Dr. Richard Barnett: 'Prediabetes Can Be Reversed.'

Getting diagnosed with prediabetes is a serious wake-up call. Without intervention, prediabetes often leads to type 2 diabetes, which puts you at increased risk for heart disease, stroke, blindness, kidney failure and other serious health problems. ​​

“The good news is that there are ways to reverse this condition with proper interventions,” said board-certified internist Dr. Richard Barnett during a free online health lecture.

What is Prediabetes and What it Means
Prediabetes occurs when your blood sugar level is higher than it should be. The level, however, is not high enough to be diagnosed as type 2 diabetes.

The condition is extremely common. According to the CDC, approximately 84 million American adults — one-in-three — have prediabetes. Of those with prediabetes, more than 84% don’t know they have it.

​Dr. Barnett warned, “Without lifestyle changes, prediabetes is likely to progress to type 2. In fact, if left treated, 37% of individuals will develop type 2 diabetes in 4 years.”

He continued, “Those with type 2 diabetes have elevated glucose in the blood, which is inflammatory and damages blood vessels.” As a result, those with type 2 diabetes have an increased risk of:

• heart disease
• stroke
• blindness
• kidney failure
• peripheral nerve damage
• foot ulcers/loss of toes, feet and/or legs

“In fact, the risk of a heart attack when you have diabetes is equal to the risk of someone who already had their first heart attack,” Dr. Barnett added.

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VIDEO: Watch "How to Stop Prediabetes From Becoming Diabetes"

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Diagnosis of Prediabetes: Hemoglobin A1C
According to Dr. Barnett, prediabetes and diabetes are diagnosed using tests that measure blood sugar levels. He stated, “Of the three types of tests — fasting blood sugar, random plasma glucose (RPG) and A1C — the A1C test provides the greatest insight.”

Click here for a descriptive table of A1C levels.

The A1C is a blood test that reflects one’s average blood sugar level over the last two to three months. It measures what percentage of a person’s hemoglobin (a protein in red blood cells that carries oxygen) is coated with sugar. The higher your A1C level, the poorer your blood sugar control, and the higher your risk of diabetes complications. A range of 5.7 to 6.4% is an indicator of prediabetes. The normal range is less than 5.7 percent.

When Should You be Tested?
Dr. Barnett explained that you are at a higher risk for prediabetes and type 2 diabetes if you have:

• high blood pressure (over 140/90)
• existing cardiovascular disease
• low HDL (good) cholesterol (40 or lower)
• high triglycerides (150 or higher)
• an issue with being overweight
• a parent or sibling with type 2 diabetes
• had a baby weighing more than nine pounds or had gestational diabetes
• a history of polycystic ovary syndrome
• and/or if you smoke cigarettes
• are inactive (physically active fewer than three times each week)
• are African American, Hispanic/Latino, Native American, Asian American or Pacific Islander

You should be tested if you are:

• 45+ years, overweight and have a BMI of 25+.
• Younger than 45 years, overweight and at an increased risk for diabetes
• Inactive

“If you are 45 years or older and not overweight, ask your doctor if you should be tested. Not all prediabetics are obese or overweight,” said Dr. Barnett.

Steps You Can Take
According to Dr. Barnett, steps you can take to reverse prediabetes or stop it from becoming diabetes include:

• Weight loss (healthy diet) — Reducing calories by 500 per day can make a huge impact on your ability to lose weight. “This is equivalent to just two cans of soda,” he said. “This reduction should translate into one pound of weight lost each week.” There are many strategies available to help you create a healthy diet such as the Mediterranean diet. The optimal goal is a sustained weight loss of 7%.
• Exercise (30 minutes per day, five days per week) — “Parking farther away, taking the stairs instead of the elevator, doing yardwork. These all count toward your 30 minutes of daily exercise. You don’t have to achieve your 30 minutes all at one time,” said Dr. Barnett. He added that including two days of resistance training is ideal and strongly encouraged.
• Medications — According to Dr. Barnett, the greatest benefit of medications, particularly Metformim, is seen in those with a higher body mass index. This medication lowers blood sugar levels by improving the way your body handles insulin. It is typically prescribed when diet and exercise alone aren’t controlling blood sugar levels.

Study Indicates Exercise and Weight Loss Can Reverse Prediabetes
Dr. Barnett concluded his talk by saying, “Even small changes can be of great benefit.” He then shared results of a Diabetes Prevention Program study that showed just 30 minutes a day of moderate physical activity along with a 5 to 10% body weight loss produced a 58% reduction in progression to diabetes.

To make an appointment with Dr. Barnett, call 303-415-4155.

Click here to view/download a PDF of slides shown during this lecture.