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Published By Dr. Rein Tideiksaar on February 14, 2017

Diabetes is a lifelong (chronic) disease in which there is a high level of sugar (glucose) in the blood. People with diabetes often have no symptoms at first. They may not have symptoms for many years. Early symptoms of diabetes include:

  • Frequent bladder, kidney, skin or other infections
  • Increased fatigue
  • Increased hunger
  • Increased thirst
  • Frequent urination

The first symptom may include:

  • Blurred vision
  • Erectile dysfunction
  • Pain or numbness in the feet or hands

The complications of diabetes (visual and peripheral nerve damage and loss of sensation in the feet and legs) are associated with visual impairment, balance loss and increased risk of falls and bone fractures.


According to the American Diabetes Association (ADA), more than 80 percent of Americans over age 60 have warnings of pre-diabetes. The ADA defines pre-diabetes as a state of high blood sugar, usually assessed by a fasting blood glucose test that’s not high enough to be diagnosed as diabetes.

Because individuals may not develop symptoms of diabetes for many years, it’s important to detect pre-diabetes to avoid getting diabetes. When blood sugar levels measure 126 milligrams per deciliter or higher, an individual has diabetes. If it’s over 100 mg but doesn’t exceed 125 mg, a person is said to have pre-diabetes. Pre-diabetes doesn’t cause organ damage or symptoms on its own but increases the risk of developing diabetes. Not everyone classified as pre-diabetic becomes diabetic. About 15 to 30 percent of those with pre-diabetes progress to diabetes within five years; the rate of progression runs higher in elders.


Because the likelihood of developing diabetes can potentially be reversed, or at least delayed, it’s important to treat pre-diabetes. The best approach consists of the following:

Healthy Eating and Weight Control

  • Work closely with your doctor to learn how much fat, protein and carbohydrates you need in your diet. Your meal plans should fit your lifestyle and habits and should include foods that you like.
  • Managing your weight and having a well-balanced diet are important. Very obese individuals (who are at great risk for diabetes) whose diet is not well-managed may consider weight-loss (bariatric) surgery.

Regular Physical Activity

Exercise helps avoid diabetes by:

  • Lowering your blood sugar level without medicine.
  • Burning extra calories and fat to help manage weight.

It’s important to talk to your doctor before starting any exercise program.

Rein Tideiksaar Ph.D., PA-C (or Dr. Rein as he is commonly referred to) is the president of FallPrevent, LLC, Blackwood, N.J., a consulting company that provides educational, legal and marketing services related to fall prevention in the elderly. Dr. Tideiksaar is a gerontologist (healthcare professional who specializes in working with elderly patients) and a geriatric physician's assistant. Check out Dr. Rein’s professional profile on LinkedIn: If you have any questions about preventing falls, please feel free to email Dr. Rein at

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