Your Health

Could You Have Prediabetes?

Image for glucose tests Just as pre-cancer may be detected and removed before turning into cancer, discovery of diabetes in its earliest stages can help prevent the development of full-blown diabetes. That, in a nutshell, is the idea behind the term prediabetes (also called impaired glucose tolerance or impaired fasting glucose).
Blood sugar levels that are higher than normal but not high enough to be called diabetes are classified as prediabetes. Evidence indicates that people with prediabetes can take steps to return their blood sugar levels to a normal range. This can prevent or delay complications that are linked to diabetes.

How Serious Is the Problem?

If you have prediabetes, then you are at risk for type 2 diabetes and other serious conditions, like heart attack and stroke.
Other long-term health problems can result if you do not have good control over your blood sugar levels. Complications related to type 2 diabetes include but are not limited to:
  • Blindness
  • Impotence
  • Kidney disease
  • Nerve damage
  • Loss of limbs

What Are the Risk Factors?

Being overweight is a risk factor for prediabetes and diabetes. Weight loss, even a few pounds, can “cure” prediabetes or reduce the chance of the condition turning into type 2 diabetes. Obesity and type 2 diabetes make your body cells less sensitive to the effects of insulin, a hormone that regulates blood sugar levels. This allows blood sugar levels to rise over time and can result in long-term damage to your body.
This is an especially important risk factor for Americans since many are overweight. African Americans, Hispanics, Native Americans, Asian Americans, and Pacific Islanders may be at an even higher risk.

How Do You Detect Prediabetes?

Prediabetes and diabetes can be diagnosed with a simple blood test. During a routine office visit, your doctor can order tests, such as:
  • Fasting plasma glucose test —You will fast for at least eight hours and have your blood glucose measured before eating. Your results may be read as follows:
    • Normal: 60-100 milligrams per deciliter (mg/dL)
    • Prediabetes: 101-125 mg/dL
    • Diabetes: 126 mg/dL or above
  • Oral glucose tolerance test —You will fast for at least eight hours and have your blood glucose measured after the fast. Then you will drink a sugary drink and have your blood glucose measured two hours later. Results two hours after the drink are usually as follows:
    • Normal: below 140 mg/dL
    • Prediabetes: 140-199 mg/dL
    • Diabetes: 200 mg/dL or above
  • Hemoglobin A1c (HbA1c) — A blood test that does not require any fasting. The HbA1c is an indicator of your average blood sugar levels over the previous 3 months. Your results may be read as follows:
    • Normal: below 5.7%
    • Prediabetes: 5.7%-6.4%
    • Diabetes: 6.5% or above

Who Should Get Screened?

The American Diabetes Association (ADA) recommends that the following people get screened for diabetes:
  • Adults of any age who are overweight or obese with one or more of these risk factors:
    • First-degree relative with diabetes
    • Low HDL (good) cholesterol level and high triglycerides levels
    • High blood pressure
    • History of diabetes during pregnancy (gestational diabetes) or having a baby weighing over nine pounds
    • Having polycystic ovary syndrome or other conditions associated with insulin resistance
    • Being inactive
    • History of cardiovascular disease
    • Belonging to an at-risk ethnic group (African American, Hispanic, Native American, Hispanic American, Asian American, or Pacific Islander)
    • Previous blood test results that show HbA1C levels at 5.7% or higher, impaired glucose tolerance, and impaired fasting glucose
  • Adults aged 45 or older without any risk factors
  • Overweight children aged 10 years and older who have two of these risk factors:
    • High body mass index (BMI) based on child's weight and height
    • Family history of diabetes
    • Signs of insulin resistance or having a condition associated with insulin resistance
    • At-risk ethnic background
  • Screening should be repeated at least every three years if the results are normal, or every year for those people who are at increased risk for future diabetes.

How Do You Treat Prediabetes?

If your test indicates prediabetes, you should have it repeated for accuracy. If you do have prediabetes, you will need to be retested every year.
Fortunately, we know that people with prediabetes can delay or prevent the onset of diabetes with lifestyle changes. Experts recommend that people with prediabetes reduce their weight by 7% and engage in modest physical activity for at least 150 minutes each week. In addition to exercising, you doctor will also recommend that you make changes to your diet. This may include eating more fruits and vegetables and whole grain foods. You should also limite intake of sugar-sweetened drinks.
If you already drink alcohol, limit your drinking moderate to amounts of alcohol (two drinks per day for men, one drink per day for women). Some studies have shown a benefit for people who drink moderately.
In some cases, medicines commonly used to treat diabetes may be prescribed to prevent people from developing diabetes.

RESOURCES

American Diabetes Association http://www.diabetes.org/

National Diabetes Education Program http://ndep.nih.gov/

CANADIAN RESOURCES

Canadian Diabetes Association http://www.diabetes.ca/

Team Diabetes Canada Canadian Diabetes Association http://www.diabetes.ca/

References

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How to tell if you have diabetes or prediabetes. American Diabetes Association website. Available at: http://www.diabetes.org/diabetes-basics/prevention/pre-diabetes/diagnosis.html. Accessed August 20, 2012.

Oral glucose tolerance test. EBSCO Patient Education Reference Center website. Available at: http://www.ebscohost.com/pointofcare . Updated September 1, 2011. Accessed August 20, 2012.

Risk factors for diabetes mellitus type 2. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed . Updated July 19, 2012. Accessed August 20, 2012.

Type 2 diabetes. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated July 17, 2012. Accessed August 20, 2012.

What to do if you have prediabetes. American Diabetes Association website. Available at: http://www.diabetes.org/diabetes-basics/prevention/pre-diabetes/if-you-have-prediabetes.html. Accessed August 20, 2012.

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