My Doctor Told Me I Have Prediabetes What Do I Do Now
There is no shortage of guidance from medical professionals about the risks and management of diabetes. But there is another closely linked condition that is far more prevalent and requires fast action: prediabetes.
About 1 in 3 Americans currently have prediabetes. More alarmingly, 84% dont know they have it. In fact, a 2018 study found that metabolic markers of prediabetes may occur 20 years before a diagnosis is made. This may be because some of the symptoms associated with a prediabetic state are often not obviously related.
Studies show that up to 170 million Americans could be prediabetic by 2030, which means many people will find themselves sitting in a doctor’s office faced with the diagnosis. So what should you do when you hear those words? Here’s what you need to know:
Act Quickly To Treat The Situation
If you suspect you have low blood sugar, Dr. Fruge recommends quickly treating the situation, which she says should include “eating healthy foods such as complex carbohydrates, beans or fruit.”
“At the Pritikin Longevity Center we serve a cup of fruit with a cup of veggies to prevent a spike in insulin, which can sometimes lead to a later drop in blood sugar again,” she explains. “Adjusting your diabetes medication as prescribed by your physician may also be necessary. It’s important to retest your blood sugar 20 minutes after eating to confirm it has improved.”
Keep a fast-acting carbohydrate snack or two on hand in case your blood sugar dips below healthy levels.
Exercise Physiologist Or Physical Trainer
People with either types of diabetes need to exercise to help control their weight and blood sugar levels. Exercising can also help reduce stress as well as help the body use insulin better.
Your healthcare provider can help you find a licensed healthcare professional with training in exercise physiology. A scientifically based fitness program can be planned by an exercise physiologist for people with diabetes.
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Darker Area Of Skin That Feels Like Velvet
A dark patch of velvety skin on the back of your neck, armpit, groin, or elsewhere could mean that you have too much insulin in your blood. This is often a sign of prediabetes.The medical name for this skin condition is acanthosis nigricans.
Acanthosis Nigricans
Often causing darker skin in the creases of the neck, AN may be the first sign that someone has diabetes.
Take action
- Get tested for diabetes
What Is Happening In My Body If I Am Diagnosed With Prediabetes
When blood sugar is consistently elevated, damage to organs , as well as the nervous system can occur. This increases the risk for heart disease and stroke, as well as kidney and eye problems. A 2020 study in the British Medical Journal found that prediabetes was linked to an increased risk of both heart disease and death studies also show an increased risk of Alzheimers disease and dementia. Not to mention it leaves you more vulnerable to complications from other illnesses, including COVID-19.
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These Hospital Doctors Dont Know Me
The new age of medicine is using hospitalists to direct care of patients while in the hospital. They have a very broad range of knowledge, but dont specialize in any one type of disease.
It is a mistake by the hospitalist if they do not immediately ask you for your prescription and just stop your regular medication or replace it with another one. They are not helping the patient as a sudden change of medication makes them very anxious adding to the anxiety of being admitted to a hospital in the first place.
When my cousin was admitted, he saw a hospitalist doctor. Most of his medications were taken away in the hospital and they chose to manage him with insulin only. I received a frantic phone call from him the night he was admitted telling me that he was not allowed to have any of his regular medications.
This can be so scary for a patient and understanding how to deal with this loss of control will help relieve those fears.
Explanation: Yes, the hospitalist may hold off on giving you your normal medications even if they are necessary until he or she is able to consult your specialist for recommendations on how to give them to you. To help avoid delays in your proper medications being given, take all your prescription medications from home in their original bottles and give them to your nurse. Ask for them to be verified as soon as possible so you can take them on a regular schedule.
Where To Find One
An endocrinologist can work in:
- A medical practice with other endocrinologists
- A group with different kinds of doctors
- Hospitals
You can search for one on the American Association of Clinical Endocrinologists website.
Some don’t see patients. They may work in universities or medical schools, where they teach medical students and residents or do research.
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Request Your Old Medication
If youve been on a specific type of insulin or medication for several years or more , insurers typically wont change your coverage, but it does happen.
If youre unwilling to try the new drug, you should immediately call your health insurance plan and request your old medication.
The health plan may say that they need a prior authorization from your doctor stating that the specific prescription drug theyre requesting is a medical necessity to you, and cannot be used interchangeably with another, cheaper drug.
A prior authorization request must be submitted through your medical professional you cannot submit one on your own behalf.
Some people run into these issues multiple times a year, for multiple medications, as the PAR process is a way for insurers to cut costs .
Have your doctor request 99 months on the prior authorization, so this headache does not become an annual event.
In a 2018 study in the Journal of Current Medical Research and Opinion, researchers surveyed 451 people with type 2 diabetes about their experiences with non-medical switching.
After their medications were switched, one in five had been told by their doctor that their blood glucose levels were somewhat or much worse than they had been on their previous medication.
About 20% also had to check their blood sugars more often than before they switched, which can become a physical, emotional, and financial burden.
Other Reasons To Call A Doctor
Sometimes people with diabetes can become overwhelmed and have a hard time coping with the disease. This is very common, especially in teens. If you find that you feel sad all the time, want to eat or sleep a lot or not at all, or you’re thinking about suicide, your doctor can be a resource for you if you don’t feel comfortable talking to a parent or teacher. He or she may refer you to a counselor, therapist, or other mental health professional who can help you understand more about why you feel the way you do and help you figure out ways to feel better.
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Does The Rest Of My Bloodwork Look Normal
A typical complete blood count test will measure more than just an hba1c. This thorough blood test measures thyroid functioning, if theres any protein in the urine, vitamin D levels, cholesterol , white and red blood cell counts, and a host of other levels meant to check in on your overall health.
Discuss with your doctor if any of these levels are out of range, especially the markers for Hashimotos disease, Antithyroglobulin antibody , as well as Tissue Transglutaminase Antibodies , a test that will be positive in about 98% of patients with celiac disease.
Both Hashimotos and Celiac are common in people with type 1 diabetes.
What Exactly Is Prediabetes
To understand the condition, you have to understand the process that occurs in the body to break down and use carbohydrates. When you consume a carbohydrate, the body needs to convert the food into glucose. It does this by relying on the hormone insulin , which is responsible for chaperoning the sugar to the cells. Insulin essentially knocks on the cell door to allow the cells to let glucose in. Once it gets into the cells, sugar is stored and can be used as energy. This physiological process is critical to avoid circulating blood sugar in the body.
In a prediabetic state, the cells dont respond in a normal manner to insulin so the body produces and pumps out even more insulin to try to elicit that response. Eventually, the pancreas becomes exhausted in the process and blood sugar increases.
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How To Create A Sick Day Plan
When you’re feeling ill, you’d like nothing more than to lie in bed with a good book or a bad movie. Yet that’s when you need to focus even more on diabetes self-care.
The key to sick days with diabetes is doing all of the thinking ahead of time. That way, when you don’t feel like concentrating, you can simply follow the plan.
Involve your diabetes care team in developing your sick day planask them when you should call for help, how often you should check your blood glucose and ketones, what medicines to take and what to eat.
I’m A Doctor And Here’s What To Do When You Get Omicron
With the omicron COVID variant proving more transmissible than any other, there’s a very good chance you’ll catch it, no matter how careful you are. To keep you safe, Dr. Tatiana Prowell, an Associate Professor of Oncology at Johns Hopkins School of Medicine, who serves people with COVID-19, tweeted a viral thread to lay out exactly what you should do the minute you or someone you know has symptoms . Read on for the exact stepsand to ensure your health and the health of others, don’t miss theseSure Signs You’ve Already Had COVID.
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This Is The First Thing To Do If Someone Has Omicron Symptoms
“The first thing to say is that if someone has COVID-19 symptoms , you have to assume they have it. You may not have a test or they may still be negative,” said Dr. Prowell. “You, as the person exposed to the one with symptoms, have to assume that you both do and don’t have Omicron too. Wait, what? I mean: assume you could infect others now and take care to avoid exposing them, BUT don’t assume it’s too late for you to avoid getting it.” She added: “Especially in households with vaccinated family members, I have seen people manage to limit Omicron to the first person who was infected. This COVID variant is incredibly contagious, but It CAN be done. Don’t give up on the idea!”
How Can I Afford My Medications
The truth is 1 in 4 people with diabetes in the United States rations their insulin due to cost alone. People are struggling and insulin is expensive. A vial of Humalog today costs over $300, whereas when it was introduced to the market in 1996 the same vial cost $21.
If youre struggling to afford your medications, youre not alone. Ask your doctor about ways to better afford your medications.
Perhaps youre eligible for Medicaid in your state, or a tax-subsidized health plan on your state exchange.
Perhaps youre eligible for reduced or free insulin at a Federally Qualified Health Center that participates in the 340b program.
Perhaps you have a state-regulated health plan thats subject to a states insulin co-pay cap legislation, or perhaps you can seek assistance from a drug manufacturer.
Ask about resources to get the help you need. The help is there, you just have to make your needs known.
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Prescribing The Wrong Medication
Diabetes medications are not one size fits all and each medication does something different. While one medication may work well for Type 1 diabetes, it may not work for someone with Type 2 diabetes, and vice versa.
Explanation: If you are prescribed a medication and your blood sugars do not seem to respond to the medication, see your doctor to discuss whether this is the right medication for you.
What Is An Endocrinologist
An endocrinologist may provide care in a specialized endocrinology practice, such as one that focuses on diabetes and endocrinology, or split their time by seeing both endocrinology and general internal medicine patients.
Endocrinologists treat diabetes, a disease of the pancreas, and diseases that affect other endocrine systems such as the thyroid, pituitary gland, and adrenal glands. These diseases may include but are not limited to:
- Pituitary diseases such as pituitary tumors or producing too much or too little pituitary hormones
- Sex hormone abnormalities
- Osteoporosis
- Lipid metabolism
Training to be an endocrinologist requires two years of additional training after a basic internal medicine residency training. After completing this training, endocrine, diabetes, and metabolism fellows are eligible to become board certified by the American Board of Internal Medicine.
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Signs Of Low Blood Sugar
With hypoglycemia, the blood sugar falls below the normal, healthy levels mentioned earlier, which can occur for a variety of reasons.
“Although some people with blood sugar problems may not experience symptoms,” Dr. Aldasouqi continued, “there are some key things to look out for. For those with low blood sugar, someone might have symptoms like anxiety, sweating, increased heart rate, confusion, and may go into what is called ‘a hypoglycemic coma’… The term ‘diabetic coma’ is also used by some.”
Other symptoms of low blood sugar may include:
- Fatigue
- Tingling or numb lips, tongue or cheek
- Blurry vision
When Diabetes Patient Should Visit Endocrinologist
For a diabetic patient, your doctor may ask you to visit an Endocrinologist
- If you are newly diagnosed with diabetes. In such a case the doctor may require an endocrinologist opinion on Pancreas and Insulin functioning to manage diabetes efficiently .
- When your Diabetes management has worsened. In such a situation, the endocrinologist shall help in giving insights on insulin therapy or Pancreas removal surgery.
- If you are using more insulin therapy.
- When the diabetes treatment is not effective enough.
Thus, when you are diabetic, your doctor may ask you to visit an Endocrinologist to gain proper information on the Insulin role in your body. With this understanding Insulin therapy and medicines can be properly planned for effective diabetes management.
Summary
An endocrinologist opinion is necessary for effective insulin therapy or in the case of newly diagnosed diabetes.
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Where Can I Find An Endocrinologist
You can ask your doctor or you can visit the healthdirect service finder. The Endocrine Society ofAustralia has a directory that allows you to search for endocrinologists based on location or the endocrinologists area of expertise.
Youll need a referral from your doctor to see an endocrinologist. You may also need to wait a while before seeing an endocrinologist, as specialists sometimes have long waiting times before you can get an appointment.
When you make a booking, you can ask how much the visit will cost, and how much you will get back from Medicare.
Generally, visits to specialists arent covered by private health funds.
Adding Insulin Too Soon In Type 2 Diabetes
Your Hemoglobin A1C came back right at 6.5. You may be down from the original number of 9.0, but your doctor feels like it isnt low enough. Your blood sugars are getting up as high as 225 mm/dl. The doctor makes the decision to start you on long-acting insulin where you take two shots a day. This scares you so you question why you have to take insulin.
Explanation: Well, your doctor may slightly be jumping the gun on this one, but it isnt unusual either. The usual parameters for starting insulin have been moved down to between 6.5 and 7.0 for hemoglobin A1C and blood sugars that run about 250 mm/dl. The reason the numbers were moved down is they have found Type 2 diabetics may be able to reverse the disease without damage to the arteries and blood vessels. Talk to your doctor if this makes you feel uncomfortable. You may still be able to bring things under control with diet and oral medications if you work hard at it.
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What To Do If You Don’t Have The Right Masks
“If you don’t have any N95/KN95/KN94 masks, please see if a nearby friend or neighbor has unused ones you can have and order them replacements. The nonprofit Project N95 is a great place to get them. Your backup plan for right now is a surgical mask.” She added: “A surgical mask has good filtration but usually not good fit. There are often gaps. Knot ear loops where they join the mask and then tuck to improve the mask fit. Here’s a short video demo. Put a cloth mask over the surgical mask,” said Dr. Prowell.
Final Word From The Doctor
“Know that if you are indoors with people from outside your household, you WILL be exposed to Omicron. The only Q is whether you’ll get infected. If you wear a very good mask and are careful, you CAN prevent it.” So follow the public health fundamentals and help end this pandemic, no matter where you liveget vaccinated or boosted ASAP wear an N95 face mask, don’t travel, social distance, avoid large crowds, don’t go indoors with people you’re not sheltering with, practice good hand hygiene, and to protect your life and the lives of others, don’t visit any of these 35 Places You’re Most Likely to Catch COVID.
Eat This, Not That!
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