[Ronin]

Hi HealthyChocolat!

I see that you are not the person with the diagnosis, but you share the concern about the "D-Word." The advice to "calm down" is well placed. It is too easy to panic. It is also easy to get confused over the whole Pre-Diabetic diagnosis.

There is a lot of controversy in the diabetic community and amongst physicians and other medical professionals about this diagnosis. My personal research says that this particular diagnosis was adpoted with the hope to catch potential Type-2 people before they sucumbed to full-blown diabetes. To that extent the condition is "reversable" but reversable only in the way that alcoholism is "reversible" only if you stop drinking alcohol forever.

A diagnosis of Pre-Diabetes is the warning that something is going wrong with the control of glucose in the blood stream. That being said a high FBG (Fasting Blood Gulcose) level is the first step in the diagnosis. A second high FBG to confirm the first should then be followed by an HbA1c test to determine the weighted average BG levels for the past 90 days. If this is over 6 then it is likely that the person is developing diabetes and an OGTT (Oral Glucose Tolerance Test) with C-Peptide readings should be done to validate the HbA1c test. The C-Peptide test as part of the OGTT is essential to avoid mis-diagnosing a person who is actually developing Type-1.5 (a failing pancreas) as a Type-2 because the treatment regimine is totally differnt. A person who has a low C-Peptide reading (heading towards Type-1.5) will respond well to insulin therapy while a person with a high C-Peptide reading (Insuling resistant heading towards Type-2) will not and needs a different course of treatment.

Yes, this is all a bit confusing and overwhelming. To put it simply, your sisters doctor is taking the appropriate course of action with modifications to diet and exercise (which have to be translated into a permanent lifestyle change) along with on-going monitoring. As I said before the ability to reverse Pre-Diabetes is like an alcoholic reversing alcoholism -- they can never go back to being "social drinkers" only recovering alcoholics. That is the good, and the bad news. The diagnosis is a wake-up-call that you need to heed.

FWIW: I have already determined that my Pre-D diagnosis, because of my low C-Peptide reading, says that my Pancreas is headed towards self destruction. However, with diet and exercise I hope to keep it working for a very long time.