When Seattle-area software engineer Aden learned he was prediabetic in 2017, he made what he thought were reasonable lifestyle changes. The now 39-year-old stopped eating meat, focused on portion control and tried his best to stay active — despite his busy, full-time job and the demands of caring for an infant at home. Based on what he knew about prediabetes — which he admits wasn’t much — he thought he was doing enough.
A few months later, Aden felt weak and dizzy after eating a few pieces of Halloween candy. When his vision blurred, he checked into a local urgent care center, where he learned his blood glucose was 500 mg/dL (that is, 500 milligrams per deciliter, a measurement that indicates the amount of a particular substance, in this case glucose, in a specific amount of blood). This reading was 2.5 times the level considered to be diabetic.
Aden was sent to the emergency room, where he began a crash course in diabetes education and a lifestyle turnaround that changed his health, his home and his habits — both inside and outside of the kitchen.
What is prediabetes?
Prediabetes is a middle-ground diagnosis between normal blood glucose levels and Type 2 diabetes, a condition characterized by elevated blood glucose that occurs when the body either resists the effects of the insulin it produces or doesn’t produce enough.
Fasting blood-glucose (or blood-sugar) levels between 100 and 125 mg/dL are considered prediabetic, says Nadia Hameed, M.D., of Bellevue’s Overlake Medical Center. Physicians also measure A1C, a longer-range measure of blood glucose, and look for levels between 5.7 and 6.4 percent as an indication of prediabetes.
By catching elevated blood glucose in the prediabetes stage, people may have a better chance to change their fate — but that’s not a guarantee.
“Prediabetes can be controlled by lifestyle changes that can bring blood sugar into a healthy range,” says Hameed. “With diabetes, we may be able to manage the condition, but unfortunately, this does tend to be a progressive disease.”
The problem is that prediabetics may not have the information they need to halt the progression, says Aden. Because diabetes is a serious condition with potentially debilitating, even fatal, complications — including damage to the kidneys, nerves, eyes, limbs and heart — a diagnosis triggers a cascade of information and resources for patients. These include access to blood-sugar testing supplies to help with daily, even hourly, glucose monitoring.
But a prediabetes status may not trigger the same urgency. Without detailed knowledge of how their diet impacts their blood-sugar levels, people might not have enough information to keep prediabetes from progressing to diabetes, Aden says.
After his emergency room visit, Aden took a couple of weeks off from work to rest, adjust and process the massive amount of diabetes information that came his way. Also coming his way was a new tool: a blood-sugar monitor, which gives him a real-time view of how food impacts his blood sugar. He soon realized that his meat-free diet was too starchy; instead of avoiding meat, he started focusing on counting carbs and filling more of his plate with vegetables. He began working with Dr. Hameed, who helped him navigate this new influx of diabetes data.
But Aden needed to change more than his diet. The deep dive into his blood-sugar data revealed something surprising: A lack of sleep was contributing to his poor blood-sugar control. To manage his diabetes, he needed to get more sleep.
For the parent of an infant son, this wasn’t as easy as simply changing the family’s menu. “We had our son sleeping in the bedroom with us, and I wasn’t sleeping much. He’d make a lot of noise, and when I got up, I’d just stay up,” he says. To catch up on sleep, Aden took a three-day trip to a relative’s home nearby to rest. At home, Aden and his wife adjusted nighttime parenting roles so Aden could get more uninterrupted blocks of sleep.
Today, Aden’s blood sugar has stabilized to levels between 80 and 160 mg/dL; he eats smaller, balanced meals regularly. “Before, I wasn’t good about eating consistently. I would skip breakfast and hardly ever ate snacks. I don’t do that anymore.”
Aden’s altered lifestyle is accompanied by a new outlook on prediabetes, he says. When a relative got the news that she was prediabetic, his advice to her was straightforward: “At this point, you should consider yourself diabetic and start to make the same changes you’d make if you had diabetes, like counting carbs. You can make those changes, but it has to start now. I wish someone had told me that.”
Editor's note: This article was sponsored by Overlake Medical Center and Clinics.