Prediabetes in Older Adults: A1C Tests and Clinical Carec

When you’re dealing with aches and pains, you know it. From sore hips to creaky knees, our bodies like to remind us of their age! But the elevated blood sugar levels of prediabetes are less obvious.

That’s because this condition tends to show up without symptoms. In fact, nearly half of people 65 and older have prediabetes, and more than three-quarters of them don’t even know it.

But that doesn’t have to be your story. Keep reading to learn more about:

• the clinical aspects of diagnosing and managing prediabetes,

• all about A1C tests and glucose monitoring, and

• how your ArchWell Health provider can support you every step of the way.

What Is the A1C Test?

The A1C test is a simple blood test used to diagnose and monitor prediabetes and diabetes. This test measures your average blood sugar levels over the past three months.

Here’s how it works:

Glucose (sugar) enters your bloodstream and attaches to hemoglobin, a protein in your red blood cells. Everyone has some sugar-coated hemoglobin, but people with prediabetes and diabetes have more.

The A1C test measures the percentage of your hemoglobin that is glycated, which means “attached to glucose.” That’s why the test is also called the glycated hemoglobin, hemoglobin A1C or HbA1c test.

Since red blood cells regenerate every three months or so, the A1C test measures your blood sugar levels from that period of time, rather than just one day.

Should I Get an A1C Test?

Regular A1C testing (every one to three years) is recommended for older adults because age is a risk factor for prediabetes. And these preventive health screenings matter — because catching prediabetes early can help prevent type 2 diabetes.

So even if you feel fine — remember, prediabetes often has no symptoms — it’s important to get tested. You can get the blood test during your regular ArchWell Health appointment, so it’s a hassle-free experience.

Good news: You don’t need to fast beforehand, and you shouldn’t have to wait long for results — they’re often turned around quickly.

Diagnosing and Managing Prediabetes

Your doctor will use the following A1C ranges to diagnose prediabetes:

• Normal: below 5.7%

• Prediabetes: 5.7% to 6.4%

• Diabetes: 6.5% or above

If your A1C test shows that you have prediabetes, that doesn’t mean diabetes is inevitable. You can take steps to reverse prediabetes and prevent type 2 diabetes — and your ArchWell Health provider can help you get started.

They will likely recommend lifestyle changes such as healthy nutrition and physical activity to help restore your blood sugar to normal levels. And you don’t have to make these changes alone! Consider joining the National Diabetes Prevention Program to build healthy habits with a support group of your peers, and lower your risk for type 2 diabetes by 71%.

Your doctor may also recommend medication (such as metformin) to help keep blood sugar down and decrease the risk of developing frailty, a potential complication for older adults who have prediabetes and high blood pressure.

Glucose Monitoring for Prediabetes

By repeating your A1C at regular intervals (typically every year or two), your provider can monitor your progress over time. Be sure to follow through with all scheduled checkups and tests.

Your doctor may also want you to come in for glucose tolerance tests. You’ll need to fast for at least eight hours before this blood test, which measures your blood sugar before and after you drink a glucose liquid.

Another possibility to consider? Wearing a continuous glucose monitor (CGM). CGMs are medical devices that measure your blood sugar levels via a tiny sensor under your skin. A transmitter sends results to a smart device so you can track changes to your levels 24/7.

Using a CGM has lowered A1C levels in people with diabetes, and there’s potential for similar results in people with prediabetes. As the CGM coordinates with your personal lifestyle plan, you can see in real time how certain foods, activities, medications and other factors affect your glucose.

Talk with your ArchWell Health provider to see if using a CGM could help you track your progress and prevent the progression to diabetes.

10 Key Questions to Ask Your Provider

Feeling confused and overwhelmed about a prediabetes diagnosis? Use this list of important questions to reduce uncertainty and get the information you need:

1. What is my A1C level?

2. Do I need to check my blood sugar levels at home? If so, how often?

3. What is the target range for my blood sugar? What should I do if it’s too high or too low?

4. When should I come back for follow-up tests and checkups?

5. Could any of the medications or supplements I’m taking affect my blood sugar?

6. How can I prevent prediabetes from turning into type 2 diabetes?

7. Are there any foods I should avoid? Can I still eat sugar?

8. How much should I exercise each week? What kinds of activities are safe for me?

9. Do I need to take medication? If so, what side effects can I expect?

10. Can you recommend any community programs or groups for preventing diabetes?

How ArchWell Health Can Help

Your primary care physician is your partner as you navigate prediabetes. Not only can they diagnose the condition, they can also provide treatment options, strategies, resources and regular monitoring to help you achieve your goals.

And through ArchWell Health’s nutrition education program, you can get a personalized nutrition plan that’s safe and appropriate for you. ArchWell Health also offers diabetes education classes that focus on nutrition, as well as various activities to support your fitness goals. Find an upcoming event at your local center.

Remember, prediabetes is treatable and reversible. So don’t let this condition have the final say! Stay in touch with your ArchWell Health team and get the support you need to lower your blood sugar — and enjoy a healthy and fulfilling life.