Gary Grasmick, MD: 'Prediabetes is a serious wake-up call.'

Nearly 85 million American adults—more than 1 out of 3—have prediabetes, which means their blood sugar level is higher than normal. If not treated, up to 70 percent of them will go on to develop diabetes within 10 years, increasing their risk for heart disease, stroke, blindness, kidney failure and other serious health problems.

“Getting diagnosed with prediabetes is a serious wake-up call. If you take corrective actions now, you could delay and even prevent the onset of type 2 diabetes—a devastating disease with many complications. This is the time to make some changes,” said Gary Grasmick, MD, of Erie Family Medicine during a free interactive discussion hosted by BCH.

Diagnosing Prediabetes
Prediabetes is diagnosed using blood tests that measure blood sugar levels:

• Fasting blood sugar requires a blood sample taken after you’ve fasted for at least eight hours.
• Random plasma glucose (RPG) is a test performed when you aren’t fasting. It measures the sugar level in your blood at that particular moment in time.
• A1C testing provides a picture of your average blood sugar control over the past two to three months. You don’t need to fast for this test.

Your healthcare provider will be looking for these numbers to make a diagnosis:

Key Risk Factors
“Being overweight is strongly linked to the development of prediabetes. Other important risk factors include a family history of diabetes, giving birth to a baby of more than 9 pounds, gestational diabetes and having polycystic ovary syndrome,” Dr. Grasmick said.

You can have prediabetes but have no clear signs or symptoms, so it’s important to talk to your doctor about your risk factors and whether you should be tested.

How to Turn Things Around
If you have prediabetes, eating the right foods, losing weight and getting regular physical activity can lower your risk for developing type 2 diabetes.

“You don’t have to do everything at once. Start with small goals, and work up to it. You don’t have to lose 100 pounds to make a difference,” said Dr. Grasmick. He recommended the following:

• Avoid white grain foods such as white flour, white rice and white bread, because they result in a quick increase in blood glucose compared with whole grains.
• Eat various forms of the Mediterranean Diet such as whole grains, lean protein, abundant fresh vegetables, fish, limited sweets and some red wine.
• Add more high-fiber foods to your diet.
• Avoid drinking regular sodas and fruit juices.

“Your goal should be to eat less than 130 grams of carbohydrates per day,” Dr. Grasmick stated. “To avoid blood glucose spikes, it’s also a good idea to eat meals in this order: protein, vegetables and then carbs.”

Dr. Grasmick said exercise should go hand in hand with diet. Losing just 5 to 10 percent of your body weight, along with getting at least 30 minutes a day of physical activity at least three days a week (but preferably five days), can lower your risk of developing diabetes. However, first talk with your doctor before starting an exercise program.

Managing Prediabetes with Medication
“Medication is an option if you can’t get blood glucose levels down enough through diet and exercise,” Dr. Grasmick explained. “Metformin is often given as a first agent in treatment, or in some cases, prevention.”

To make an appointment with Gary Grasmick, MD, or our other Erie Family Medicine providers—Josh Taylor, MD, and Liz Locricchio, FNP—call 303-415-5813.

View PowerPoint slides from Dr. Grasmick's discussion on how to "Stop Prediabetes from Becoming Diabetes.”

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