As a former Olympian who represented Britain for 15 years in the hop, Michelle Griffith-Robinson had rarely considered the possibility of running the risk of diabetes.
Slim and athletic, Michelle still trained several days a week and lived an active lifestyle in Devon with her husband, former Welsh rugby player Matthew Robinson, and their three athletic children.
But in September last year, while Michelle was undergoing reconnaissance for a suspected kidney problem, doctors gave her a shocking news – blood tests had revealed that she was pre-diabetic. The measurements showed that the 47-year-old, a personal trainer and lifestyle stylist, since she stopped exercising in 2006, had blood sugar levels that brought her right in the middle of the pre-diabetic range.
Michelle Griffith-Robinson, pictured with her three children, Elijah, left, Reese, top, and Eden, right, underwent a routine blood test last September to show that she had pre-diabetes
& # 39; I was blown away, & # 39; says Michelle today. # I walked into that room, glowing with health, really fit, and you would never have said I was at risk of developing type 2 diabetes.
& # 39; But it only shows that you can't judge a book by its cover – it's what's going on. If it can happen to me, it can happen to anyone. & # 39;
Pre-diabetes does not cause symptoms and you can look and feel good – as the case of Michelle proves. So why should you think, should you worry about that? After all, it means that the blood sugar levels are high, on the edge of type 2 diabetes, but not yet in full condition. Certainly, it is a matter of crossing that bridge when you join it, or not at all? Well, not according to the latest proof.
It is known that type 2 diabetes itself dramatically increases the risk of problems, from heart attacks and strokes to blindness, amputations and erectile dysfunction. That is why the roughly four million VK patients usually receive medication or other treatments to control the worst effects.
Michelle represented Great Britain in the 15-year hop step, including the 2006 Commonwealth Games, pictured
But many experts now believe that the microscopic damage to organs, nerves and cells caused by high sugar levels actually starts much earlier than previously thought. Those with pre-diabetes are also at risk for heart disease, kidney problems and possibly dementia.
Studies have shown that many of those with elevated blood sugar levels can delay or even prevent diaphragm transition to type 2 diabetes by making simple lifestyle changes to lose weight and become more active. As a diabetes expert, Naveed Sattar, professor of metabolic medicine at the University of Glasgow, explains: & # 39; If you have the diagnosis, you can do something about it, this can make a big difference to your health. & # 39;
A diagnosis of pre-diabetes offers a crucial opportunity – one that Michelle, who represented Britain at the 1996 Atlanta Games, seized on typical determination. Her lifestyle changes have had an impact over the past nine months.
She says: “My diet was already fairly balanced, but I changed it to more eggs and mackerel, good lean sources of protein and lots of vegetables because they are full of vitamins, minerals and fiber, and they also fill . I cut down fruit and now avoid sweet snacks or chips. I snack on yogurt and walnuts instead.
& # 39; I go running a few times a week and do a weight session in the gym. I have lost almost 10 pounds and my blood glucose levels show that I have almost no pre-clinical range. I wasn't fat, but it's about how much fat your own body can tolerate. & # 39;
Michelle, whose mother is from Jamaica and a father from Barbados, has an increased risk of the condition because of her ethnicity.
Michelle, pictured with her family, including her former Welsh international rugby husband, Matthew, second left, said she changed her lifestyle due to the diagnosis
It is believed that people of African and Caribbean descent can store fat differently, causing it to be stored in the liver and pancreas, which in turn affects insulin production.
But in the case of Michelle it is thought that there is also a strong hereditary risk factor. Her mother, 25 years a nurse at the NHS, was diagnosed with 58-year-old type 2 diabetes and her grandmother in Jamaica died of diabetes-related complications. Four aunts and two cousins also have the condition.
Michelle is now determined to teach her own children – Reese, 15, Eden, 13 and five-year-old Elijah – to stay healthy. She says: & # 39; Maybe I would have been diabetic now if I had not taken action. & # 39;
THE SIMPLE TESTS THAT CAN SPOT A KILLER
Amazingly, one in three adults in the UK is thought to be pre-diabetic – around 14 million people.
That figure has tripled in just ten years, driven up by the increasing tide of obesity. Yet most people have no idea that they live with the condition unless they have a blood test at their doctor's office. In the past, pre-diabetes was mainly picked up by chance, for example after a person was admitted to hospital with a heart attack.
But this is starting to change, as doctors increasingly offer tests to detect problems with blood sugar before they get serious.
One of these, known as a fasting plasma glucose test, involves eating and drinking nothing except water for eight to ten hours before a blood sample is taken from the arm. Those with pre-diabetes will have a higher than normal value, but this only provides a snapshot of the blood sugar level at that time.
Michelle, whose mother is from Jamaica and a father from Barbados, has an increased risk of the condition because of her ethnicity
Another, better indicator is a so-called HbA1c blood test. This gives the average blood sugar level of a patient over the previous two to three months.
HbA1c is what is known as glycated hemoglobin. This is done when glucose – a type of sugar that is digested from food – sticks to red blood cells in the bloodstream. The more glucose remains in the bloodstream, the more HbA1c there is. The test looks for a percentage of the blood as a whole that consists of HbA1c, and this measurement can tell doctors if you have premiabetics, or even type 2 diabetes.
It is possible to get a do-it-yourself test kit to measure HbA1c in some pharmacists and online, which could indicate an increased risk of pre-diabetes. However, for a definitive diagnosis, it is important to consult your doctor.
IT'S TIME TO COME WITH THE PROGRAM
Could doctors be able to detect it years before it strikes?
Diabetes warning signs could be picked up years before even pre-diabetes is diagnosed, according to some researchers.
A study, which followed 6,500 officials over a ten-year period, discovered that it was possible to detect subtle early changes in blood glucose and insulin resistance in those who developed type 2 diabetes a few years later.
The study, by scientists at University College London, suggested that it would be possible to & # 39; pre-diabetes & # 39; – which means that action can be taken even faster to protect the health of those most at risk.
Researchers monitored the blood sugar level of the group and the ability of their tissues to respond over time to the hormone insulin, which is involved in blood sugar control.
Those who went on to develop type 2 – 505 people – showed a rapid acceleration of blood sugar levels, which began with the condition three years before they were diagnosed. Their insulin sensitivity also dropped sharply in the five years prior to diagnosis.
Changes were also noted in the behavior of the type of pancreatic cells that produce insulin.
Their activity increased in the three to four years prior to diagnosis, and then declined because they struggled to cope with higher sugar levels.
Principal investigator Dr. Adam Tabak said: & # 39; The most important message to come out of this type of research is to explain how the disease develops and what its history is. We know that lifestyle intervention can prevent more than 50% of type 2 cases. & # 39;
But he added that it would be enormously expensive and time-consuming to intervene at this stage, and others warned that more research was needed before such early tests could be reliable enough.
Libby Dowling, senior clinical consultant at the Diabetes UK charity, says: & We estimate that more than half of all cases of type 2 diabetes can be prevented or delayed if we can intervene early. That means identifying people with an increased risk of developing diabetes, and then helping them manage their weight and lifestyle. It is important to realize that type 2 diabetes is not a matter of course. & # 39;
The government is so concerned about the escalating number of cases that it is investing £ 90 million in a Diabetes Prevention Program (prevention diabetes, co.uk) in collaboration with Diabetes UK. The system is being rolled out in community centers, church buildings and gyms across England, with 212,000 pre-diabetic patients who were referred by general practitioners last year.
Adults with elevated blood sugar levels are offered monthly face-to-face meetings, usually in a group, with specialized nurses. The nurses provide exercise tips and advice on making dietary changes to lose weight.
Some who struggle to attend regular meetings receive fitness tracking equipment. The latest figures show that patients who lost about half a stone saw their blood sugar levels return to normal.
Prof. Sattar says: & # 39; Studies also suggest that people with pre-diabetes who successfully address the problem have fewer heart attacks later in life, fewer cardiovascular diseases and lower overall mortality. & # 39;
EARLY AND CARE FOR YOUR HEALTH
Not everyone with pre-diabetes will develop full-blown type 2 – and it is currently not understood why this is the case. For this reason, pre-diabetes has proven to be controversial.
Diabetes UK says it does not use the label, and it is not approved by the World Health Organization or the British drug watchdog NICE.
Part of the concern comes from the United States, where people with pre-diabetes are more likely to be prescribed drugs such as metformin to lower their blood sugar levels, leading to claims that people are receiving unnecessary medication.
Some British patients with pre-diabetes may be prescribed metformin, but this should be strictly determined case by case by general practitioners. Dr. Nicola Guess, from King's College London, says: & # 39; Pre-diabetes is controversial because many will not get type 2, and others will return to normal. But the value of identifying it is that lifestyle changes can be super effective in preventing type 2.
& # 39; Patients with pre-diabetes are generally very happy that they have been informed so that they can do something about it. & # 39;
Even if you are told that you have pre-diabetes, it may be tempting not to take action. But the sooner you act to reduce your weight and protect your body against the effects of high blood sugar levels, the more you improve your long-term health.
Some people with pre-diabetes may even have an increased risk of heart problems.
Prof. Sattar says: & Even if you manage to postpone your diabetes for five years, those five years that you have no diabetes have protected your blood vessels and heart against damage caused by high sugar levels. The younger you develop type 2 diabetes, the greater the excessive risk of death, heart disease and heart failure.
& # 39; Get away from thinking that type 2 is inevitable if you have pre-diabetes – that's so important. Even if you can't postpone it forever, those few extra years before being diagnosed will mean a big boost to your health. & # 39;
Dr. Ellie Cannon & # 39; s diabetes Q & A
Mr. GP told me that I have pre-diabetes – do I get sick?
No, we test for pre-diabetes so that you can do something about it. Changes in diet, exercise and lifestyle can help prevent you from developing type 2 diabetes and, conversely, pre-diabetes. It is also very important to know that pre-diabetes is a risk factor for other conditions such as heart disease, so smoking, high blood pressure and other things that can further increase the risk of heart attack or stroke should be considered.
It's an alarm: you have to take charge and make the changes so that you don't get sick.
I have had two different tests for pre-diabetes, two months apart. The first was normal, but the second indicated pre-diabetes. Which should I trust?
You must trust both tests. If the second has indicated pre-diabetes, it means that on average there is a higher blood sugar level than before.
We see this when someone is on their way to pre-diabetes, perhaps due to food or weight changes.
It can be the start of a downhill trend, so make sure you get a new test within three months. We usually check these levels for the best accuracy every quarter.
Will the missing breakfast lower and control my blood sugar?
For some people, intermittent fasting can be a very effective way to control blood sugar levels and even reverse pre-diabetes. But it is not a guarantee. There are two methods that people report that they work. The first is time-limited eating, where you hold 16 hours and only eat during one window per day – for example from 1:00 pm to 8:00 pm. Alternatively, people opt for periodic fasting twice a week when they cut down to 800 calories. It is not for everyone and does not work guaranteed. Try it and if you can, you should have a blood sugar test two to three months later.
Do meal replacements replace a suitable way to limit my calorie intake?
Some data has taught us that using the shakes on a very low 800-calorie-per-day diet, up to three months, can reverse type 2 diabetes and also pre-diabetes. But it is difficult to maintain even a week or two, so often fails. I recommend a low GI diet instead, choosing foods that are known to take longer to digest and sustain us longer.
Med diet helped me shift the pounds
For Maggie Hartley, the diagnosis of pre-diabetes was precisely the catalyst for change she needed
For Maggie Hartley, the diagnosis of pre-diabetes was precisely the catalyst for change she needed. Despite various diets over the years, the pounds turned out to be harder to shift. When Maggie, 72, saw her practice nurse for routine checkups in March, her BMI was over 30, placing her in the overweight category.
The nurse performed an HbA1c blood test, which showed that the blood sugar level was just above the threshold for pre-diabetes. & # 39; I was not surprised at all & # 39 ;, confesses Maggie, a retired PA from Bognor Regis, West Sussex. & # 39; I am overweight and your body shape changes after the menopause. But I'm glad I found out. It gives you that ability to focus and make the important changes that you thought really didn't matter.
& # 39; I am much more motivated to stick to a healthy lifestyle. & # 39;
Maggie, left, now follows a Mediterranean diet, plays tennis twice a week and enjoys walking.
She eats a late breakfast with boiled eggs, cherry tomatoes and homemade spelled bread, a typical lunch is salmon with a lot of salad and evening meals consist of roasted vegetables.
She has cut meats and bacon and no longer buys cookies.
Fortunately, her blood sugar levels are now almost normal again.
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