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Published on November 16, 2018

Diabetes: Prediabetes, Eye Care and Gestational

In this Fox 8 House Call series, Cone Health experts discuss diabetes topics, including:

Diabetes: Prediabetes, Eye Care and Gestational


If you’ve been diagnosed with prediabetes, it means your blood sugar levels are higher than normal but not high enough for you to be considered diabetic. Diabetes is diagnosed by taking a reading of an individual’s blood sugar levels using one of three tests: fasting, random or 3-month average blood sugar. An individual without diabetes has a fasting blood sugar level below 100, a random blood sugar level below 140 and a 3-month average blood sugar level, known as the A1C, below 5.7%. An individual is diagnosed with diabetes if their fasting blood sugar level is above 126, their random blood sugar level is above 200 or their A1C is above 6.4%. When a person has blood sugar levels that fall in between the normal and diabetes ranges, they are considered to have prediabetes.

Risk factors that may lead to prediabetes and diabetes include:

  • Age – risk increases after the age of 45.
  • Body Mass Index (BMI) above 25.
  • Race and ethnicity.
  • Family history.

You may also be at risk if you are below the age of 45 but have other risk factors such as high cholesterol, high blood pressure and a BMI above 25. Most people with prediabetes don’t experience any symptoms and the only way to know they have it is through a blood test. Annual appointments with your primary care provider are important because they can advise you when a blood test may be beneficial and help you make any necessary lifestyle changes.

Unlike type 2 diabetes, prediabetes can be reversible. By detecting prediabetes early and adopting the proper lifestyle modifications, a diabetes diagnosis can be postponed or prevented. Regular exercise and adopting healthy eating habits can help normalize your blood sugar levels over time. Moderate exercise, like walking or water activities for 30 minutes a day, 5 days a week, is ideal. When it comes to healthy eating, patients should try to include fruits, vegetables, whole grains, protein and calcium-rich foods.

Individuals who are diagnosed with prediabetes should talk to their doctor about getting a referral to nutrition and diabetes education services to develop a preventive plan customized to their health condition and personal needs. Cone Health’s Nutrition and Diabetes Education Services have exceptional teams of registered dietitians and certified diabetes educators dedicated to educating and treating patients throughout the community with prediabetes and diabetes.

Donetta Floyd, RD, LDN, is a registered dietitian with Cone Health Nutrition and Diabetes Education Services.

Diabetes & Eye Health

Diabetes can affect the body in many ways, and you may have heard that it can cause eye problems and even lead to blindness. However, early detection and intervention of eye issues in diabetes patients can help prevent and/or postpone damage to the retina or vision loss. This is why it is extremely important for patients with diabetes to get a comprehensive eye exam annually.

There are a few forms of diabetes-related eye disease, including:

  1. Diabetic retinopathy – When the blood vessels in the retina (the light-sensitive tissue lining the back of the eye) are damaged from diabetes.
  2. Diabetic macular edema - Occurs when blood vessels in the retina of patients with diabetes begin to leak, causing fluid buildup that can lead to vision loss.
  3. Cataracts – Permanent blurring of vision from cataracts can be caused by changes to the lens due to excess blood sugar.
  4. Glaucoma – When pressure builds within the eye, leading to a gradual loss of sight.

Retinopathy is the most common eye problem people with diabetes face, but it may not cause any symptoms that patients can see in the early stages of disease. People with diabetes should get regular eye exams, even before they lose vision, so their physician can look for signs and symptoms of retinopathy and treat it quickly. Treatment may include injections or laser treatment.

Risk factors of eye disease include uncontrolled blood sugar, high blood pressure and smoking. While proper blood sugar control and early intervention are key in preventing retinal damage and/or vision loss in diabetes patients, there have been many advancements in medications and surgical procedures that can help restore vision in diabetes patients who have already developed eye disease. If you have recently been diagnosed with diabetes, it is important to talk to your doctor about getting a comprehensive eye exam as soon as possible.

Brian Zamora, MD, PhD, is a board-certified ophthalmologist with Triad Retina & Diabetic Eye Center and a member of Cone Health Medical Group.

Gestational Diabetes

Gestational diabetes is a form of type 2 diabetes that is only present during pregnancy, but having gestational diabetes puts a woman at elevated risk of developing diabetes outside of pregnancy in the future. Gestational diabetes can be very serious if not treated properly, as it increases risk of injury to the mother and baby. Therefore, it is important for women to know the main risk factors for the condition, which include:

  • Body weight – The higher an individual’s body mass index (BMI), the higher the risk for gestational diabetes. Gaining too much weight during pregnancy is also a risk factor.
  • History of gestational diabetes – If a woman had gestational diabetes in a previous pregnancy, she is more likely to have it again.
  • Previous birth of an infant over 9 pounds – Giving birth to a bigger baby can be a sign of high blood sugar in the mom.
  • Ethnicity - Individuals with Hispanic, African, Native American, South or East Asian, and Pacific Island ancestry all have greater risk.
  • Family history - Having a close family history of type 2 diabetes puts an individual at greater risk.
  • Age – As women age, their risk of experiencing gestational diabetes increases.

Since the condition is often asymptomatic, or has no symptoms, standard practice recommends that all pregnant women get screened for it during the third trimester of their pregnancy or earlier if they are high risk. Gestational diabetes is diagnosed through a glucose tolerance test that measures the level of glucose in the blood, which may be followed by additional testing if the results from the original test are abnormal. If a woman is diagnosed with gestational diabetes during her pregnancy, it is important that she receives the proper prenatal and postnatal care to ensure her safety, as well as her baby’s.

To help monitor expecting moms with diabetes, Cone Health offers the Babyscripts program. This program uses a special app that connects to a portal that her physician can access to monitor her levels. Every time a woman checks her glucose levels, she can enter her results into the app for her OB/GYN to see. Using Babyscripts, her doctor can see changes in levels in real time and check in on the mom if anything seems abnormal, rather than waiting the 2 weeks between traditional appointments. This allows the patient and physician to work more closely to control blood sugar levels and keep both mom and baby as healthy as possible.

Kelly Leggett, MD, specializes in obstetrics and gynecology at the Center for Women's Healthcare and is the clinical transformation officer for Cone Health.

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