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Learning About Prediabetes, Prevention, & Symptoms of Diabetes

What Is Prediabetes?

  • Before people develop type 2 diabetes, they almost always have “prediabetes” – blood glucose levels that are higher than normal, but not yet high enough to be diagnosed as diabetes.
  • Doctors sometimes refer to prediabetes as impaired glucose tolerance (IGT) or impaired fasting glucose (IFG), depending on what test is used when it was detected.
  • This condition (prediabetes) puts you at higher risk for developing type 2 diabetes and cardiovascular disease.

No Clear Symptoms.

  • There are no clear symptoms of prediabetes – so you may have it and not know.
  • You usually find out you have prediabetes when being tested for diabetes.
  • If you have prediabetes, you should be checked for type 2 diabetes every 1-2 years.

Results indicating prediabetes are: 

  • An A1C of 5.7% – 6.4%
  • Fasting Blood Glucose of 100-125 mg/dl.
  • An OGTT 2 hour blood glucose of 140 mg/dl-199 mg/dl

Preventing Type 2 Diabetes:

  • You will not automatically develop type 2 diabetes if you have prediabetes.
  • For some people with prediabetes, early treatment can actually return blood glucose levels to normal range.
  • Research shows that you can lower your risk for type 2 diabetes by 58% by:
    • Losing 7% of your body weight (15 pounds if you weigh 200 pounds)
    • Exercising moderately (such as brisk walking) 30 minutes a day, 5 days/week
    • Don’t worry if you can’t get to your ideal body weight – losing 10-15 pounds can make a huge difference

Symptoms of Diabetes:

**The following symptoms are typical of diabetes.  However, some people with type 2 diabetes have symptoms so mild – they go unnoticed.

Common Diabetes Symptoms:

  • Urinating often
  • Feeling very thirsty
  • Feeling very hungry – even though you’re eating
  • Extreme fatigue
  • Blurry vision
  • Cuts/bruises that are slow to heal
  • Weight loss (even though you’re eating more) type 1
  • Tingling, numbness, or pain in the hands/feet (type 2)

Diagnosing Diabetes – Testing Options


  • There are several ways to diagnose diabetes.
  • Each way usually needs to be repeated on a 2nd day to diagnose diabetes.
  • If your doctor determines that your blood glucose level is very high, or if you have classic symptoms of high blood glucose in addition to one positive test, your doctor may not require a second test to diagnose diabetes.
  • 86 millions Americans have prediabetes.


  • The A1C Test measures your average blood glucose for the past 2-3 months.
  • The advantage of this type of diagnosis is that this way you don’t have to fast or drink anything.
  • Diabetes is diagnosed at an A1c of greater than or equal to 6.5%.

Results:  Normal (less than 5.7%), Prediabetes (5.7%-6.4%), Diabetes (6.5% or higher)

Fasting Plasma Glucose (FPG)

  • Checks your fasting blood glucose levels.
  • Fasting = not having anything to eat or drink (except water) for at least 8 hours before the test.
  • Test is usually done first thing in the morning, before breakfast.
  • Diabetes is diagnosed at FPG of greater than or equal to 126 mg/dl.

Results:  Normal (less than 100 mg/dl), Prediabetes (100 mg/dl-125 mg/dl) Diabetes (126 mg/dl or higher)

Oral Glucose Tolerance Test (OGTT)

  • At two-hour test that checks your blood glucose levels before and 2 hours after you drink a special sweet drink.
  • The test tells your doctor how your body processes glucose.
  • Diabetes is diagnosed at 2 hour blood glucose of greater than or equal to 200 mg/dl.

Results:  Normal (less than 140 mg/dl), Prediabetes (140 mg/dl-199 mg/dl), Diabetes (200 mg/dl or higher)

Random (Casual) Plasma Glucose Test

  • A blood check at any time of the day when you have severe diabetes symptoms.
  • Diabetes is diagnosed at blood glucose of greater than or equal to 200 mg/dl.

American Diabetes Month: November



  • One in 11 Americans have diabetes.
  • Approximately 1.25 million American children and adults have type 1 diabetes.
  • Of the 30.3 million adults with diabetes, 23.1 million were diagnosed and 7.2 million were undiagnosed.
  • The percentage of Americans age 65 & older remains high, at 25.2%, or 12.0 million seniors (diagnosed & undiagnosed).
  • 1.5 million Americans are diagnosed with diabetes each year.
  • In 2015, 84.1 million Americans, age 18 & older, had prediabetes.
  • Diabetes remained the 7th leading cause of death in the U.S. in 2015, with 79,535 death certificates listing it as the underlying cause of death.  A total of 252,806 death certificates listed diabetes as an underlying or contributing cause of death.


  • About 193,000 Americans under age 20 are estimated to have diagnosed diabetes.
  • In 2011-2012, the annual incidence for diagnosed diabetes in youth was estimated at 17,900 with type 1 diabetes and 5,300 with type 2 diabetes.


Rates of Diagnosed Diabetes in Adults:

  • 7.4% non-Hispanic whites
  • 8.0% Asian Americans
  • 12.1% Hispanics
  • 12.7% non-Hispanic blacks
  • 15.1% American Indians/Alaskan Natives

The Breakdown Among Asian Americans:

  • 4.3% for Chinese
  • 8.9% for Filipinos
  • 11.2% for Asian Indians
  • 8.5% for Asian Americans

The Breakdown Among Hispanic Adults:

  • 8.5% for Central & South Americans
  • 9.0% for Cubans
  • 13.8% for Mexican Americans
  • 12.0% for Puerto Ricans


  • Diabetes was the 7th leading cause of death in 2015.
  • Diabetes may be underreported as a cause of death.

National Rural Health Day: November 16, 2017

“It’s Not Just a Day…It’s a Movement”

Over 60 million Americans live in rural and frontier communities…

*Rural Communities are wonderful places to live and work, but they also have unique healthcare needs.  Today, more than ever, rural communities must address:

  • accessibility issues
  • lack of healthcare providers
  • needs of an aging population suffering from a greater number of chronic conditions
  • larger percentages of un- or under-insured citizens

**Rural hospitals struggle daily as declining reimbursement rates and disproportionate funding levels make it challenging to serve their residents.



Stomach Cancer: Know the Types…And Your Risk

**Hereditary Diffuse Gastric Cancer (HDGC)

  • An inherited cancer syndrome
  • Leads to an increased risk for both diffuse gastric cancer and lobular breast cancer

3 Types of Stomach Cancer (adenocarcinoma):

Noncardia (distal) Stomach Cancer –

  • May develop from long periods of inflammation and irritation in the lower portion of the stomach.
  • It is associated with the chronic infection of Helicobacter pylori (H. pylori) bacteria.
  • More common in developing countries.
  • Risks include:  tobacco use, alcohol consumption, obesity, environmental exposure to dust and fumes, and a diet rich in smoked, salted, and pickled foods.j
  • Treatment of H. pylori infection can decrease the risk of stomach cancer development –
    • Tests to detect H. pylori infection are:  blood antibody, urea breath test, stool antigen, and stomach biopsy

Proximal Stomach Cancer –

  • Starts in the upper part of the stomach and may extend into the gastro-esophageal junction – where the esophagus joins the stomach.
  • Tends to occur in those that are obese or have gastro-esophageal reflux disease (GERD).
  • More common in U.S. than other parts of the world.

Diffuse Stomach Cancer –

  • An aggressive cancer that grows rapidly in the cells of the stomach wall.
  • Unlike other cancers that form a mass or tumor – these caner cells are diffused – spread or scattered widely or thinly.
  • Difficult to diagnose due to diffuse nature.
  • Tends to affect younger people with a family history of the disease – or those having a genetic syndrome.
  • A pathologist can determine whether the cancer is the diffuse type.  Some words that might be used by the pathologist include:
    • “signet ring carcinoma”
    • “diffusely infiltrating”
    • “poorly differentiated”
    • “mixed or isolated cell types”
    • “Linitis plastica” is an older term to describe diffuse gastric cancer

Less Common (Rare) Stomach Cancer Types:

  • Gastrointestinal stromal tumors (GIST)
    • Rare tumors that start in stomach muscles or connective tissue – may be cancerous or non-cancerous.
    • Typically found in stomach – although can be found anywhere in the digestive tract.
  • Carcinoid Tumors
    • Start in the stomach’s hormone-producing cells.
    • Most of these types of tumors do not spread to other organs.
  • Lymphoma
    • Starts in the stomach’s immune cells.
  • Liposarcoma
    • Cancer that arises in fat cells and deep soft tissue.
  • Other stomach cancers –
    • Very rare, but can start in the stomach
    • squamous cell carcinoma
    • small cell  carcinoma
    • leiomyosarcoma (a muscle cancer)

November: “No Stomach for Cancer”

November is Stomach (gastric) Cancer Awareness Month

Stomach (gastric) Cancer:

  • Defined by the National Cancer Institute (NCI) as cancer that forms in tissues lining the stomach.
  • The stomach is located in the upper abdomen, between the esophagus and small intestine.
  • The cancer occurs when cells in the stomach become abnormal and multiply.
  • 90-95% of stomach cancers are adenocarcinomas – meaning they arise form the mucosal tissue lining the inside of the stomach.
  • Abnormal cells may spread over time to invade deeper into the stomach wall or eventually spread to nearby tissues or organs.
  • Adenocarcinomas further classified as an intestinal type or diffuse type – based on how the cells look under a microscope.

***Usually stomach cancer grows slowly over the course of several years causing few, if any, symptoms.***

Stomach Cancer Stats:

  • 5th most common cancer type worldwide.
  • 1 million new cases each year, globally.
  • 1 in 111 men and women will be diagnosed in their lifetimes.
  • 1-3% of stomach cancers are related to inherited cancer syndromes.
  • 80% risk in hereditary cases:
    • Hereditary Diffuse Gastric Cancer (HDGC) increases the risk for diffuse gastric cancer (80% risk by age 80) and lobular breast cancer (42% for women by age 80)
  • 4% 5-year survival rate for Stage 4 stomach cancer patients (overall 5-year survival rate is 29.3%).
  • 3rd most common cause of cancer deaths globally.
  • $1.8 billion was spent on the care of stomach cancer patients in the U.S. in 2014.
  • Only 0.23% of the National Cancer Institute’s 2013 budget was dedicated to stomach cancer.

Did You Know?

  • Stomach cancer is difficult to detect and is typically diagnosed in late stages.
  • Treatment of H. pylori infection (a common bacterial infection of the stomach) can decrease the risk of stomach cancer development.
  • A diet high in smoked, salted, and pickled foods, tobacco use, and obesity can all increase stomach cancer risk.
  • People who carry the BRCA1 and BRCA2 gene mutations, which increase the risk of breast and ovarian cancer, may also have an increased risk of developing stomach cancer.
  • Stomach cancer can be hereditary, sometimes caused by a gene mutation (CDH1 is one such gene).
  • Preventative complete stomach removal (gastrectomy) is the treatment of those with a CDH1 gene mutation.
  • Stomach, lobular breast, and colon can or are all risks for those with a CDH1 gene mutation.
  • A person can live a normal life without a stomach.
  • Early detection of stomach cancer is the key to survival.