November is Diabetes Awareness Month. Diabetes is a chronic condition in which the amount of sugar in the blood is higher than normal and the sugar cannot get into the body’s cells to be used properly for energy.

The three types of diabetes include Type 1 diabetes, Type 2 diabetes and gestational diabetes. With Type 1 diabetes, the body no longer makes enough insulin — the key that unlocks the door to the cell and let’s sugar into the cell. In a person with Type 2 diabetes, the body’s cells become resistant to insulin. Gestational diabetes is a form of diabetes that occurs during pregnancy.

According to the 2020 Centers for Disease Control National Diabetes Statistics Report, as of 2018, a total of 34.2 million people have diabetes (10.5 percent of the U.S. population. Of that, 26.9 million people are diagnosed with diabetes but 21.4 percent are undiagnosed (7.3 million people).

Diabetes is at epidemic proportions — up 800 percent since 1960. More importantly, one in three people (88 million people aged 18 years or older) have prediabetes and nearly 90 percent of those people don’t know they have it. One-third of people with prediabetes will go on to develop Type 2 diabetes. In order to prevent Type 2 diabetes, a person needs to know if they have prediabetes and treat the prediabetes first.

Prediabetes comes before a person develops Type 2 diabetes. With prediabetes, the amount of sugar in the blood is higher than normal but not high enough to be considered diabetes.

A person with prediabetes can actually have the condition for years and not know it. There are no clear symptoms for prediabetes, so it is important to know if you should be tested for prediabetes. There are many factors involved with the development of prediabetes that you can control. Your chances of having prediabetes go up if you:

• If you have a parent, brother or sister with diabetes.

• If you are age 45 or older.

• If you are Black, Hispanic/Latino, American Indian, Asian American or Pacific Islander.

• If you are overweight.

• If you are physically inactive.

• If you have high blood pressure or take medicine for high blood pressure.

• If you have low HDL cholesterol and/or high triglycerides.

• If you had diabetes during pregnancy.

• If you have been been diagnosed with polycystic ovary syndrome.

Blood sugar levels help to determine if a person has prediabetes or diabetes. A normal fasting blood sugar is less than 100. When the fasting blood sugar is between 100 and 125, this is called prediabetes. If the fasting blood sugar is 126 or above, this is positive for Type 2 diabetes.

If a person develops prediabetes, they are at a higher risk for developing Type 2 diabetes and heart disease. If you develop prediabetes, you might get Type 2 diabetes soon or in the near future. You are also at a higher risk for having a heart attack or stroke. The good news is that prediabetes can be treated and Type 2 diabetes can be prevented.

Healthy choices that you can sustain long-term will make the biggest impact in preventing progression from prediabetes to developing Type 2 diabetes. The Diabetes Prevention Program Study showed that 30 minutes of moderate physical activity per day as well as a 5-10 percent weight loss resulted in a 58 percent reduction in diabetes development.

Focusing on family wellness is key in the treatment of prediabetes and prevention of Type 2 diabetes.

Ways to manage prediabetes include eating a breakfast daily. This helps to “break” the “fast” your body was in overnight while you were sleeping and it tells your body you are awake and ready for the day. By doing this, it tells our liver to stop producing extra sugar which can lead to the development of prediabetes and diabetes. Eat a balanced diet with half of your plate from vegetables, a quarter of your plate from proteins (lean meats) and a quarter of your plate from starches/carbs.

Avoid sugary drinks or snacks. One sugary drink per day can increase your risk of diabetes by 15 percent and drinking two sugary drinks per day can increase your risk by 26 percent. Choose foods that are lower in calories, high in fiber and are lower in saturated fats.

Avoid pre-packaged foods which are high in empty calories. Practice portion control when you eat at home, use smaller plates. When you eat out at a restaurant, ask for a take-out container when your meal is served and immediately package half of your meal to take home and eat the next day.

Routine exercise is important to reduce one’s risk of developing prediabetes or diabetes. Choose something you enjoy doing. Doing little is better than no exercise at all.

Walking is a perfect way to start exercising slowly. It is important to plan for exercise in your day so that you stick with an exercise routine. Stopping smoking can also reduce your risk of developing diabetes.

It’s important for people to learn their prediabetes risk, be screened regularly and take the steps necessary to delay or prevent Type 2 diabetes.

The American Diabetes Association (ADA) launched its first risk test in 1993. To learn your risk of prediabetes, take the test at

A person with a high score on the online risk test (five or higher) is at significant risk for having prediabetes. However only a blood test can determine an official diagnosis. Talk with your primary care provider about your risk of prediabetes and diabetes.

Justine Fierman is an experienced family nurse practitioner of 22 years who is board-certified in advanced diabetes management and is also a certified diabetes educator (now called a certified diabetes education and care specialist). She is in private practice and cares for patients age 18+ with diabetes at the Miranda Diabetes Care Center in Intervale. She believes “diabetes is a lifelong journey with different paths a person can go down.” She sees her team’s role as helping guide people on their journey to achieve the best outcomes with the least obstacles. For information or an appointment with Justine Fierman, call: (603) 730-5125.

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