Pre-diabetes diagnosis is call to action

Dear Dr. Donohue: My doctor tells me I have “pre-diabetes.” I’m not sure what that means or how it’s treated. Am I destined for diabetes? What should I be doing for it? — K.M.

ANSWER: Pre-diabetes is indicated by a fasting blood sugar that’s higher than normal but not high enough to be considered diabetes. People with it can progress to diabetes. It’s sort of a mile marker on the road to diabetes.

After a 10-hour fast, the normal blood sugar should be less than 100 mg/dL (5.6 mmol/L). If it’s higher than 125 (6.9), then the person has diabetes. Numbers between those two values indicate pre-diabetes.

Weight loss, when indicated, is one way to get out of pre-diabetes territory. Losing only 5 percent to 7 percent of current body weight can usually bring the blood sugar down to normal ranges.

Exercise is another important way to lose the pre-diabetes label. People who spend 150 minutes a week in exercise can usually remove the pre-diabetes label. Fat blunts insulin’s ability to lower blood sugar. With less fat on board, blood sugar normalizes.

This condition is not just a hazard for developing diabetes. It also leads to heart disease. When the risks for heart disease as well as diabetes are high in a person with an abnormal fasting blood sugar, then the question of prescribing medicine comes to the fore.

The diabetes booklet explains the intricacies of this illness along with its treatment. Readers can obtain a copy of it by writing: Dr. Donohue — No. 402W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.

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Dear Dr. Donohue: What’s the best way to ice an injury like a sprained ankle? Do you just put the ice directly on the ankle and wrap a bandage over it to keep it in place? I’m my school’s basketball trainer — with the help of the coach. — J.J.

Answer: Cold has a number of beneficial actions for an injury. It constricts blood vessels, and that stops bleeding. In every injury, blood vessels break. You might not see evidence of it, but it happens. Cold stops swelling. It numbs nerves, and that lessens pain.

•Don’t put ice directly on the skin. Put a towel between the ice and the skin. Gently massaging with ice produces a more uniform drop in temperature throughout the area of injury.

•Twenty minutes of icing is long enough.

•Freezing water in a paper or plastic-foam cup gives you a handy way to apply the ice. Peel away the paper at the end of the cup that comes in contact with the injury and hold on to the cup with the paper end.

•If icing produces pain, stop immediately.