Prediabetes Treatment
So as we round out the month of discussing PREDIABETES, I want to end the month discussing treatment for prediabetes. In a post I wrote earlier in the month, I gave an Overview of Prediabetes so if you haven’t read that one make sure go back and check it out. Today I want to get into the treatment and examine the AACE algorithm specifically for prediabetes. One of my favorite reference sources is the American Association of Clinical Endocrinologists (AACE). I tend to lean more toward their algorithms because I find them to be more detailed. The great thing though is that AACE and the ADA work collaboratively so you can’t go wrong with either one.
Before we get into the treatment, let me give you a refresher over prediabetes. It is a higher than normal blood sugar that has not quite met the threshold of diabetes. Clinically, it is defined as a Hgb A1c of 5.7-6.4%. If a patient has 2 separate readings of 6.5% or higher, a provider can consider them a diabetic. Over the years, prediabetes has been known by other names: Borderline diabetes, impaired glucose tolerance, subclinical diabetes (this is the term I remember from undergrad nursing).
Image from American Association of Clinical Endocrinologists
How to Manage Prediabetes
Above is the algorithm for prediabetes. As you can see, we primarily press LIFESTYLE MODIFICATIONS. Let me remind you that even when medication is started, lifestyle modifications are still implemented. Think of it as medications are an adjunct therapy to lifestyle modifications. After lifestyle mods are implemented and hyperglycemia still persists, then you can consider medications. There are four drug classes that could be used. I’ll link them here if you need a refresher—> Metformin (Biguanide), Acarbose, GLP-1 RA’s, TZD’s.
For a deeper dive, I created a video over on my channel, Kim E. The Diabetes NP. Check it out and let me know what you think! Also, I referenced some GREAT resources & videos throughout the video including my FREE NP Diabetes Starter Pack so I’ll link them all below:
+Lifestyle Modifications Video