Last Updated: Nov 14, 2018
For Linda Famiglio, MD, a neurologist from Danville, Pa., the fight against diabetes truly hit home when she learned her adult brother had developed the disease.
“I thought ‘why didn’t I let him know that there were things he could do to prevent diabetes?’ ” Dr. Famiglio says.
Since then, Dr. Famiglio has traveled across the state to sound the alarm about a looming public health crisis.
More than 1.4 million Pennsylvanians have type 2 diabetes, according to the American Diabetes Association. There are estimates that another 3.5 million Pennsylvanians have prediabetes – where a person’s blood glucose (sugar) level is higher than normal, but not yet high enough to be diagnosed as diabetes.
If left unaddressed, about 15-30 percent of those with prediabetes typically progress to type 2 diabetes within five years, says Dr. Famiglio.
“These truly are epidemic – diabetes and prediabetes,” says Dr. Famiglio. “The great thing is this is an epidemic that we can actually do something about. Absolutely we can impact it.”
There are no outward symptoms for prediabetes. As a result, many people do not realize they have it.
The United States Preventive Task Force suggests that every adult get screened on a regular basis. You can be at higher risk of getting prediabetes if you are overweight, have a family history of type 2 diseases, or have a family history of gestational diabetes, says Dr. Famiglio.
Two common tests for prediabetes include:
- A blood sample that can be taken after an overnight fast. A fasting blood sugar level of less than 100 mg/dL is normal; a fasting blood sugar level between 100 to 125 mg/dL is considered prediabetes.
- The Hemoglobin A1C test, which doesn't require fasting, measures your average blood sugar level for the past two to three months. It shows the percentage of blood sugar attached to hemoglobin, the oxygen-carrying protein in red blood cells.
If You’re Diagnosed …
If you’ve been diagnosed with prediabetes, here are three of the best ways to decrease your chances of progressing to diabetes:
- Increase your physical activity. “That’s walking and moving,” not necessarily high-impact exercise, says Dr. Famiglio. She recommends 150 minutes of physical movement in a week.
- Improve your diet. “You think some juices are good for you,” says Dr. Famiglio, “but in reality, the simple sugar drinks and food are very difficult for our bodies to manage well and keep our blood sugar at an even level.”
- Get more quality sleep.
Structured programs such as the national Diabetes Prevention Program (DPP) “is the only way we absolutely know to decrease your chance of getting diabetes,” she says. “You go to classes with other people. You get your sugars and your weight managed. You learn how to eat differently. You get increased exercise.”
The Pennsylvania Medical Society (PAMED) has partnered with the American Medical Association (AMA) and Centers for Disease Control and Prevention (CDC) to promote the national DPP. PAMED encourages employers to include the DPP as a covered benefit through their employee health insurance plan.
According to the CDC’s online locator, there are nearly 100 facilities that run DPP programs in Pennsylvania. The locations range from doctors’ offices to hospitals to YMCAs.
The goal of the program is to lose about 5 percent of your body weight. Dr. Famiglio says physicians and other health care providers play a critical role in guiding patients through this process.
“This is something that people can truly do something about,” Dr. Famiglio says. “This is something that we can have the greatest impact as physicians. If we institute programs that prevent prediabetes from going on to diabetes, we could have 50 or 60 percent of our patients not progress. And that’s a very, very high level of impact – more so than almost anything we do.”