Often referred to as borderline diabetes, Prediabetes can be better described as a condition where the blood sugar levels are higher than normal but still not high enough to exceed the threshold used for diagnosing or classifying diabetes. However, before delving deeper into Prediabetes, its best to understand what diabetes is first.
Diabetes is a chronic disease that occurs either when the pancreas is unable to produce enough insulin or when the body isn’t able to make optimal utilization of the insulin it produces. Insulin is responsible for regulating blood sugar levels while also providing us with the energy which we need to survive. When this insulin is not burned effectively by the cells, it results in a spike in blood glucose levels which can build up to harmful levels. Blood sugar levels are gauged by the amount of sugar or glucose present in the blood. Blood sugar levels can vary according to factors such as your age, overall health, diet, as well as the medications you take.
Diabetes can be classified into two types: Type 1 and Type 2 diabetes. Individuals diagnosed with type 1 diabetes are unable to produce their own insulin because their body attacks its insulin-producing cells and therefore need the help of insulin injections to survive. Individuals suffering from type 2 diabetes, on the other hand, are able to produce their own insulin but not in adequate quantities as their body does not respond well to insulin produced by the pancreas. Type 2 diabetes, whilst treatable, is currently not fully reversible.
Diabetes is on the rise in countries all over the world – especially in low and middle-income countries. A diabetic person has a lifestyle entirely different from those of not suffering from the endemic. Living with diabetes is a challenge that several people around the world are facing on a daily basis. Hence, when it comes to diabetes, being on top of things is extremely vital as diabetes is a condition that needs active planning and complete awareness of one’s body
Overview of Prediabetes
Because Prediabetes doesn’t classify as a fully-blown diabetes, it is often regarded as the “grey area” that lies between normal glucose levels and diabetic levels. That said, individuals diagnosed with Prediabetes are said to be at a greater risk of developing type 2 diabetes as well as an array of cardiovascular (heart and circulation) diseases. Furthermore, as per recent global estimates, its believed that nearly 5-10 percent of individuals with Prediabetes will eventually go on to develop type 2 diabetes in the future.
As per a research done by the Health Survey for England, the prevalence of Prediabetes in England alone more than tripled between 2003 and 2011. It was estimated that nearly 35.3 percent of the adult population – or 1 in 3 individuals – had diabetes. In yet another recent study done in the UK, it has been revealed that nearly 16 million people qualified as having Prediabetes and thus have a high risk for developing type 2 diabetes.
Prediabetes includes 2 conditions:
- Impaired Glucose Tolerance (IGT): where blood sugar levels are higher levels than normal but not high enough to be considered diabetes.
- Impaired Fasting Glucose (IFG): where blood sugar levels spike up higher than normal after a period of fasting (8 hours for diagnosis). However, it’s still not considered high enough to be classified as diabetes.
It needs to be mentioned that it’s possible for a person to have both Impaired Glucose Tolerance as well as Impaired Fasting Glucose at the same time.
Here are some more damning statistics as revealed by Diabetes UK:
- Nearly 4.7 million people in the UK have diabetes.
- Every two minutes, someone living in the UK is diagnosed with diabetes
- It has been estimated that by 2030, more than 5.5 million people will have diabetes in the UK.
- As compared to people living without diabetes, people suffering from diabetes are more than 2.5 times likely to experience heart failure, nearly 2.5 times more likely to have a heart attack and 2 times more likely to have a stroke.
- Diabetes has been recognized as one of the leading causes of preventable sight loss in the UK.
More than 50 percent of all cases of Type 2 diabetes could be prevented or delayed. However, without making a sustained and concerted effort by committing to lifestyle changes, incorporating healthy eating, increasing levels of activity and shedding excess weight, approximately one in three people with Prediabetes will further go on to develop type 2 diabetes. In that regard, as per a study done by the US Diabetes Prevention Program as well as similar studies carried out in Finland, Japan and India, it has been shown that reducing your body weight by only 6 percent – through exercise and lifestyle changes – can help in cutting down your overall risk of developing type 2 diabetes by up to 60 percent.
Many people might already be living with Prediabetes but are completely unaware of it. This is because the condition often develops gradually and the symptoms are not always obvious and at times there may be no signs. In many cases, a person is often only diagnosed by accident during a routine blood test or only learns of their borderline diabetic state once the symptoms of type 2 diabetes start to surface. Therefore, being aware of the risk factors is essential. Just like type 2 diabetes, risk factors for Prediabetes are also very similar. They include the following:
- Being obese or overweight – Having a high body mass index (BMI) of 25 or over or those who carry excess around the waistline are especially at risk.
- Having a close relative (parent or sibling) or family history who currently has or has had diabetes and/or heart disease are at risk.
- Having high blood pressure along with low levels of HDL (good cholesterol) or high triglycerides can increase risk.
- Being over the age of 40.
- Living a sedentary lifestyle and being physically inactive.
Other people at risk include:
- Women diagnosed with Polycystic Ovarian Syndrome (PCOS)
- History of gestational diabetes (women who have had diabetes in pregnancy) or giving birth to a baby weighing more than 4.5 kilograms.
- Those from certain ethnic backgrounds such as the Pacific Islands, African American, Hispanic/Latino, and South Asian ethnicity.
- People diagnosed with Atherosclerotic cardiovascular disease.
- Individuals suffering from a particular sleep disorder called as obstructive sleep apnea have an increased risk of insulin resistance. Similarly, individuals who work in jobs which require changing shifts or night shifts, which could lead to sleep problems, also are at an increased risk.
Causes of Prediabetes
Unfortunately, we still can’t pin point the exact cause of prediabetes. However, family history and genetics are said to be important factors that can lead to prediabetes. Similarly, being under high stress, a lack of activity and exercise along with excess fat in the abdomen are also said to be decisive factors in causing prediabetes.
Prediabetes is said to occur because of the body’s inability to efficiently and effectively synthesize sugar. This results in the accumulation of sugar in the bloodstream which, in turn, affects its ability to provide energy, temperature regulation, and in the formation of proteins required for muscles and other tissues. Sugar enters the body from the foods we consume.
Insulin is released from the pancreas whenever we consume food. Our body requires insulin to helps balance out blood sugar levels and also to keep them in a normal range. Insulin also plays a role in ensuring the blood sugar levels don’t get too high (hyperglycemia) while also preventing it from going too low (hypoglycemia).
In the event of prediabetes, this process gets affected and affects the pancreas’s ability to keep producing enough insulin to regulate sugar levels. This results in a build-up of sugar in the bloodstream and if left untreated, causes a spike in high blood sugar levels and eventually diabetes.
Symptoms of Prediabetes
Prediabetic individuals generally experience no signs and symptoms of diabetes until it progresses to type 2 diabetes. The only sure-shot method to find out whether you have prediabetes is to get your blood sugar levels tested. Some of the symptoms that can act as precursor for type 2 diabetes include:
- Excessive thirst and increased urination
- A feeling of fatigue, lethargy, and general tiredness
- Increased appetite and gradually putting on weight
- Cuts and bruises that take a long time to heal
- Itching of the skin along with other skin infections
- Blurred vision,
- Severe headaches and dizziness
- Unexplained mood swings.
It’s important not to ignore the symptoms, or try to manage them yourself without being diagnosed. Therefore, its important to listen to your body and alert your doctor if you notice any new symptoms or problems. These conditions won’t go away on their own, and the sooner you seek help, the easier it would be for you to manage them.
There’s a blood test which can help you check for prediabetes which you can request the next time you have a blood check up. It can be used to test your fasting blood sugar levels. Fasting blood sugar can be described as your blood sugar level before you consume anything first thing in the morning. Here are some of the prescribed ranges for the results of a Fasting Plasma Glucose (FPG) Test:
- Normal Range is between 70 and 99 mg per deciliter (dL)
- Prediabetes Range is between 100 and 125 mg per deciliter (dL)
- Diabetes Range is higher than 126 mg per deciliter (dL)
An HbA1c (haemoglobin A1c) test can also be used as a screening tool to determine the presence of prediabetes. An HbA1c in the range of 5.7 percent to 6.4 percent is consistent with prediabetes. An HbA1c of 6.5 percent or higher indicates the presence of diabetes.
Can you Prevent Diabetes? - Diet, fitness, regular health checks, no alcohol
As per the latest studies conducted by WHO, Diabetes is now responsible for an estimated 3.4 million deaths annually. The good news is that are several ways you can reduce your risk of developing prediabtes and further on, type 2 diabetes. The more you understand the factors that influence your blood sugar levels, the better prepared you will be to keep diabetes at bay.
Understanding and taking note of foods that spike your blood sugar is a great start to modifying your diet. However, besides having a balanced iet Proper monitoring along with a change in diet and making a few lifestyle changes can help you control diabetes and in some cases, even reverse the symptoms. Here are some healthy-living strategies you could follow which can help you return your blood sugar levels to normal, monitor your current situation, and guide you better:
- One of the key components of a lot of diabetes management plans is figuring out how to count or keeping a track of your daily intake of carbohydrates. Everyone requires some carb intake on a daily basis. Carbohydrates are the foods that often have the biggest impact on your blood sugar levels and hence avoid meals that are short on nutrients and comprise large quantities of carbohydrates, which increase blood sugar levels. Try incorporating a healthy low-carb diet which comprises of nutrient-dense, high-fibre carb foods such as avocados, berries, eggs, non-starchy vegetables, olives, nuts, and seeds. Instead of eliminating carbs altogether, you should try and maintain meal-to-meal consistency by distributing your carbohydrates throughout the day. However, it makes sense to test your blood sugar levels before and after your meals to find your personal carb tolerance. A registered dietician can sit down with you and plan a great, healthy meal plan. The general rule of thumb is the fewer carbs you consume, the less your blood sugar will rise.
- Coordinate your meals and medications while being cautious with new medications. Moreover, you should make every meal well-balanced by eating food in equal and smaller portion spread across fixed intervals throughout the day. A planned approach to eating proportionately is to include three food groups of protein, carbohydrates, and vegetables at each meal.
- Start paying attention to the Nutrition Facts label found on the outside of the packaging or container. This will help you determine exactly what your favourite foods contain which, in turn, can help you make the best food choices. These labels will have all relevant information such as the serving size, number of servings the package contains along with a handy list of ingredients and nutritive values. You can start by looking at the serving size and keep in mind, if you eat more, that means you'll be consuming more calories, carbohydrates, etc.
- Consume less fatty food as being overweight is a major risk factor for diabetes. Choose olive and canola oil for cooking purposes and salads. Incorporate good protein foods such as eggs, low-fat dairy products, lean meats, poultry, fish, beans, and nuts in your diet. Eat a variety of fruits and vegetables and have a mixture of whole-grain foods and root vegetables daily.
- Increase your water intake and include one bitter dish in each mealtime like bitter-gourd juice, fenugreek etc. Eat bread, cereals, and pasta made with whole grains instead of white flour. Try opting for brown rice instead of white rice and choose sweet potatoes instead of white potatoes. Contrary to its name, sweet potatoes are widely regarded as an “anti-diabetic food. While at it, also try to reduce the intake of salt in your food and try avoiding putting salt in cooked food altogether.
- Exercise on a regular basis as it helps in allowing your body to make better use of insulin and in helping you feel fit and healthy. A 45-minute walk must be part of your daily routine as it can help decrease the levels of glucose in your blood. Brisk walking and swimming, at least 5 times a week, does the trick. Additionally, also try to make time for some strength and resistance training as it will help improve the way your muscles work.
- Take the additional precaution of your foot as being a diabetic any kind of nerve injury, movement problems, and toxicities can result in severe foot problems. Besides getting an annual foot examination, you need to inspect your feet regularly to check for any signs of infections, loss of feeling or calluses. There are several special in-soles, foot thermometers and acupressure foot mats available on the market that can help you monitor your feet.
- Take a urine test every year to check for the presence of glucose and ketones in the urine. This can even be done with an at-home urine test kit. Additionally, urine also needs to be checked for the presence of albuminuria/microalbuminuria.
- Take extra precaution of your eyes as carelessness can cause serious damage to the small blood vessels in your retina, the back part of your eye. This illness is named diabetic retinopathy. Fact is, over 1,700 individuals have their eye-sight seriously compromised as a result of their diabetes annually in the UK itself.
- It is imperative that you go for regular health check-ups to check your blood sugar levels. However, a lot of external factors such as stress and illness could also wreck havoc on your blood sugar levels. This is where Self-blood glucose monitoring (“SBGM”) steps in. Especially if you take insulin on a regular basis, it becomes extremely important to check your blood sugar before each injection to be on the safer side. There are several glucose meters available in the market that range from basic to high-tech. Therefore, ensure you opt for a blood-glucose meter that fits your precise requirements while being hassle-free to use as you will be using it to test your sugar levels on a regular basis. You can even opt for an OGTT (Oral Glucose Tolerance Test) once in a year as it will help monitor improvements or progression to type 2 diabetes
- Thereafter, you should also make it a point to see your dentist at least twice a year to ensure your teeth and gums are healthy. Diabetes can often lead to periodontal disease; a chronic, inflammatory disease that can destroy your gums, the surrounding tissues, and even your bones.
- Diabetes can raise your blood pressure so checking your blood pressure regularly is one of the most important things you can do. Keeping your blood pressure in check can help reduce incidences of strokes, heart attacks, eye diseases and kidney failures. It has been revealed that nearly 10,350 people living in the UK have ended up with End-Stage Kidney Failure due to diabetes. Blood Pressure monitoring tools can not only help keep a track of your blood circulation and flow but also helps you track your blood pressure limits on a regular basis.
- Don’t opt for an afternoon siesta as it may result in disruptions in night-time sleep patterns resulting in disorders such as Obstructive Sleep Apnea (OSA). However, make sure you get adequate sleep during the night.
- Don’t smoke as it increases your blood sugar levels. Increased blood sugar can cause severe diabetic problems, such as problems with your kidneys, heart, in addition to blood vessels.
- Don’t consume alcohol especially in excessive quantities as it can result in your blood glucose levels to spike up abnormally, depending on how much you drink.
- Don’t skip meals as it can wreak havoc on your metabolism.
- Don’t drink soda, aerated or sugary drinks on a regular basis. Similarly, avoid indulging in fruit juices, sugary desserts and sweet soft drinks, or other beverages high in sugar. You can instead try switching from sodas to drinking water as it will go a long way in boosting your overall health.
- Avoid eating processed food as they are generally filled with fat, calories, and sodium, while also containing unhealthy ingredients such as trans fats and high-fructose corn syrup. Avoid consuming fatty foods such as biscuits, cakes and pastries which are high in saturated fats.
- Don’t make starchy carbohydrates your main course. Instead, opt for healthier choices such as low-GI carbohydrates (grains and pulses), lean meat, fish, poultry or meat alternatives. That said, make sure not to overeat as it would lead you to consuming un-needed fats thus resulting in high blood sugar levels.
The Bottom Line
Diabetes has gone on to become the fastest growing health crisis of our time. Moreover, the fact that diagnoses for diabetes have doubled in just couple of decades should raise a lot of red flags. Managing prediabetes or diabetes can be a challenge indeed prove to be a challenge – especially if you’re doing it on your own. Try finding support and make yourself accountable for your food choices and exercise regime. Educate and empower yourself – the power to manage diabetes is in your hands so wield it carefully for the best possible results!