What are diabetes and pre-diabetes?
Diabetes is a disease caused by a lack of regulation of blood sugar levels. There are two types of diabetes.
In Type 1 Diabetes, the immune system attacks the pancreatic cells that produce insulin, so the body cannot make enough insulin.
In Type 2 Diabetes the body’s cells don’t respond to insulin as well as they should (insulin resistance). In response the pancreas churns out more insulin and eventually wears out, resulting in a lack of insulin.
Prediabetes is when the transition towards diabetes has begun and glucose dysregulation has started. There is some insulin resistance, but not quite at the threshold to cause diabetes. Pre-diabetes can be reversible with lifestyle and diet changes.
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Why is prediabetes a problem?
If not reversed, prediabetes usually develops into diabetes within five years.. Type 2 diabetes can have serious consequences, harming many organ systems from the heart (increased heart attack and stroke risk), kidneys (chronic kidney disease) to nerves (diabetic neuropathy, blindness). Non-healing ulcers can even lead to amputations of the limbs.
How do I know if I have prediabetes?
You need to have your glucose levels tested in one of 3 ways.
Fasting plasma glucose - This involves fasting for eight hours (the only intake allowed is water) and your baseline glucose is measured.
- Normal 70-99mg/dL
- Prediabetes 100-125mg/dL
- Diabetes >125mg/dL
HbA1C (hemoglobin A1c) - This examines how many hemoglobin molecules in your blood are bound to sugars and is an estimate of your blood glucose over the past three months
- Prediabetes 5.7-6.4%
- Diabetes >6.4%
OGTT (oral glucose tolerance test) - This is a 2 hour oral glucose tolerance test which involves drinking 75g of sugar and examining blood sugar levels after 2 hours
- Normal <140mg/dL
- Prediabetes 140 - 199mg/dL
- Diabetes >199mg/dL
You and your doctor can decide the test most appropriate for you. Alternatively, to screen for prediabetes the random blood glucose test (RBG) can also be used. This involves taking a random sample of blood at any time so results should be taken as a rough guide only as blood glucose levels fluctuate during the day between mealtimes. Most people will have higher glucose levels on this test but if your glucose levels are significantly high between 140-199mg/dL there is a chance you have prediabetes and it is worth going for one of the more reliable tests indicated above.
Prediabetes is usually asymptomatic, which means that these glucose tests are really important at getting a diagnosis. Diabetes, on the other hand, can become symptomatic and presents with problems such as thirst, frequent urination, dry mouth, slow healing, vision and sensation changes.
How do I get my glucose levels back to normal?
The good news is that prediabetes is reversible and there is a lot that you can do.
- Lose weight - Having a high BMI makes you more likely to develop diabetes. Fatty tissue causes insulin resistance, especially around your stomach area rather than your limbs.
- Get more active - Exercise increases the sensitivity of cells to insulin. It also helps you to lose weight.
- Eat healthily - This will also help to keep your weight under control.
- Consider taking Metformin - Taking medication such as metformin decreases the risk of developing type 2 diabetes. Metformin increases glucose utilization/ insulin sensitivity of the cells of the body.
Prediabetes is very prevalent and carries a significant risk of turning into type 2 diabetes. The dangers of type 2 diabetes can be avoided by getting blood glucose tested early and making simple lifestyle changes to reverse prediabetes.