What Is Prediabetes?
Prediabetes is a medical condition where blood sugar levels are higher than normal, but not high enough yet to be diagnosed as type 2 diabetes. It is usually asymptomatic. It is detected during routine health check-up.
In India, there are nine crore people living with Prediabetes. If this condition is ignored and not prevented with diet, lifestyle and medical intervention, almost 75 percent of Prediabetes cases are likely to develop diabetes within the next 5 years. India is next only to China in number of persons affected by diabetes mellitus. In India, diabetes and heart disease occur a decade earlier as compared to the western population. Prediabetes also puts you at increased risk of developing heart disease and stroke.
What Causes Prediabetes?
Insulin is a hormone made by your pancreas that helps blood sugar to enter into cells for use as energy. If you have prediabetes, the cells in your body don’t respond normally to insulin. Your pancreas makes more insulin to try to get cells to respond. Eventually your pancreas can’t produce enough insulin, and your blood sugar rises, leading to prediabetes and type 2 diabetes.
What are risk factors for Prediabetes ?
• Being overweight BMI >25kg/m2
• Being 40 years or older
• Having a parent, brother, or sister with type 2 diabetes
• Certain race e.g., American Indians
• Being physically inactive
• Ever having gestational diabetes (diabetes during pregnancy) or giving birth to a baby who weighed more than 3.5 kg
• Having polycystic ovary syndrome
How to diagnose Prediabetes?
You can get a simple blood sugar test to find out if you have prediabetes.
Fasting Plasma Glucose: 100-125 mg/dl 2-Hr
Post Prandial Plasma Glucose: 140-199 mg/dl
HbA1c: 5.7-6.4%
Can Diabetes be prevented?
If you have prediabetes, losing a small amount of weight if you’re overweight and getting regular physical activity can lower your risk for developing type 2 diabetes. A small amount of weight loss means around 5% to 7% of your body weight.
Eat a healthy diet – Try to eat a diet with lots of fruits, vegetables, and low-fat dairy products, but low in meats, sweets, and refined grains. Try to avoid soft drinks, like cola and juice.
Regular physical activity means getting at least 150 minutes a week of brisk walking or a similar activity. That’s just 30 minutes a day, five days a week.
If you are at high risk for developing type 2 diabetes, your doctor might also suggest taking a medicine called "metformin" to help lower your risk.
According to American Diabetes Association Guidelines, metformin therapy should be considered in those with prediabetes, especially for those with BMI ≥35 kg/m2, those aged <60 years, and women with prior gestational diabetes mellitus.
If you smoke, quitting can also lower your risk of getting type 2 diabetes. Quitting smoking also lowers your risk of stroke, heart disease, and lots of other problems.
Several major randomized controlled trials, including the Diabetes Prevention Program (DPP), the Finnish Diabetes Prevention Study (DPS), and the Da Qing Diabetes Prevention Study (Da Qing study), demonstrated that lifestyle/behavioural therapy featuring an individualized reduced-calorie meal plan is highly effective in preventing type 2 diabetes and improving other cardiometabolic markers (such as blood pressure, lipids, and inflammation) in prediabetics. The DPP demonstrated that an intensive lifestyle intervention could reduce the risk of incident type 2 diabetes by 58% over 3 years.
Prediabetes is associated with heightened cardiovascular risk; therefore, screening for and treatment of modifiable risk factors such as high blood pressure and dyslipidemia for cardiovascular disease are suggested.
Dr Ravi Kant Saraogi.
MD, DM, FACE, FICP
Consultant Endocrinologist & Diabetologist, Kolkata
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