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Prediabetes and the Prevention

of Type 2 Diabetes
What does prediabetes mean? Why should you get screened?
It means your blood sugar is higher than normal Diabetes can affect every organ in your body. It
but lower than the levels of someone with is the leading cause of kidney disease, adult onset
diabetes. blindness and non-traumatic amputation.

normal prediabetes diabetes

9 million Canadians have type 2 diabetes or pre-


diabetes. That's about 26% of Canadians. Often people with diabetes die earlier than people
without diabetes. 80% of people with diabetes
If all those people were in Ontario, will die of a heart attack or stroke. This risk can
that would be almost 70% of the be dramatically decreased by proper treatment of
population. Of those 9 million peo- blood sugar, blood pressure, and cholesterol.
ple, 2/3 of them have prediabetes.

Every year 3-8% of people with prediabetes will


develop type 2 diabetes. The good news is that
up to 60% of type 2 diabetes cases are prevent-
able with lifestyle changes.

Should you be screened, and if so how often?


I am If you answer yes to any of the following statements:
I have a parent, brother or sister with type 2 diabetes

40 or I am a member of a high-risk group for developing type 2 diabetes


(Aboriginal, African, Asian, South Asian, Hispanic)
older I have complications typically associated with diabetes
I have vascular disease such as heart disease, history of stroke or TIA
(transient ischemic attack) or peripheral vascular disease
I had diabetes during my pregnancy
I gave birth to a baby that weighed more than 4 kg (9 lb.) at birth
Recommended I have high blood pressure or high cholesterol (or other fats in my blood)
you get screened I am overweight (especially if extra weight is around my belly)
at least every 3 I have been diagnosed with any of the following conditions; Polycystic Ovary
years Syndrome, Schizophrenia
Recommended you get screened earlier and more often

www.hdlab.ca/diabetestools 1
Making lifestyle changes is the best way to prevent type 2 diabetes
How can you get started with lifestyle changes?
Eat right
Make your plate look like this Control your portions

Vegetables

Meat/ grains and vegetables meats/ fats


Grains/ starches as much as alternatives size of the tip
Meat alt-
Starches size of your you can hold size of your palm, of your thumb.
ernatives
fist. in both hands. thickness of your
little finger.

Eat Right Resources


Want to speak with a dietitian? Eat Right Ontario (www.eatrightontario.ca) is an excellent site from the
Ontario Ministry of Health Promotion. E-mail or call a dietitian with your questions from the site. The site
also includes articles on diabetes prevention and recommended cookbooks.
Looking for recipes and shopping tips? Dietitians of Canada (www.dietitians.ca) includes tips on how to
eat healthier such as how to read food labels and recipes to try.

Move More
1. Get at least 150 minutes a week of exercise (i.e. Brisk walking)
2. Park further away from your destination and walk
3. Take the stairs rather than the escalator or elevator

Move More Resources


Want to get active? Public Health Agency of Canada (http://tinyurl.com/Public-Health-Agency) has tips
for getting active for various age groups.

Weigh Less
If you are overweight, by losing just 10 lbs. you can reduce your risk by 58%.

Weigh Less Resources


Want a free interactive tool to help you lose weight? Healthy Weight Action Plan
(www.heartandstroke.ca/hwplan) is an online tool from the Heart and Stroke Foundation of Canada.
It supports individuals in a 12 week program as they move towards a healthy weight.

www.hdlab.ca/diabetestools 2
How to be screened
There are 4 types of blood tests that your doctor might send you to the lab to get done. The first two
shown below can screen for prediabetes and diabetes and the 3rd and 4th can only screen for diabetes.
In most cases, you will require a second test on another day to confirm the diagnosis.
FPG (Fasting Plasma Glucose)
If doing this test, you must fast for at least 8 hours beforehand. Fasting means not eating any food and drinking
only water.

Normal Prediabetes Diabetes


3.9 — 6.0 6.1 — 6.9 7.0 and above
4 5 6 7 8 9 10 11

Blood glucose level

2hPG (2 hour Plasma Glucose)


Your glucose levels will be measured two times: after fasting and again 2 hours after consuming 75 g of glucose.
Diabetes
2 hours after consuming glucose 11.1 and above

Normal Prediabetes
3.9 — 7.7 7.8 — 11.0
4 5 6 7 8 9 10 11

Blood glucose level

Casual PG (Casual Plasma Glucose)


This is only done if there are symptoms of diabetes. Taken any time of day, without regard to when last meal
was eaten.
Diabetes
11.1 and above

Normal
3.9 — 11.0
4 5 6 7 8 9 10 11

Blood glucose level

A1C
Taken any time of day without regard to when last meal was eaten. Provides an indication of your blood
sugar control over the previous 3 months.

Normal Diabetes
3.9 — 6.4 6.5 and above
4 5 6 7 8 9 10 11

Blood glucose level

1. 2008 CDA Clinical Practice Guidelines. Canadian Journal of Diabetes.2008;32(Supp 1):S1-S201.


2. Canadian Journal of Diabetes. 2011; 35(3):247-249

Developed September 2011 by: Lori MacCalum, BScPhm, PharmD, is a Pharmacist and Assistant Professor at the Leslie Dan Faculty
of Pharmacy, University of Toronto, Clinical Lead at the Health Design Lab, Li Ka Shing Knowledge Institute, St. Michael’s Hospital.
Heather McGaw, User Experience Designer at the Health Design Lab, Li Ka Shing Knowledge Institute, St. Michael’s Hospital. 3

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