The Odds You Will Have Diabetes in 10 Years: What is Healthy?

2 1/2 years before my mom died, she had a routine physical with her doctor. I called her and asked her how it went. The doctor said to her, "You're fine" and my mom tried to move onto another subject. I proceeded to ask her some questions about her blood work and what the actual numbers were.

What is your fasting blood sugar/glucose?

This was the number I was most concerned with. My mom reminded me that the doctor looked at it and said,

You're normal and come back next year.

I persisted as to what the number was. My mom said her fasting blood sugar/glucose was 110 and reminded me that she was normal. My mom heard my exhale in frustration and she asked,

What is the problem? The doctor told me I am fine and to come back next year.

I told her that she had a 166% chance of developing diabetes in the next 10 years. This is the problem. I am confident; she was not on year 1 of being pre-diabetic. I believe she was on year 9 3/4 of 10 and along with all your of other current ailments, diabetes will be added to that list.

My mom was confused, why did her doctor say she was "fine" and "normal" and to "come back next year" when her son, a Personal Trainer, who is a not a doctor is telling her she is not fine?

Let’s define some terms.

What is diabetes? Mayo Clinic defines diabetes as to a group of diseases that affect how your body uses blood sugar (glucose). Glucose is vital to your health because it's an important source of energy for the cells that make up your muscles and tissues. It's also your brain's main source of fuel. If you have diabetes, no matter what type, it means you have too much glucose in your blood. Too much glucose can lead to serious health problems: cardiovascular disease, neuropathy (nerve damage), kidney damage (nephropathy), eye damage (retinopathy), food damage, skin conditions, hearing impairment, Alzheimer’s disease, among others.

WebMD tells us you officially have diabetes if your fasting blood sugar is 126 or higher.

What is prediabetes? Mayo Clinic explains, prediabetes means that your blood sugar level is higher than normal but not yet high enough to be classified as type 2 diabetes. Without intervention, prediabetes is likely to become type 2 diabetes in 10 years or less. If you have prediabetes, the long-term damage of diabetes — especially to your heart and circulatory system — may already be starting. There's good news, however. Prediabetes can be an opportunity for you to improve your health. Progression from prediabetes to type 2 diabetes isn't inevitable.

Diabetes.org officially tracks prediabetes as your fasting blood sugar/glucose level between 100 mg/dl to 125 mg/dl. WebMD explains the numbers have changed through the years. Between 1997 and 2003, 110 to 125 mg/dl range was pre-diabetic. Due to the significantly elevated health risks of prediabetes, the American Diabetes Association changed the definition to 100mg/dl to 125mg/dl in 2003.

What is impaired glucose intolerance? Patient.info defines glucose intolerance as the following. If you have pre-diabetes (impaired glucose tolerance), your blood sugar (glucose) is raised beyond the normal range but it is not so high that you have diabetes. However, if you have pre-diabetes, you are at increased risk of developing diabetes. You are also at increased risk of developing conditions such as heart disease, peripheral arterial disease and stroke (cardiovascular diseases). If pre-diabetes is treated, it can help to prevent the development of diabetes and cardiovascular disease. The most effective treatment is lifestyle changes including eating a healthy balanced diet, losing weight if you are overweight, and doing regular physical activity.

Let's step back for a second.

According to the CDC, the % of Americans who had diabetes in 1959 was .87% (1.49 million Americans afflicted), vs. 2012, 9.3% (29.1 million Americans afflicted). Today, 86 million adults (more than 1 in 3 Americans) have prediabetes, where their blood sugar levels are higher than normal but not high enough to be classified as Type 2 Diabetes. The CDC projects by 2050, 33% of all Americans will be diagnosed with diabetes (those numbers do not include the Americans with prediabetes). National Institutes of Health released in 2005, for the first time in the modern era, our children of today will not outlive their parents due to the diabetes and obese epidemic upon us. Statistically, we are not as healthy as we think we are.

How was her son able to anticipate her condition? I utilized a study conducted by Kaiser Permanente. Kaiser Permanente has one of the nation's largest not-for-profit health plans. They have Hospitals and subsidiaries, Health Plans, Medical Groups, etc. In the study, 46,578 members watched their fasting glucose levels less than 100mg/dL. All the members did not have any previous diagnosis of diabetes or impaired fasting glucose. The subjects were assigned to 1 of 4 categories (less than 85, 85-89, 90-94, or 95-99 mg/dL). Kaiser monitored the members if the were healthy, developed diabetes, died, or left the health plan, between January 1997 to April 30, 2007. Cox regression analysis was used to estimate the risk of incident diabetes, adjusted for age, sex, body mass index, blood pressure, lipids, smoking, cardiovascular disease, and hypertension.

What did they discover?

The conclusion Kaiser came up with was "The strong independent association between the level of normal fasting plasma glucose and the incidence of diabetes after controlling for other risk factors suggests that diabetes risk increases as fasting plasma glucose levels increase, even within the currently accepted normal range."

What does this mean?

 Every fasting blood glucose number over 84 is a 6% increase in diabetes within the next 10 years. What does this mean? If you have your blood sugar tested and it is 86, you have a 12% chance to develop diabetes in the next 10 years or an 88% chance you won't. I would classify that as pretty good odds. The problem is when your fasting glucose levels in the 90s or higher, our odds are not in your favor. Let's say your fasting glucose is at 98. Most physicians would say, "You’re fine." Are you really fine with the odds of 84% chance you will develop diabetes in the next 10 years. Let's use the same percentage but a different analogy. Let's say, you have the opportunity to purchase a $1. Now, we will use your fasting blood sugar (98) as your odds of winning. Right now, you have an 84% chance of winning $242 million dollars. Would you buy it? I will remind you, there is only a 16% chance you will lose. Odds are, it's as close as you can get for a sure thing. Before you buy it, you can probably start spending your $242 million right away.

What do other organizations say?

The National Institute of Health published a study stating, “over 1/3 of adults in the U.S. suffer from glucose intolerance.” Remember, glucose intolerance is defined by Patient.info as having prediabetes. The US National Library of Medicine wrote, “Observational evidence shows associations of prediabetes with early forms of nephropathy, chronic kidney disease, small fibre neuropathy, diabetic retinopathy, and increased risk of macrovascular disease.” They go on to say, “According to an ADA (American Diabetes Association) expert panel, up to 70% of individuals with prediabetes will eventually develop diabetes. In a Chinese diabetes prevention trial, the 20-year cumulative incidence of diabetes was even higher (greater than 90%).

Dr. William Davis an author of Wheat Belly and a cardiologist who practices in Milwaukee, Wisconsin, Dr. William Davis said, “I practice preventative cardiology, and there is no shortage of heart disease, overweight people, diabetes and prediabetes. If you want to avoid heart attack or bypass surgery, part of that equation is that you can’t be diabetic or pre-diabetic.”

Is there an inexpensive way to determine one’s fasting glucose? Yes. Simply invest in a glucose monitor. The prices start from around $10 and go up from there. When you wake up in the morning, test your fasting glucose. At a minimum, track your numbers a couple times each morning for a couple of weeks. Take the numbers and compare it to what Kaiser discovered.

What are you to do?

To ensure you are healthy, utilize what Kaiser Permanent discovered. Every number over 84 is a 6% increase in risk of diabetes over the next 10 years. Dr. William Davis points out that prediabetes and diabetes are part of the equation for heart attacks or bypass surgery. Track your fasting blood glucose when you wake up in the morning by investing in a glucose monitor. Monitor your fasting glucose often to see trends. Understand that food has an impact on your blood. Take control of your health. It all starts first thing in the morning.

 

Steven Zahn

ACE Certified Personal Trainer

NASM Certified Personal Trainer

Pre and Post Partum Certified

Dragondoor Publications: HKC Russian Kettlebell Certified