Contrary to popular belief, there is no such thing as borderline diabetes. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus considers fasting blood sugar levels below 100 normal; levels over 126 are high and considered an indication of type 2 diabetes. This obviously leaves a gap, so why isn't 100 to 126 called borderline? This group is "too high to be considered altogether normal," according to the Expert Committee. For this reason, individuals in the 100 to 126 range on repeated tests are labeled with impaired fasting glucose, a strong indication of early diabetes. This stage is also called prediabetes, illustrating its progressive nature. Because type 2 diabetes is usually driven by excess weight, losing weight is the single most important action a prediabetic can take to avoid development of the full-blown disease.
Weight Loss
Losing 10 percent of your body weight will significantly reduce the risk of developing diabetes and other lifestyle-related diseases -- even if you never achieve a normal weight range. This means a 250-lb. man could lose 25 pounds to significantly reduce his diabetes risk. Setting a goal of six months to achieve a 10 percent weight loss is a safe and appropriate goal for most individuals. Check with a physician first to ensure weight loss is appropriate for you, especially if you have been sedentary and plan to include aerobic exercise in your weight loss strategy.
Body Mass Index
Body Mass Index, or BMI, is a generally effective screening tool for overweight and obesity. Normal BMI, 20-25, represents the ideal range for warding off obesity-related diseases like diabetes. A BMI between 25 to 30 is considered overweight and increases chances of diabetes, and over 30 is considered obese with a significantly increased risk of developing diabetes. One limitation of BMI is that highly athletic people and body builders may be screened as overweight because muscle is heavier than fat.
Ideal Body Weight
Many dietitians still use a calculation called Ideal Body Weight to assess patients for obesity. Although the term "ideal" remains controversial, some people find Ideal Body Weight more straightforward than BMI, especially because no chart is needed. To calculate Ideal Body Weight, use the following formulas. Women: Take 100 lbs. for your first 5 feet of height. Add 5 lbs. for every inch over 5 feet. For example, a 5-foot, 4-inch woman would take 100 plus 5 times 4 to arrive at 120 lbs. The result can go up or down 10 percent to provide an Ideal Body Weight range, so in the case of our 5-foot, 4-inch woman, her Ideal Body Weight would range between 108 and 132 lbs., depending on bone structure and muscle mass. Men: Take 106 lbs. for your first 5 feet of height. Add 6 lbs. for every inch over 5 feet. Again, this amount can vary by 10 percent, depending on body composition.
Waist Size
In addition to weight on the scales, the amount of fat around the belly will increase risk of prediabetes. A waist circumference over 35 for women and over 40 for men increases risk of diabetes and other weight-related diseases. Correct measurement of waist circumference can be taken at home by measuring just above the hipbones, not at the slimmest or heaviest area of your waistline.
References
- American Diabetes Association: Diagnosis and Classification of Diabetes Mellitus
- University of Columbia Missouri: Diabetes Mellitus Type 2 impaired fasting glucose
- American Dietetic Association, 2005, Certification in Adult Weight Management Study Manual.)
- National Heart Lung and Blood Institute: Assessing Your Weight and Health Risk
