Prediabetes

What is prediabetes?

Prediabetes means that your blood glucose, or blood sugar, levels are higher than normal but not high enough to be called diabetes. Glucose comes from the foods you eat. Too much glucose in your blood can damage your body over time.

If you have prediabetes, you are more likely to develop type 2 diabetes, heart disease, and stroke. But if you make some lifestyle changes now, you may be able to delay or prevent type 2 diabetes.

What causes prediabetes?

Prediabetes usually happens when your body has a problem with insulin. Insulin is a hormone that helps the glucose get into your cells to give them energy. A problem with insulin could be:

• Insulin resistance, a condition in which the body can't use its insulin properly. It makes it hard for your cells to get glucose from your blood. This can cause your blood sugar levels to rise.
• Your body can't make enough insulin to keep your blood sugar levels at a healthy level

Researchers think that being overweight and not getting regular physical activity are major factors in causing prediabetes.

Who is at risk for prediabetes?

About 1 out of every 3 adults has prediabetes. It is more common in people who:

• Are overweight or have obesity
• Are age 45 or older
• Have a parent, brother, or sister with diabetes
• Are African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, Native Hawaiian, or Pacific Islander American
• Are not physically active
• Have health conditions such as high blood pressure and high cholesterol
• Have had gestational diabetes (diabetes in pregnancy)
• Have a history of heart disease or stroke
• Have metabolic syndrome
• Have polycystic ovary syndrome (PCOS)

What are the symptoms of prediabetes?

Most people don't know they have prediabetes because usually there are no symptoms.

Some people with prediabetes may have darkened skin in the armpit or on the back and sides of the neck. They may also have many small skin growths in those same areas.

How is prediabetes diagnosed?

There are a few different blood tests that can diagnose prediabetes. The most common ones are:

• Fasting plasma glucose (FPG) test, which measures your blood sugar at a single point in time. You need to fast (not eat or drink) for at least 8 hours before the test. The results of the test are given in mg/dL (milligrams per deciliter):
  • A normal level is 99 or below
  • Prediabetes is 100 to 125
  • Type 2 diabetes is 126 and above
• A1C test, which measures your average blood sugar over the past 3 months. The results of an A1C test are given as a percentage. The higher the percentage, the higher your blood sugar levels have been.
  • A normal level is below 5.7%
  • Prediabetes is between 5.7 to 6.4%
  • Type 2 diabetes is above 6.5%

If I have prediabetes, will I get diabetes?

If you have prediabetes, you may be able to delay or prevent type 2 diabetes through lifestyle changes:

• Losing weight, if you are overweight
• Getting regular physical activity
• Following a healthy, reduced-calorie eating plan

In some cases, your health care provider may also recommend taking diabetes medicines.

Can prediabetes be prevented?

If you are at risk for prediabetes, those same lifestyle changes (losing weight, regular physical activity, and a healthy eating plan) may prevent you from getting it.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Emergency Medical Services

If you get very sick or badly hurt and need help right away, you should use emergency medical services. These services use specially trained people and specially equipped facilities.

You may need care in the hospital emergency room (ER). Doctors and nurses there treat emergencies, such as heart attacks and injuries. For some emergencies, you need help where you are. Emergency medical technicians, or EMTs, do specific rescue jobs. They answer emergency calls and give basic medical care. Some EMTs are paramedics - they have training to do medical procedures on site. They usually take you to the ER for more care.

If you or someone you know needs emergency care, go to your hospital's emergency room. If you think the problem is life-threatening, call 911.

Health Disparities

Health disparities are health differences between different groups of people. These health differences may include:

• How many people get certain diseases
• How severe the diseases are
• How many people have complications because of the diseases
• How many people die from a disease
• Whether people can get health care
• How many people get screened for a disease

These groups of people may be based on:

• Race
• Ethnicity
• Immigrant status
• Disability
• Sex or gender
• Sexual orientation
• Geography
• Income
• Level of education

NIH: National Institute on Minority Health and Health Disparities

Intimate Partner Violence

What is intimate partner violence (IPV)?

Intimate partner violence (IPV) is abuse that happens in a romantic relationship. The intimate partner could be a current or former spouse or dating partner. IPV is also known as domestic violence.

IPV may include different types of abuse, such as:

• Physical violence, when a person hurts or tries to hurt a partner by hitting, kicking, or using another type of physical force.
• Sexual violence which involves forcing or attempting to force a partner to take part in sexual activity when the partner does not or cannot consent. The sexual activity could include things like sex acts, sexual touching, or non-physical sexual events (e.g., sexting).
• Emotional abuse, which includes threats, name-calling, put-downs, and humiliation. It can also involve controlling behavior, such as telling a partner how to act or dress and not letting them see family or friends.
• Economic abuse, also called financial abuse, which involves controlling access to money.
• Stalking, which is repeated, unwanted contact that causes fear or concern for the safety of the partner. This can include watching or following the partner. The stalker may send repeated, unwanted phone calls or texts.

Who is affected by intimate partner violence (IPV)?

It is hard to know exactly how common IPV is because it is often not reported.

But we do know that anyone can be affected by it. IPV can happen to anyone. It affects people with all levels of income and education.

What are the signs that someone is experiencing intimate partner violence (IPV)?

If you think that a loved one might be experiencing IPV, watch for these signs:

Does your friend or loved one:

• Have unexplained cuts or bruises?
• Avoid friends, family, and favorite activities?
• Make excuses for their partner's behavior?
• Look uncomfortable or fearful around their partner?

Does your friend or loved one's partner:

• Yell at or make fun of them?
• Try to control them by making all the decisions?
• Check up on them at work or school?
• Force them to do sexual things they don't want to do?
• Threaten to hurt themself if the partner wants to break up?

What can I do if I am experiencing intimate partner violence (IPV)?

Your safety is the most important concern. If you are in immediate danger, call 911.

If you are not in immediate danger, you can:

• Get medical care if you have been injured or sexually assaulted.
• Call a helpline for free, anonymous help. You can contact the National Domestic Violence Hotline at 800-799-SAFE (7233) or 800-787-3224 (TTY). You can also chat with them through their website or through text by texting START to 88788.
• Find out where to get help in your community. Contact local organizations that can help you.
• Make a safety plan to leave. Intimate partner violence usually does not get better. Think about a safe place for you to go and all of the things that you will need when you leave.
• Save the evidence. Keep evidence of abuse, such as pictures of your injuries or threatening emails or texts. Make sure that it is in a safe place the abuser cannot access.
• Talk to someone you trust, such as a family member, a friend, a co-worker, or a spiritual leader.
• Consider getting a restraining order to protect yourself.

How can I help someone who is experiencing intimate partner violence (IPV)?

Let your loved one know that being treated this way isn't healthy and that they are not to blame. You should:

• Call 911 if there is immediate danger.
• Watch for the signs of abuse. Learn about the signs and keep track of the ones that you see.
• Find out about local resources. Get the addresses and phone numbers of some local resources in your community. Then you'll be able to share the information if the person is ready for it.
• Set up a time to talk. Make sure you can have your conversation in a safe, private place. Your loved one's partner may have access to his or her cell phone or computer, so be careful about sharing information over text or email.
• Be specific about why you are worried. Describe the behaviors that concern you. Be as specific as possible when explaining why you are worried.
• Plan for safety. If your loved one is ready to leave an abusive partner, help make a plan for getting out of the relationship as safely as possible. An intimate partner violence counselor can help with making a safety plan.
• Be patient and do not judge. You should talk about your concerns with your loved one, but you need to understand that they may not be ready to talk about it. Let them know that you're available to talk at any time, and that you will listen without judging them.

Mental Disorders

What are mental disorders?

Mental disorders (or mental illnesses) are conditions that affect your thinking, feeling, mood, and behavior. They may happen over a short period of time or come and go. Some can be chronic (long-lasting). They can affect your ability to relate to others and function each day..

What are some types of mental disorders?

There are many different types of mental disorders. Some common ones include:

• Anxiety disorders, including panic disorder, obsessive-compulsive disorder, and phobias
• Depression, bipolar disorder, and other mood disorders
• Eating disorders
• Personality disorders
• Post-traumatic stress disorder (PTSD)
• Psychotic disorders, including schizophrenia

What causes mental disorders?

There is no single cause for mental illness. A number of factors can contribute to risk for mental illness, such as:

• Your genes and family history
• Your life experiences, such as stress or a history of abuse, especially if they happen in childhood
• Biological factors such as chemical imbalances in the brain
• A traumatic brain injury (TBI)
• Prenatal (before birth) exposure to viruses, toxic chemicals, or other substances such as alcohol and drugs.
• Use of alcohol or recreational drugs
• Having a serious medical condition like cancer
• Having few friends, and feeling lonely or isolated

Mental disorders are not caused by character flaws. They have nothing to do with being lazy or weak.

Who is at risk for mental disorders?

Mental disorders are common. Many Americans will be diagnosed with a mental disorder at some time in their life.

How are mental disorders diagnosed?

The steps to getting a diagnosis include:

• A medical history
• A physical exam and possibly lab tests, if your provider thinks that other medical conditions could be causing your symptoms
• A psychological evaluation. You will answer questions about your thinking, feelings, and behaviors.

What are the treatments for mental disorders?

Treatment depends on which mental disorder you have and how serious it is. You and your provider will work on a treatment plan just for you. It usually involves some type of therapy. You may also take medicines. Some people also need social support and education on managing their condition.

In some cases, you may need more intensive treatment. You may need to go to a psychiatric hospital. This could be because your mental illness is severe. Or it could be because you are at risk of hurting yourself or someone else. In the hospital, you will get counseling, group discussions, and activities with mental health professionals and other patients.