Prediabetes: an Elephant in the Room

November is National Diabetes Month, and it's unfortunate that we need to dedicate an entire month to increasing awareness about this disease. It's estimated that 29 million folks in the United States have diabetes, and even more surprising, 1 out of 4 of us don't even know that we have it.

Individuals develop diabetes because they aren't producing enough of the hormone insulin, and/or have developed a resistance to insulin, such that their cells do not respond to the hormone when it arrives. Obesity has been identified as one factor that increases the cell's resistance to insulin.

Insulin's job in the body is to direct glucose, the most abundant sugar in foods, into the cells to be used as immediate energy or stored in another form for later use. With diabetes, insulin may be available in the blood but the cells' decreased sensitivity to it interferes with its ability to work properly in the body. The bloodstream ends up becoming flooded with glucose that can't enter the cells for its use. Because of this, many individuals have to take medication to help the insulin work properly and/or inject themselves with insulin to manage their blood glucose levels.

But there is an even larger elephant in the room. More than a third of Americans, 86 million adults, have prediabetes. These folks are on deck to develop diabetes in the future. Prediabetes is a condition whereby individuals have higher than normal blood glucose levels but not quite high enough to be classified as having diabetes. Unfortunately, individuals with prediabetes not only have a higher risk of developing diabetes but also heart disease and stroke.

Click here for this interactive quiz to see if you have or are at risk for prediabetes.

The good news is that research suggests that those with prediabetes can prevent or delay getting diabetes by as much as 58 percent by losing a modest amount of weight (7 percent of a person's body weight) and moving regularly (walking 2.5 hours weekly).

According to registered dietitian nutritionist Toby Smithson, author of "Diabetes Meal Planning and Nutrition for Dummies" and a spokesperson for the Academy of Nutrition and Dietetics, studies have shown that meeting with a registered dietitian nutrition, who can design an eating plan that meets your needs, reduces both the need for medications and the risk of developing the health complications from diabetes. You can find a RDN who specializes in diabetes on the AND website.

The appointments could be covered by your health insurance. This could be the best way to tackle the elephant in the room.

Joan Salge Blake is a Clinical Associate Professor at Boston University and the author of "Nutrition &You," 3^nd Edition, Pearson/Benjamin Cummings (2014), "Nutrition & You: Core Concepts to Good Health," Pearson/Benjamin Cummings (2010), and "Eat Right The E.A.S.Y. Way," Prentice Hall Press (1991). She is the co-author of "Nutrition: From Science to You," Pearson/Benjamin Cummings (2016). Joan has conducted more than 1,000 media interviews and has been quoted in or written for various media outlets, such as the New York Times, Food Network, Newsweek, Washington Post, Forbes, Prevention, WebMD, Consumer Reports, Boston Globe, Newsday, Time, The Atlanta Journal Constitution Readers Digest, and Cosmopolitan, People, Parade, Cooking Light, Parents, Shape, Self, More, Sports Illustrated, Woman's Day, More, All You and O magazines. She has appeared on CBS, The Early Show, CNN, CBS News Boston, NBC News, Boston, NPR and Fox TV, Boston. In 2012, Joan was named by Good Housekeeping Magazine as the expert to follow on Twitter for healthy eating. She is currently working towards her doctorate. Follow her on Twitter at: @JoanSalgeBlake.