PREDIABETES

Prediabetes can be considered an alarm bell that warns us that we are on the path to diabetes.

This is a condition where the blood sugar level is higher than normal, but not yet above the level that is characteristic of diabetes.

How does prediabetes develop

Under normal conditions, the body produces the hormone insulin, which helps cells absorb glucose and controls its amount in the blood.

The presence of prediabetes means that this mechanism is not working as it should: either not enough insulin is produced, or the body cannot respond to its action properly.

The exact cause is unknown, although genetics and family history are known to play a leading role in the development of the disease.

A very important factor is also an inactive lifestyle and excess weight, especially the presence of excess fat mass in the waist area.

Prediabetes is associated with a higher risk of cardiovascular disease, but this risk can still be prevented at this stage of metabolic disorder.

Symptoms are usually not pronounced, so everyone over the age of 45 should be screened every three years, or earlier if they have risk factors for developing diabetes. For a list of them, see here.

Diagnostics

Three types of laboratory tests are used to detect prediabetes:

Determination of fasting blood glucose – the diagnostic indicator is 100-125 mg/dL (5.6 – 6.9 mmol/L);

Oral glucose tolerance test – First, a fasting blood sugar test is performed, then the test subject drinks glucose dissolved in water, and a repeat blood sugar test is performed two hours later. The diagnostic range is 140 – 199 mg/dL (7.7 – 11 mmol/L);

Glycosylated hemoglobin – diagnostic indicator is 5.7 – 6.4%.

The concept of prediabetes encompasses two diagnoses, depending on which of the following diagnostic tests the disorder is detected in. These are:

Impaired fasting glycemia (based on a fasting blood sugar reading above normal)

and/or

Impaired glucose tolerance (based on changes detected by a glucose tolerance test).

Treatment

Lifestyle modifications can help people with prediabetes delay or prevent the progression of the disorder and the development of diabetes.

To do this, three "golden" rules must be observed:

1. Weight control: If you are overweight or obese, you are at higher risk of developing prediabetes into diabetes. Losing just 5 to 10% of your body weight can make a difference.
2. Physical activity: You should aim for at least 30 minutes of moderate-intensity physical activity every day or most days of the week, such as cycling, swimming, or just walking. Aerobic exercises that increase your heart rate are ideal, but starting this type of exercise for the first time requires specialist advice.
3. Nutrition: The diet should consist of lean proteins, whole grains, and vegetables. Calories, portion sizes, and sugar and starchy carbohydrate intake should be reduced. The proportion of fiber-rich foods should be increased, as it helps to speed up the feeling of fullness and makes it easier to control the amount of food eaten.

As for medication treatment, the decision to prescribe appropriate medications is made individually, taking into account the patient's condition.

Prediabetes is also a problem in children. The same lifestyle changes recommended for adults can help stop the progression of the disease in children.

Author: Elga Giorgadze (MD of Endocrinology)

Read also:

• GLUCOSE LEVEL IN THE BLOOD: TERMINOLOGY, TESTING METHODS AND NORMAL RANGES
• Prevention of type 2 diabetes
• Diabetes risk factors and screening
• General information about diabetes mellitus
• Most frequently asked questions