Prediabetes - Diagnosis, Treatment and Prevention

Prediabetes, what is it, what are the symptoms, how is it treated, can it be cured? How is it prevented? These questions and more will be treated here in this article.

Prediabetes may be defined as the condition in which not all the symptoms of diabetes is present in a person, but blood sugar level is higher than normal even though not yet high enough to be classified as type 2 diabetes.

In most cases being prior to or being an early stage of diabetes, the characterization of what happens during prediabetes is similar. What is that? Well let's see.

Now ordinarily when food is eaten, the hormone insulin is released by the pancreas to assist the body in the foods processing. Insulin does this by enabling food glucose entry into the body's cells where it will be used for fuel. This action lowers the glucose level in the blood.

However as in diabetes, in a person with prediabetes, the insulin producing organ- the pancreas, either no longer produces insulin, or that person's body cells become resistant to its action or both. Due to this, blood sugar remains at an abnormally high level and this can lead to diabetes with all its attendant complications; heart disease, kidney failure, blindness, amputations, etc.

This latter condition, where a person's body cells become resistant to the action of insulin is referred to as Impaired Fasting glycemia or Impaired Fasting Glucose (IFG).

Although associated with increased risk of heart disease and insulin resistance, Impaired Fasting glycemia is less of a risk than Impaired Glucose Tolerance (IGT). The difference between the two is that while Impaired Glucose Tolerance emphasizes the insulin resistive aspect of the condition, Impaired Fasting Glucose describes the abnormal blood glucose level of it.

They are related in the sense that a person with a high resistance to insulin, i.e. impaired glucose tolerance is likely to have a higher than normal blood sugar-that is Impaired fasting glucose. However the opposite is not necessarily true - that high IFG correlates to high IGT and in fact it has been found that many patients with impaired fasting glucose have normal responses to a glucose tolerance test.

The criteria for impaired fasting glucose as relates to World Health Organization (WHO) and American Diabetic Association (ADA) standards differ slightly. Whereas the ADA criteria is fasting plasma glucose level from 5.6 mmol/L (100 mg/dL) to 6.9 mmol/L (125 mg/dL), for WHO, the criteria is from 6.1 mmol/l (110 mg/dL) to 6.9 mmol/L (125 MG/dL).

Though Prediabetes does not have any precise signs or symptoms, the prevailing wisdom is that the individual should watch out for symptoms of type 2 diabetes. These include increased thirst and frequent urination, constant hunger, unexplained weight loss, weight gain, flu-like symptoms including weakness and fatigue, slow healing of cuts and or bruises, recurring bladder or vaginal infections, blurred vision, slow healing of cuts or bruises and recurring gum or skin infections.

In addition there are risk factors associated with prediabetes; 1) being overweight, with a body mass index above 25, 2) being inactive, 3) being aged 45 or older, 4) having a family history of type 2 diabetes, 5) being African-American or a Pacific Islander, 6) being a person having high blood pressure, 7) having a high-density lipoprotein (HDL) or the "good" cholesterol below 35 miligrams per deciliter (mg/dL) (0.9 milimoles per liter, or mmol/L) or a triglyceride (a type of fat in blood) level above 250mg/dL (2.83 mmol/L), 8) having sleep disorders and 9) having a large waist size.

In addition to this if you are a woman - if you have polycystic ovary syndrome - a condition marked by obesity, irregular menstrual periods and excessive hair growth, having developed gestational diabetes when you were pregnant or gave birth to a baby who weighed more than 9 pounds (4.1 kilograms), then you are at an higher risk.

The American Diabetes Association recommends that people, from the age of 45 (or a person below that age having any of the risk factors mentioned) should consult their doctor for possible blood screening.

The following are tests that a doctor may require you to take to screen for diabetes. The Glycated haemoglobin (A1C) test. This gives a person's average blood sugar level for the past two to three months. A normal A1C is below 5.7 percent whilst that between 5.7 and 6.4 percent is prediabetic;

Fasting blood sugar test. Here, a blood sample is taken and assessed after the individual has gone without food for at least eight hours or overnight. Here, a blood sugar level lower than 100 milligrams per decilitre (mg/dL)-5.6 milimoles per litre (mmol/L) is normal, between 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is prediabetes or what is sometimes called Impaired Fasting glucose, whilst 126 mg/dL (7.0 mmol/L) or higher is indicative of diabetes.

The Oral Glucose Test may also be recommended although it is rarely used except during pregnancy. Here the individual is given a sugary solution to drink after s/he must have fasted for at least eight hours or overnight. Blood sugar measurement will then be taken after two hours. A blood sugar level less than 140mg/dL (7.8 mmol/L) is normal. From 140 to 199mg/dL (7.8 to 11.0 mmol/L) prediabetic or impaired glucose tolerance (IGT), whilst 200mg/dL (11.1 mmol/L or higher reflects Diabetes.

If the individual does turn out to be prediabetic, then the doctor may require he check that persons HDL cholesterol, A1C, total cholesterol, Low Density Lipoprotein (LDL) cholesterol and triglycerides at least once a year.

So how can Prediabetes be treated?

In this regard, the first necessary thing for adoption is a healthy lifestyle. This will include eating healthy foods. This means a low-calorie, low-fat, high in fiber diet. A diet consisting of more fruits, vegetables and whole grains.

Be more physically active.

A person looking to lower his risk for becoming prediabetic should strive to be physically active. In addition to resistance training like weightlifting, the American Diabetes Association recommends 30 to 60 minutes of moderate physical activity daily.

Lose excess weight. Where you are overweight, losing 5-10 percent of your body weight has been shown to lower the chances of developing type 2 diabetes.

As far as medicine goes, persons considered to be at a high risk of developing diabetes may be required to take the diabetes drug metformin (Glucophage).

With regards to alternative medicine, therapies including chromium, ginseng, cassia cinnamon, glucomannan, prickly pear cactus, coenzyme Q10 and others have indicated promise in the treatment or prevention of type 2 diabetes. However further tests still needs to be made on them. In addition to this, it is also recommended that one consults his/her doctor before engaging alternative therapies so as to enable him give appropriate advice.

Finally, it must be said that prediabetic or not, the adoption of a healthy lifestyle is a boon to good health. In fact it is the key to prevention. As such, irrespective of whether one has a predisposition for developing diabetes or any other disease, the general advice has always been to take it up. That advise remains. It has not changed.