Pre-Diabetes and Reducing Diabetes Risk

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Pre-Diabetes and Reducing Diabetes Risk

Question:

I have had two high glucose readings six months apart. The first was 119, the second 115. Is there a natural way I can reduce my level to normal? I am on hydrochlorothiazide (25 mg) for blood pressure. I read that it can increase your glucose level. Is this true?

Answer

Your mild glucose elevations fit the diagnosis of "pre-diabetes." Pre-diabetes occurs when your body develops insulin resistance, but you are able to make enough insulin to keep the glucose elevations from rising into the diabetes range.

When your glucose elevations are slightly above normal, they don't cause any symptoms. However, if you have pre-diabetes, you have about a 10% chance of developing type 2 diabetes within one year. Your chance of developing type 2 diabetes during your lifetime is roughly 70%.

You can improve your chance of developing diabetes. This was shown in 1993 by the Diabetes Prevention Program. This three-year study included more than 3,200 people with pre-diabetes. They were identified because they had high blood glucose levels after meals. People in the study adopted reasonable diet and exercise habits. They lost an average of 5% to 7% of their body weight. This reduced their chance of developing diabetes by nearly 60% during the three years they were studied.

Hydrochlorothiazide is an excellent drug to treat high blood pressure. It is possible that blood glucose levels may increase slightly in a small number of people who take this medication. The effect is not large, so this drug is one of the top choices for blood pressure control for people who have diabetes and for people who don't. It is not clear why some people have an increase in blood sugar in the presence of this medication. Experts disagree about whether it is fair to blame the medication at all.

Mary Pickett, M.D., is a lecturer for Harvard Medical School and an assistant professor of medicine at Oregon Health & Science University in Portland, OR. At OHSU, she practices general internal medicine and teaches medical residents and students.

Last updated:	July 20, 2009