Who Should Be Screened for Diabetes at 35?

If you are overweight, you are at risk of developing blood sugar problems at a younger age, and your doctor should check for diabetes sooner.

Diabetes, especially type 2 diabetes, has become more common as Americans become heavier, affecting about 13 percent of adults.

What’s more — more than a third of them meet the criteria for prediabetes, meaning they are likely to become diabetic if they don’t take action.

You can reduce your risk for diabetes, but most people don’t know they have prediabetes. That’s why the U.S. Preventive Services now recommends that overweight people who are 35 through 70 be screened for diabetes.

This isn’t hard; you’ll give blood and most likely get a score called the A1C test. Losing as little as 5 to 7 percent of your body weight  — that’s 10 to 14 pounds if you weigh 200 now — could bring you to safe blood sugar levels. Good health habits overall can reduce your risk of developing type 2 diabetes.

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What is the A1C test?

Your A1C score represents your average blood sugar level over the past two to three months.

If your A1C level is between 5.7 and less than 6.5 percent, your levels are in the prediabetes range.

If you have an A1C level of 6.5 percent or higher, your levels are in the diabetes range.

You’ll be given medical advice on how to keep your levels safe, ideally below 5.7.

If your doctor tells you that your blood sugar is too high, but you’re not quite diabetic, pay attention.

You probably won’t have any symptoms when you first hear the news, but if you notice changes talk to your doctor. Early signs of diabetes include urinating frequently, unusual hunger or thirst, fatigue despite getting enough sleep, blurry vision, numbness or tingling in your hands or feet, dry skin, slow-healing sores, and frequent infections.

Why you can’t ignore prediabetes

Over time, too much blood sugar, also called glucose, is rough on your body. People with diabetes often develop major complications that includes kidney failure, blindness, and nerve damage (nerve damage can lead to amputation of a toe, foot, or leg). Some research suggests that diabetes doubles the risk of depression, and that chance increases as you experience more health problems. Sickness gets in the way of enjoying your life and reaching your goals.

Losing weight can feel impossible — but that’s not true. For inspiration, read “Lose It Forever: The 6 Habits of Successful Weight Losers.” It tells the success stories of several people from the National Weight Control Registry, which enrolls adults who have lost at least 30 pounds and kept it off for at least a year. They exercise on average an hour a day (walking counts) and change what they eat. Jamie Ash was plump at 16 and didn’t lose weight until she took up hiking in midlife. You can read her story in “Lose It Forever.”

You’ll need to get active for at least 150 minutes a week, ideally spread out during the week (You don’t want to injure yourself by overdoing it on weekends). Building muscle is also important, especially for women past menopause. Make sure you talk to your doctor about your exercise plan.

Both resistance training and aerobics help bring blood sugar under control and will help you lose weight and keep it off. Being slight and frail isn’t your goal.

Get support for success

Most people find that joining a group helps them change their habits over time and feel better in the process. Look for group approved by the National Diabetes Prevention Program. Some are online, some are in-person, and others combine the two. During the first six months of the program, you will meet weekly in a group with a trained coach. For the next six months, you’ll meet once or twice a month to maintain the changes you’ve made.

Talk to your doctor about Metformin

Millions of people with type 2 diabetes take Metformin, and plenty of evidence backs the drug for prevention. The American Diabetes Association (ADA) first recommended Metformin for people with prediabetes in 2008, with specific guidelines.

Metformin lowers the amount of glucose your liver releases and helps your muscles use glucose more efficiently.

It may help to suppress appetite and is linked to weight loss: six pounds, on average, after a year of taking the drug, according to one large study.

Metformin does have a downside. It seems to interfere with the development of muscle mass in older people. In the past, scientists thought that Metformin might help people develop muscle, but that turned out not to be true.

Few patients who have been tested and found to be at risk for diabetes are offered a Metformin prescription, according to a large national study. Doctors hope that telling people to lose weight and exercise more will do the trick, and some think that taking a pill will make people less motivated to change their habits. Ask yourself: Is that true of me? You can resolve to lose weight and exercise more while also taking Metformin. On the other hand, if you already know you can’t focus on losing weight right now, but you would take the Metformin, speak up. An honest conversation with your doctor will help.

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