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What is prediabetes: causes, diagnosis, and treatment


Beginner’s guide to understanding, managing, and reversing prediabetes


Table of contents:


What Is Prediabetes?

Prediabetes is the intermediate state between normal glucose tolerance and diabetes. It is also referred to as impaired glucose tolerance (IGT) or impaired fasting glucose, depending on which diagnostic test was performed to assess blood sugar levels. In simpler words, when the blood sugar level is higher than normal but is not high enough to identify as ‘Diabetes’, the state is called ‘Pre-diabetes’. The increase in blood sugar levels in case of pre-diabetes starts because of the “Insulin Resistance” developed by the body. Prediabetes is reversible with a proper treatment plan and some lifestyle adjustments. If the recommendations are not followed and appropriate lifestyle changes are not adopted, prediabetes eventually may develop into type 2 diabetes.


What causes prediabetes?

Insulin is the hormone that regulates the sugar or glucose levels in our body. The pancreas produces it and is responsible for helping glucose in your blood enter the liver, fat, and muscle cells for energy. Insulin resistance is when your body is not able to use insulin effectively, the pancreas produce more insulin to help glucose reach your cells. If the pancreas are not able to produce enough insulin, the sugar level in your blood rises.


What are the risk factors for prediabetes?

In pre-diabetes, usually, there are no clear symptoms and people can have it for years without even knowing about it. Certain factors may lead to the condition of developing pre-diabetes and need to be kept in mind. Some of them are:

  • Having age 45 or more

  • Family history

  • Being overweight/ Having a body mass index of more than 27

  • If you have previously had gestational diabetes*

  • Have improper lifestyle habits like poor diet and sedentary lifestyle.

  • History of a stroke or a heart disease

  • Pre-existing conditions such as high blood pressure and abnormal levels of cholesterol.

  • Polycystic Ovary Syndrome (PCOS)

*Gestational diabetes:

This condition occurs in some women during pregnancy and usually goes away after it. The risk of getting diagnosed with pre-diabetes or type 2 diabetes increases if you have been diagnosed with gestational diabetes before.


How is prediabetes diagnosed?

The tests that are conducted to diagnose diabetes and pre-diabetes are the same. The following are the tests usually recommended for the diagnosis:

Fasting plasma glucose test:

Also called the FBS test in short. You can’t eat or drink anything except for water during the fasting period 8 hours before the test. This test helps in checking your baseline blood sugar level.

Oral glucose tolerance test:

It is conducted by drawing your blood before and 2 hours after consuming a sweet drink. This test determines how well your body uses carbohydrates.

HbA1c test:

Also known as the A1c test or glycated haemoglobin test. The hbA1c test gives you a wide picture of the average blood sugar profile. This test is conducted for diagnosing prediabetes and diabetes. Generally conducted every 90 days, it helps you monitor the effectiveness of your diabetic treatment.


Depending on the results of these tests, the pre-diabetes state can be referred to as either ‘impaired fasting glucose’ or ‘impaired glucose tolerance’.

In impaired fasting glucose condition, there is an increase in blood sugar after not eating for a certain time like in the morning. While in the impaired glucose tolerance condition, there is an increase in blood sugar level after eating sugar. Diabetes diagnosis criteria are different from the criteria for prediabetes. According to the American Diabetes Association, the following results are related to pre-diabetes:

  • Fasting plasma glucose test: 100-125 mg/dl

  • Oral glucose tolerance test: 140-199 mg/dl

  • HbA1c test: 5.7%-6.4%


Treating prediabetes. An opportunity to prevent type 2 diabetes.

After getting diagnosed with prediabetes, many wonder if it is possible to go from being prediabetic to normal.

Here’s the good news:

  • Prediabetes is reversible if long-term lifestyle changes are adopted.

  • Prediabetes diagnosis is an opportunity to prevent type 2 diabetes.

According to CDC, if you’re an overweight person diagnosed with prediabetes, you can lessen the risk of developing type 2 diabetes by:

  • Losing a small amount of weight;5% – 7% of your total body weight.

  • Incorporating some regular activity like 30 minutes of brisk walking, 5 days a week.

As per a lifestyle change program led by CDC, you can reduce the risk by 58% and 71% if you are over the age of 60. Here are a few highlights from the program:

  • Working out a way to eat healthier and lead a more physically active life.

  • Coming up with a system to help find solutions to problems that can taper off your progress, manage stress and stay motivated.

  • Making these realistic and long-lasting lifestyle adjustments with the help of a trained coach.

  • Having a support group of people dealing with similar issues, challenges, and goals.

It is important to consult with your doctor and follow the diabetes control programme that’s right for you.


The diabetes treatment generally includes:

A healthy diet:

Fiber-rich diet that includes nuts, sprouts, vegetables, and fruits. It’s essential to opt for foods that are low in carbs. You can consider going for products like Fenuflakes; flakes of methi (fenugreek), a plant-based protein high in fibre and ultra-low in carbs.

Physical activities:

It is important, especially if you lead a sedentary lifestyle to incorporate some physical activities such as brisk walks, yoga, running, cycling, etc. in your daily routine.

Stop smoking:

If you stop smoking, it will help your body to process insulin more effectively.

Medications:

After you get diagnosed with prediabetes, it is essential to follow the treatment plan and medications prescribed by your doctor. Along with this, you can also opt for Ayurvedic medicine for diabetes as an add-on therapy in your diabetes control program.


Complications:

Prediabetes can further develop into type 2 diabetes or some other conditions if treatment is not received on time:

  • Stroke

  • Skin infections

  • Nerve damage

  • Poor blood flow in the foot which might lead to amputation

  • Heart diseases

  • Damage to kidneys

  • Eye damage and trouble with hearing

  • Alzheimer’s disease


Takeaway:

  • Prediabetes can develop into several health concerns or develop into type 2 diabetes if left untreated.

  • With long-term lifestyle adjustments, prediabetes can be reversed.

  • Along with lifestyle choices, it is important to follow the treatment plan recommended by the doctor.

  • Taking support from people with similar challenges and opting for add-on therapy can also help a great deal in managing prediabetes.

Remember, freedom from diabetes and prediabetes can be achieved with discipline and dedication to the betterment of your health.



References:

https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance


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