Prediabetes is a growing concern with today’s high obesity rates

By 57, Alex Rodriguez has survived some major health scares. He has undergone two open-heart surgeries in the past two years, and in August, after routine blood tests at Mount Sinai Medical Center, he learned he was prediabetic.

“I didn’t feel anything,” said Rodriguez, a former sales manager for nearly 30 years at a technology production company who lives in Sunny Isles Beach. “I never really had any symptoms.”

That is often the case with prediabetes, a condition where a patient’s blood-sugar level is higher than normal but not yet elevated to be classified as Type 2 diabetes. A prediabetic blood glucose level measures between 100 and 125 milligrams per deciliter after a fasting glucose test, which requires a patient to fast for at least eight hours or overnight. Diabetes is diagnosed when blood glucose levels are 126 mg/dL or above.

There may not be any symptoms, but there are some risk factors for prediabetes, including: being overweight with a body mass index of more than 25, older than 45, a family history of diabetes, not exercising regularly, gestational diabetes during pregnancy and high blood pressure. Hispanics, African Americans, Native Americans, Pacific Islanders and Asian Americans also are at higher risk.

Rodriguez had some of the risk factors. His father suffers from diabetes, and he has high blood pressure and is overweight. Rodriguez weighs 360 pounds after gaining 100 pounds after his heart surgeries. He now takes Metformin to treat his condition.

He is not alone. Prediabetes is a growing concern. In 2012, 86 million Americans age 20 and older had prediabetes, a condition in which blood glucose levels are higher than normal but are not high enough for a diagnosis of diabetes. People with prediabetes are at increased risk for developing Type 2 diabetes and for heart disease and stroke.

Without proper care and intervention, prediabetes is likely to develop into diabetes within 10 years. Diabetes can lead to other complications, including high blood pressure, heart disease, high cholesterol, stroke, kidney disease, blindness and amputations.

But not everyone with prediabetes will contract diabetes. A study of more than 3,000 people who were overweight and had prediabetes found that those who lost a modest amount of weight by exercising more and following a diet low in fat and calories sharply reduced their risk of developing diabetes by 58 percent. Taking Metformin also reduced risk, although less dramatically.

The National Institute of Diabetes and Digestive and Kidney Diseases conducted the study at 27 clinical centers around the country, including at UHealth-University of Miami Health System.

“Weight gain has a significant effect for the general population, specifically those affected by prediabetes,” said Dr. Ronald Goldberg, professor of medicine at the Diabetes Research Institute and the Division of Endocrinology, Diabetes and Metabolism at UHealth- University of Miami Health System.

Eliminating sugary carbohydrates and adhering to a Mediterranean diet that includes lean meats, fruits and vegetables can help people lose weight, said Dr. Melissa Franco, family practice physician at Baptist Health South Florida.

Patients should find and eliminate the highest source of carbohydrates in their diet such as soda, said Dr. Rossana Calderon, endocrinologist at Mount Sinai Medical Center in Miami Beach. For example, one 7.5-ounce can of classic Coca-Cola has 25 grams of carbohydrates, according to calorieking.com.

“Change slowly so they can adapt it to their daily routine,’’ Calderon said.

Patients should also perform some form of moderate activity 30 minutes daily, five times a week. Brisk walking, light jogging, Pilates and yoga are all forms of moderate activity, said Dr. Stephen Avallone, medical director of Huizenga Executive Health and Internal Medicine at Cleveland Clinic of Florida.

For middle-aged women in their 50s, menopause becomes an additional challenge for weight loss. Metabolism slows, fat mass increases and lean muscle mass declines, Avallone said. A good rule of thumb is for a woman in her 50s to consume 200 fewer calories daily than she did in her 30s and 40s.

“Start moving more and consuming less,’’ Avallone said. “The more you move, the more you burn. Exercise can help to keep a better blood sugar level.’’

This story was originally published December 28, 2015 at 9:39 PM with the headline "Prediabetes is a growing concern with today’s high obesity rates."