The Yellow Card: A Brief Guide To Prediabetes

Prediabetes, a precursor to diabetes type 2, is defined by glucose levels that are higher than normal, but not high enough to qualify as diabetes. The condition is easily reversible, yet most people progress on to type 2 due to the lack of awareness and an early diagnosis.

Types:

Depending on the tests conducted by doctors, prediabetes is categorized as follows:

1- Impaired Fasting Glucose (IFG):

In this case, the liver becomes resistant to insulin (the glucose assisting hormone), resulting in excess glucose production after fasting, usually after waking up; and is indicated via elevated blood glucose levels that are higher than 99 mg/dl but lower than 126 mg/dl-the threshold for diabetes in a Fasting Plasma Glucose Test (FPGT) after an 8-hour fast.

2- Impaired Glucose Tolerance (IGT):

IGT is diagnosed when muscle tissues are resistant to insulin and glucose intake, resulting in excess blood glucose, particularly after meals or taking sugary foods or drinks, and is tested for via an Oral Glucose Tolerance Test (OGTT).

Symptoms:

The condition does not present any clear symptoms. However, experiencing certain diabetes symptoms such as persistent hunger and nausea, or dark, thick patches of skin, usually on the neck, armpits, elbows, knees and knuckles, and gout (lump formation due to uric acid buildup in the tendons, joints and bones) might indicate prediabetes.

Moreover, the following test results also indicate prediabetes:

• A Hemoglobin A1c of 5.7% – 6.4%,
• An FPGT between 100 – 125 mg/dl,
• Or an OGTT between 140 mg/dl – 199 mg/dl.

Risk Factors:

Type 2 diabetes and prediabetes share common risk factors, including:

1- Weight:

An accumulation of excess fatty tissues, particularly between muscles and the skin around the abdomen, due to a sedentary lifestyle and/or a processed carbohydrate-rich diet prevents glucose storage in other cells, resulting in high blood glucose and prediabetes.

2- Waist Size:

Having a Body Mass Index (BMI), i.e. a ratio of weight and height for determining a healthy weight, over 25, or a waist size greater than 40 inches in men, and 35 inches in women are major risk factors of prediabetes.

3- Age:

While it can affect anyone, the risk of prediabetes escalates after 45, possibly due to loosening of muscle mass, weight gain and reduced exercise as a result of aging or other age-related conditions, such as reduced bone density. This of course cannot be prevented but can be slowed down by adopting a healthier lifestyle.

4- Gestational Diabetes:

Women with high blood sugar during pregnancy, or who have given birth to babies weighing more than 9 pounds are at an increased risk of developing prediabetes and type 2 diabetes, along with their children.

5- Polycystic Ovarian Syndrome (PCO):

The chances of prediabetes greatly increase in women who have had or are suffering from PCO, which is characterized by irregular menstruation, obesity and excess hair growth in male pattern areas.

6- Obstructive Sleep Apnea:

Irregular sleeping patterns due to multiple sleep disruptions resulting from airway obstruction disturb the metabolism and increase the risk of insulin resistance, which is also increased in people working night, or fluctuating shifts.

Preventing Type 2:

Type 2 diabetes is not an inevitable conclusion following a prediabetes diagnosis. In fact, the risk of progression towards type 2 can be reduced by almost 58% through an early diagnosis and taking the following measures:

• Lose 7% of your body weight, or more if you are over 200 pounds through moderate exercises such as brisk walking, light weightlifting, and low-resistance exercises for at least 30 minutes a day, 5 days a week.
• Increase your step count through simple lifestyle changes such as taking the stairs instead of the lift, parking your car a bit farther than your office, etc.
• People with a high risk of progression might be prescribed oral diabetes drugs, usually metformin, to aid in blood glucose reduction alongside lifestyle and dietary changes.
• People with a BMI over 40 or those who cannot lose weight through exercise due to medical conditions such as hypertension can opt for weight-reduction surgery.
• Get retested within 3-6 months after the first diagnosis and every year after that to ensure that your condition does not progress towards type 2 diabetes.

If not maintained well, prediabetes can increase the risk of kidney failure, cardiovascular disease, and stroke. So make sure to continue following the dietary and lifestyle changes recommended by your doctor. Moreover, if you possess any of the risk factors above, consult your endocrinologist (diabetic specialist). In order to deal with this problem you will likely have to make a number of lifestyle changes, including doing more exercise and reducing your sugar intake. This goes for both children and adults as the condition is similar in both.

At oladoc, you can find an endocrinologist in Lahore, Karachi, and Islamabad and get an appointment. Moreover, you can also get an appointment by calling our helpline: 042-3890-0939.