A third of San Antonians have prediabetes; doctors urge testing

November Diabetes Awareness Month. Vector illustration with ribbon and drop of blood

During Diabetes Awareness Month (November), UT Health San Antonio endocrinologist Carolina Solis-Herrera, MD, reminds the community that one in every three people in San Antonio has prediabetes, which physicians define by a hemoglobin A1C percentage of 5.7% to 6.4%. Hemoglobin A1C is a blood test that measures average glucose levels over the past three months.

Carolina Solis-Herrera, MD
Carolina Solis-Herrera, MD

“We are entering flu season, and an infection can spike glucose levels,” Solis-Herrera said. “We urge everyone — especially those with diabetes and prediabetes — to be vaccinated against the flu as soon as possible.”

One in six San Antonians already has type 2 diabetes, which is defined by an A1C percentage of 6.5% or higher. At 16% type 2 diabetes prevalence, San Antonio is 6 percentage points higher than the U.S. average of 10%. The disease is much more highly prevalent in Hispanics, who make up more than 60% of the Alamo City’s population.

Type 2 diabetes mellitus is a consequence of multiple medical problems occurring simultaneously. The body has less insulin — the hormone that lowers blood sugar — and is not sensitive to it. This results in chronically high levels of glucose (sugar) circulating in the blood, which over time damages vessels, tissues and organs.

Diabetes and prediabetes are cardiovascular disease risk factors. Predisposed individuals are at higher risk of heart attack or stroke. As its name indicates, prediabetes is a prequel of diabetes.

“About 10% of patients with prediabetes will go on to develop diabetes-related eye disease, kidney disease or neuropathy of the lower extremities,” Solis-Herrera said. “Healthy eating and regular exercise (30 minutes a day five days a week) can help prevent these debilitating complications.”

Young and old alike should have regular checkups, she urged. Type 2 diabetes and prediabetes are being found more frequently in children.

“Here in San Antonio a few years ago, we had the youngest case in the world, a 5-year-old with type 2 diabetes,” Solis-Herrera said. UT Health San Antonio pediatrics faculty offer childhood diabetes detection and care at University Health’s Texas Diabetes Institute.

Recently, two classes of drugs have proven to be very effective in treating type 2 diabetes and reducing the risk of heart attack and stroke, Solis-Herrera said. One class of drugs also showed a reduction in the risk and progression of kidney disease. Weight loss is another outcome of these drug therapies.

“These medications are widely available, and most insurances cover them,” Solis-Herrera said. “Combination therapy for the treatment of type 2 diabetes is proving more effective than single-drug therapy, so your doctor may prescribe more than one medicine to treat the disease.”

Many San Antonians do not know they have type 2 diabetes or prediabetes. An aversion to the traditional method of monitoring blood glucose level through finger sticks may have prevented some individuals from being screened.

“Importantly, there is technology that is readily available that helps individuals monitor their glucose levels without finger sticks,” Solis-Herrera said. “There are also continuous glucose monitoring systems that check sugar throughout the day. We are advancing in our ability to diagnose and manage this very common disease.”


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