Prediabetes - The Calm Before the Storm |
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What is Prediabetes Prediabetes, also known as Borderline Diabetes, Impaired Glucose Tolerance (IGT) or Impaired Fasting Glucose (IFG), refers to a state of increased blood glucose levels, but not increased enough to be classified as type 2 diabetes. Patients with prediabetes are on the road to developing full blown diabetes, with research suggesting that prediabetic patients are likely to develop into type 2 diabetics in under 10 years, without intervention. When a persons blood glucose is elevated above normal for a sustained period, even if it does not reach critical diabetic levels, they are still at an increased risk of the same type of damage diabetes mellitus causes to the heart and blood vessels. The good news is that prediabetes does not inevitably lead to diabetes. If addressed early with diet and lifestyle modification, such as losing weight and taking part in more exercise or physical activity, blood glucose may return to normal levels over time. Prediabetes affects almost 60 million Americans and is a huge public health concern. Diagnosis of Prediabetes The diagnosis of prediabetes can me made in a number of ways. Fasting Blood Glucose Test The patient must not eat anything for 24 hours period, and a blood glucose reading is then taken. If the reading is between 99 and 126mg/L (5.5 and 7 mmol/L) the patient has confirmed prediabetes. Oral Glucose Tolerance Test This involves measuring your blood sugar level two hours after drinking a standardized glucose solution. If the reading is between 140 and 200mg/L (7.8 and 11.1 mmol/L) prediabetes is confirmed. Random Blood Glucose Test If your blood glucose level is over 140mg/L (7.8 mmol/L) at any time, this is an indication of insulin resistance, and warrants either a fasting blood glucose test or an oral glucose tolerance test to confirm the diagnosis. The Cause of Prediabetes Prediabetes is caused by the same disease process as type 2 diabetes, namely insulin resistance. In patients with prediabetes, their cells are starting to become resistant to the effects of the hormone insulin. While insulin still has a considerable effect, it is diminished somewhat, resulting in a slight but not critical increase in blood glucose. Instead of glucose moving out of your blood and into your cells, it begins to build up in the bloodstream. This happens because the cells have decided not to listen to what insulin is telling them to do. Insulin would like the cell to open all its glucose doorways and let it flow through, however, the cells don't like having too much glucose inside them. As a result, they only open their glucose doorways a little, causing glucose to enter more slowly than usual. This causes a backlog and leads to an increase of glucose in the blood. Exactly why this happens is not fully understood although there are certain important factors which are believed to contribute to it. The main culprits are 1. Eating a lot of sugary food. 2. Excessive fat - especially central/abdominal fat. 3. Lack of physical exercise. For a more in depth look, see our article on the cause of diabetes. Treatment and Prevention of Prediabetes In order to prevent the onset of type 2 diabetes, preserve the function of your beta cells, and delay the microvascular and cardiovascular complications associated with the disease, prediabetic patients are given the same advice as that given to actual diabetes. Obesity is an huge factor, therefore exercise and weight loss is the main focus. The American College of Endocrinology (ACE) and the American Association of Clinical Endocrinologists (AACE) have developed lifestyle intervention guidelines for preventing the onset of type 2 diabetes. Lifestyle interventions such as these have been found to provide the greatest benefit in preventing progression into type 2 diabetes: Eating a healthy balanced diet low in salt. Physical exercise, between 30 to 60 minutes, at least five times per week. Reducing your weight, by even 5-10%, has a major impact on fat mass, blood pressure, and blood glucose. Studies have shown that a low-carb diet is a valuable prevention method in both diabetes and prediabetes. |
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