for controlling A 1C levels.

DO

Eat healthy: Eat a high-fibre diet that includes lots of fruits and vegetables and some healthy protein, like low-fat dairy and white meat. Consider meeting with a dietitian to get advice on what a healthy diet is and how to improve yours.

Get moving: Sign up for a gym or meet with a trainer to get a physical activity program set up for you. You need to get at least 150 minutes of moderate-intensity physical activity each week. Figure out what kind of exercise you like to do and gradually work on increasing it.

Set weekly goals for changing your diet and increasing your physical activity: Keep a journal, and reflect on whether you are meeting these goals every week.

Learn how to manage stress: If you're a stress eater, try to find healthy ways to cope. Doing meditation, exercising or just talking to a family member or friend about how you're feeling can help.

DON'T

Don't overeat: Make sure that your portions are in check. Consult the food-portions tool kit at un/ockfood.ca for a dietitian-approved guide to eyeballing healthy serving sizes.

Don't consume sugar-sweetened beverages: Make a habit of having water as your go-to for staying hydrated. If you're a coffee or tea lover, gradually reduce the amount of sugar you add to your order.

Don't eat many processed foods, red meats and refined grains: Make chicken, fish and plant-based proteins, like legumes, the stars of your meal.

Don't be sedentary: Find more ways to add activity to your daily routine, such as taking a walk on your lunch break.

Next, check out some genius ways to have a healthy life on a budget.