Prediabetes is also commonly referred to as ‘borderline’ diabetes and is a metabolic condition and growing global problem that is closely linked to obesity. If undiagnosed or untreated, prediabetes can develop into type 2 diabetes; which, whilst treatable, is currently not fully reversible. The main problem is that prediabetes is usually not diagnosed as there are no obvious symptoms.
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What is prediabetes?
Prediabetes is characterised by the presence of blood glucose levels that are higher than normal but not yet high enough to be classed as diabetes. For this reason, prediabetes is often described as the “gray area” between normal blood sugar and diabetic levels. In the UK, around 7 million people are estimated to have prediabetes and thus have a high risk for developing type 2 diabetes. (1) In a US study published online in JAMA last year, nearly 50% of adults living in the U.S. have diabetes or pre-diabetes, a condition where a person already has elevated blood sugar and is at risk to develop diabetes. (2)
Prediabetes may also be referred to as impaired fasting glucose (IFT), if you have higher than normal sugar levels after a period of fasting, or as impaired glucose tolerance (IGT), if you have higher than normal sugar levels following eating. The constantly increasing number of new cases of prediabetes presents a global concern as it will have far-reaching implications on the future burden on healthcare. Between 2003 and 2011, the prevalence of prediabetes more than tripled, with 35.3% in UK and 50% in US of the adult population having prediabetes. (2)(3)
Learn more about prediabetes
Prediabetes is a critical stage in the development of diabetes, for it is at this point that lifestyle choices can be made to turn it around. Early, decisive action can slow down or even halt the development of type 2 diabetes.
What are the symptoms of prediabetes?
The problem is that many people have prediabetes but are completely unaware of it as there are no obvious symptoms, because the condition often develops gradually without any warning signs. In fact, much of the time, the sufferer only learns of their borderline diabetic state once the symptoms of type 2 diabetes start to appear. On this basis, it is useful to be aware of the risk factors of prediabetes and to try to prevent their onset.
What are the risk factors for prediabetes?
You should be tested for prediabetes if you:
- Are overweight/obese
- Have a close relative (parent or sibling) who currently has or has had diabetes
- Have high blood pressure, low HDL (‘good’ cholesterol) or high triglycerides
- Are over the age of 40
- Have given birth to a baby who weighed over 9 pounds
While pre-diabetes may affect anyone, of any age, gender or racial type, some groups are genetically more prone. These include:
- South Asian
- Native American
Testing for prediabetes
Either a fasting plasma glucose test or an HbA1c test may be used to diagnose type 2 diabetes or prediabetes.
The following results indicate the presence of prediabetes:
Fasting plasma glucose: 6.0 mmol/L to 6.9 mmol/L
HbA1c: 42 to 47 mmol/mol (6.0 to 6.4%)
If your results are above the upper limits for prediabetes, your doctor may either diagnose you with type 2 diabetes or take another test in the near future to confirm whether you have diabetes. If you have symptoms of diabetes but have an HbA1c of below 42 mmol/mol (6.0%), you may be given an oral glucose tolerance test (OGTT).
If you are diagnosed with prediabetes, your doctor should clearly set out the steps you need to take to lower your risk of developing type 2 diabetes.
Can I stop prediabetes developing into type 2 diabetes?
The good news is that cases of prediabetes that are identified early on can be reversed, preventing them from progressing into full-blown type 2 diabetes. Each year, 5% to 10% of people diagnosed with prediabetes go on to develop type 2 diabetes.
The two principle factors to consider are:
- Changes to your diet
- Changes to your lifestyle by introducing a regime of physical exercise
Making these changes will help your blood sugar levels return to normal. In fact, the recently completed Diabetes Prevention Program study conclusively showed that people with borderline diabetes can prevent the development of type 2 diabetes by making dietary changes and increasing their level of physical activity. For a comprehensive and individual plan, speak to your doctor.
The above is a guide only to provide you with an overview of what to look for and how to prevent it, but if you are in any doubt, consult your doctor and implement the changes to your diet and lifestyle as briefly mentioned above.
For more information, see these other posts on HealthReporterDaily:
- Preventing the Type 2 diabetes epidemic: October 2009 – Diabetes UK, published 2009
- Prevalence of prediabetes in England from 2003 to 2011: population-based, cross-sectional study – Arch G Mainous III, Rebecca J Tanner, Richard Baker, Cilia E Zayas, Christopher A Harle (2014).