Prediabetes

Prediabetes refers to a higher than normal blood sugar level that is not high enough to be considered type 2 diabetes. However, those with prediabetes are likely to develop type 2 diabetes without lifestyle changes such as eating a healthy diet and exercise. According to the Centers for Disease Control and Prevention (CDC), about eighty-eight million American adults—more than one in three—have prediabetes. The vast majority are unaware that they have the condition. Prediabetes puts a person at risk of heart disease and stroke.

Background

Diabetes mellitus refers to a group of conditions affecting the body’s use of glucose. Glucose comes from food and enters the bloodstream when food is eaten. If it has insulin, glucose then makes its way into the body’s cells. Insulin is a hormone made by the pancreas.

When an individual has diabetes, the body does not produce or respond normally to insulin. Because of this, the pancreas continues to produce insulin to meet the demand. However, eventually the pancreas slows down, and the blood sugar rises, creating diabetes.

There are three main types of diabetes: type 1 diabetes, type 2 diabetes, and gestational diabetes. (Prediabetes is not considered a type until it becomes type 2 diabetes.) Type 1 diabetes is believed to be an autoimmune condition in which the immune system mistakenly destroys the cells in the pancreas that produce insulin causing the body to produce little or no insulin. People with type 1 diabetes need daily insulin injections to keep blood glucose levels from rising too high. While type 1 diabetes can develop at any age, it most often develops in children and adolescents.

Type 2 diabetes is the most common type, accounting for about 90 percent of all diabetes cases. This type of diabetes begins as insulin resistance. This means the body does not correctly use insulin. This causes the pancreas to produce insulin until it is overworked and can longer keep up with demand, causing blood sugar to rise.

While most individuals can combat type 2 diabetes with a healthy diet and increased physical activity, some require medication or insulin to control their condition.

Gestational diabetes causes high blood sugar during pregnancy, which can lead to complications for mother and child. Gestational diabetes usually disappears after pregnancy.

Diabetes is a serious condition that affects all major organs in the body. People with diabetes may develop serious complications such as nerve damage, which can lead to the amputation of a foot or leg; kidney failure; and blindness.

Overview

While individuals with prediabetes have a high blood sugar level, it is not yet high enough to be considered type 2 diabetes. Prediabetes is often the precursor to type 2 diabetes—most people with type 2 diabetes first had prediabetes.

People with prediabetes no longer process glucose correctly. This means that sugar builds up in the bloodstream instead of providing cells with energy. While prediabetes is not yet diabetes, it is a serious condition. The long-term damage to the heart, blood vessels, and kidneys caused by diabetes begins during prediabetes.

Prediabetes usually does not cause any symptoms. Individuals need a blood sugar test to see if the condition is present. This is a fasting blood test that assesses a patient’s blood sugar level before the patient has eaten in the morning. The result of this test falls into these ranges:

Normal: between 70 and 99 mg per dL

Prediabetes: between 100 and 125 mg per dL

Diabetes: higher than 126 mg per dL

Physicians often request an A1C blood test if the fasting blood test indicates prediabetes. An A1C blood test shows a patient’s average blood sugar level over a three-month period. The result of this A1C blood test are as follows:

Normal: below 5.7 percent

Prediabetes: between 5.7 percent and 6.4 percent

Diabetes: 6.5 percent or higher

Risk Factors

The exact cause of prediabetes is not known. However, having a family history of the condition and being overweight appear to play an important role in whether an individual will develop the condition.

Weight is a primary risk factor. Those with fatty tissue around the abdomen appear to be at risk. A large waist size may indicate insulin resistance. Men with a waist size larger than 40 inches, and women with a waist size larger than 35 inches are at risk.

Other risk factors include having a sedentary lifestyle; being age forty-five or older; and having a parent or sibling with type 2 diabetes. Smoking also increases the risk of developing prediabetes as does having obstructive sleep apnea. While it is unclear why, some races and ethnicities are more likely to develop insulin resistance. They include Black, Hispanic, American Indian, and Asian American.

Women who have had gestational diabetes while pregnant are at a greater risk as are those who have given birth to a baby weighing 9 or more pounds. Women who have had polycystic ovary syndrome, which is characterized by irregular menstrual periods and obesity, are at a greater risk.

Treatment

The best way for people to avoid prediabetes progressing into type 2 diabetes is to lose at least 7 percent of their starting weight. Patients should exercise moderately for at least 30 minutes five times a week. They should eat foods such as vegetables, fruits, whole grains, lean proteins such as fish and chicken, and low-fat dairy products. They should avoid fried, processed, and sugary foods along with sweetened drinks.

A doctor may prescribe medication to prevent prediabetes from developing into type 2 diabetes. However, losing weight, eating healthy, and exercising are usually more effective.

Signs of Type 2 Diabetes

Patients who have moved from prediabetes to type 2 diabetes may have increased thirst, frequent urination, and increased hunger. They may be fatigued and have blurred vision.

Bibliography

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“13 Early Signs and Symptoms of Prediabetes.” Diabetics Guide, 22 Mar. 2018, diabetics.guide/13-early-signs-and-symptoms-of-prediabetes/?utm‗source=%2Bprediabetes&utm‗medium=13EarlySignsandSymptomsofPrediabetes&utm‗campaign=adw‗us&gclid=Cj0KCQjwnueFBhChARIsAPu3YkTxKi4Lu3ntZuUyKkGVN2Xb3gAb4CWbmu1SRRjT8atL1sPCcKbu7ywaAlzKEALw‗wcB. Accessed 3 June 2021.

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