An in-depth guide to Prediabetes

Around the world, Diabetes is a common lifestyle disease. Unfortunately, some people will never understand how they got Diabetes.

Chances are you probably know someone who has Diabetes and is being treated for it. As the world advances and changes, chronic diseases, including Diabetes, Hypertension, Cholesterol, and other ailments, have become increasingly prevalent.

Although you cannot prevent Prediabetes and Diabetes, it helps to be aware of the symptoms so that you can get early access to treatment.

What is Prediabetes?

Prediabetes is a common medical condition where blood sugar levels are elevated but not high enough to diagnose Type 2 Diabetes.

Nearly one-third of the American population, or 88 million people, have Prediabetes. In India, according to the National Urban Diabetes, the incidence of Prediabetes is thought to be 14%.

Identifying these individuals is the main issue that has to be dealt with to implement an early therapeutic intervention.

Your blood sugar level can return to normal with the help of a balanced diet, regular exercise and maintaining a healthy weight. The same lifestyle modifications that can prevent Type 2 Diabetes in adults may also be used to regulate blood sugar levels in children.

According to the National Institutes of Health (NIH), Prediabetes can be controlled and even reversed. Treatment options for the condition include medication, diet and exercise adjustments

Symptoms of Prediabetes

Although you may have Prediabetes, getting Diabetes is not a certainty. However, the likelihood of developing Diabetes is higher. Compared to persons with normal blood sugar levels, those with Prediabetes have a 5 to 15-fold increased chance of developing Type 2 Diabetes.

If you do not make any healthy changes to your eating or exercise routine, those chances will increase.

Most adults with Prediabetes do not exhibit any symptoms; if they do, the symptoms are very mild and go unnoticed for a long time. Though occasionally, there are warning signs.

Polycystic ovarian syndrome and acanthosis nigricans, which result in dark, thick and usually velvety areas of skin, are two disorders that Prediabetes can bring on. The following regions are where this discolouration is most prevalent:

• Elbows
• Neck
• Knees
• Knuckles
• Armpits

You should see a doctor if you have any of the following symptoms and have a family history of Diabetes.

• Increased thirst
• Frequent urination
• Increased appetite
• Fatigue
• Blurred vision
• Prickling or numbness in the hands or feet
• Recurrent infections
• Slowly healing sores
• Unexplained weight loss

These symptoms may indicate the progression of your Prediabetes to Type 2 Diabetes. A doctor can determine if you have Prediabetes through a series of tests and help you confirm it.

Causes of Prediabetes

It is unclear what exactly causes Prediabetes. However, it appears that family history and genetics have a role to play.

Your body gets the majority of its glucose from the food you eat. When you eat food, the pancreas produces the hormone insulin, which causes blood sugar from the food to enter your body's cells and act as an energy source. In this way, insulin lowers your blood sugar level.

Even though Prediabetes is an earlier stage of the condition, its causes are similar to those of Diabetes. They include

• Insulin resistance: This condition in which cells do not react to insulin as intended.
• Increased metabolic disruption: This results from growing insulin resistance and hyperglycemia.

Risk factors of Prediabetes 

The factors that increase your risk of Type 2 Diabetes also increase your risk of Prediabetes.

These factors include:

• Age: The risk of Prediabetes increases beyond the age of 45, even though Diabetes can arise at any age.

• Body weight: A significant risk factor for Prediabetes is being overweight or obese. Your cells become insulin resistant as fat tissue surrounding your abdomen increases, especially inside and between the muscle and skin.

• Waist size: A large waist size may signify insulin resistance. Women with waist measurements more than 35 inches and men with a waist above 40 inches are more likely to have Prediabetes.

• Diet: Consuming red and processed meat and beverages with added sugar is associated with a higher risk of Prediabetes. There has been evidence that eating a diet high in fruits, vegetables, nuts, whole grains, and olive oil lowers the risk of developing Prediabetes.

• Physical inactivity: The likelihood of having prediabetes increases with the degree of inactivity. Exercise enhances insulin sensitivity, burns sugar for energy, and helps maintain a healthy weight.

• PCOS (polycystic ovarian syndrome): Prediabetes is more likely to develop in women with PCOS, a condition marked by menstrual irregularity, excessive hair growth, and obesity.

• Race or ethnicity: Some racial or ethnic groups, including Black, Hispanic, American Indian and Asian Americans, are more prone to Prediabetes. However, the cause of this is unknown.

• Family history: If you have close relatives who have Type 2 Diabetes, you may be more prone to develop Prediabetes.

• Tobacco use: Smoking may also increase the likelihood of developing insulin resistance.

• Medical history: A greater risk of insulin resistance and Prediabetes may be associated with several diseases, such as sleep apnea, gestational diabetes, polycystic ovarian syndrome, high blood pressure, and elevated cholesterol or triglyceride levels.

• Gestational Diabetes: Pregnancy-related Diabetes increases the likelihood that both you and your unborn child may develop Prediabetes (Gestational Diabetes). In the event that you have Gestational Diabetes, your doctor will likely perform blood sugar checks at least every three years.

Diagnosis of Prediabetes

Your doctor will need to do a blood test to diagnose Prediabetes accurately. To do this, you must take a blood sample for testing.

The results may vary depending on the test type. You should repeat the test to confirm the diagnosis, advises the National Institutes of Diabetes and Digestive and Kidney Diseases. Your doctor will carry out one or more of the tests listed below:

1. Fasting plasma glucose (FPG) test

To prepare for the FPG test, your doctor may recommend fasting for eight hours or overnight. Before you eat, a medical practitioner will draw blood to test it.

• The normal range is defined as fasting blood sugar levels less than 100 mg/dL, or 5.6 mmol/L.
• Diabetes is defined as having fasting blood sugar levels between 100 and 125 mg/dL (5.6 and 7.0 mmol/L).
• For Type 2 Diabetes, you must have fasting blood sugar levels of 126 mg/dL (7.0 mmol/L) or greater.

2. Oral glucose tolerance test (OGTT)

For an OGTT, fasting is also necessary. Your doctor will perform two blood sugar checks: once at the beginning of the visit and once more two hours after you've had a sugary beverage.

After 2 hours,

• It is normal to have blood sugar levels under 140 mg/dL (7.8 mmol/L).
• Blood sugar levels between 140 and 199 mg/dL (7.8 and 11.0 mmol/L) are prediabetic. This disorder is referred to as impaired glucose tolerance.
• Blood sugar level of 200 mg/dL (11.1 mmol/L) or higher is considered Type 2 Diabetes.

If you have Prediabetes, your doctor will evaluate your blood sugar levels at least once a year.

3. Haemoglobin A1c test

Your baseline blood sugar over the past two to three months is measured by the haemoglobin A1c test, often known as the A1c test or glycosylated haemoglobin test.

This test may be done whenever it's convenient and doesn't need fasting.

An HbA1c result between 5.7 and 6.4% indicates the presence of Prediabetes. However, a second HbA1c test is advised to confirm the findings. High HbA1c levels indicate the likelihood of Prediabetes progressing to Type 2 Diabetes.

• A1c readings of less than 5.7% are generally regarded as normal.
• A1c levels between 5.7 and 6.4 % indicate the presence of Prediabetes.
• When the A1c level is 6.5% or above in two independent tests, it signifies Type 2 Diabetes.

4. Children and testing for Prediabetes

No matter the patient's age, doctors use the same blood sugar readings to diagnose Prediabetes. According to the American Diabetes Association, you should take tests for children aged 10 and older who are overweight or obese and have:

• Relative suffering from Type 2 Diabetes
• Issues such as low birth weight, high blood pressure or polycystic ovarian syndrome that are indicators of insulin resistance or disorders connected to it.

The American Diabetes Association recommends testing a child with a high risk of developing Prediabetes at least every three years if their first test results are normal.

Treatment of Prediabetes

It is possible to think of treating Prediabetes as preventing Type 2 Diabetes. If your doctor determines you have Prediabetes, they'll advise making certain lifestyle adjustments.

According to the Diabetes Prevention Program research, those who adhered to these modifications over time saw their risk of developing Diabetes decreased by around 58%.

The best ways to manage Prediabetes are:

1. Eat a healthy diet

Working with your nutritionist to develop a meal plan that still includes your favourite foods while making minor adjustments as needed can increase your chances of long-term success and prevent you from feeling deprived.

2. Exercise regularly

For several reasons, exercise is a great way to reverse Prediabetes. First, you may reduce the weight that raises your risk for Prediabetes by exercising regularly.

Additionally, the more glucose your body utilises when exercising, the faster it leaves your system. Last but not least, physical activity stimulates the GLUT-4 cell receptor, which facilitates glucose uptake from circulation and transport into cells.

Exercises that help activate the GLUT-4 system include cardio and weightlifting.

3. Lose weight

If you have Prediabetes and your doctor has prescribed weight loss but don't know where to start (or you've tried every diet with no luck), look for help.

If you've had trouble losing weight in the past, hire a nutritionist and a trainer. Even a little loss of 5 to 10% of your body weight can drastically lower your chance of getting Type 2 Diabetes and reverse your Prediabetes.

4. Take medication

A medication called Metformin, which prevents your liver from producing more glucose when you don't need it, may be prescribed by your doctor. You should take this medication if you have Prediabetes and are at a very high risk of getting Type 2 Diabetes because of comorbid conditions like obesity.

Treatment of Prediabetes in children

Prediabetic children should adopt the lifestyle modifications advised for adults with Type 2 Diabetes, including

• Losing weight
• Eating more fibre and less refined fats and carbs
• Limiting portion sizes
• Eating out less frequently
• Engaging in physical activity for at least one hour each day

For kids with Prediabetes, medication is often not advised until lifestyle adjustments aren't lowering blood sugar levels. Metformin is frequently suggested if medication is required.

Prevention of Prediabetes 

Exercise and a diet low in salt, sugar, fat and carbs can help avoid Prediabetes. Other suggestions are:

• Avoid smoking
• Control your alcohol intake
• Take blood sugar medications as directed by your doctor

When to see a doctor?

Consult your doctor if you have Diabetes concerns or any Type 2 Diabetes signs or symptoms such as frequent urination, excessive thirst, unexplained weight loss etc. If you have Diabetes risk factors, speak with your doctor about blood sugar testing.

Conclusion

Prediabetes raises the risk of developing Type 2 Diabetes, heart disease and stroke if left untreated. Fortunately, it may be reversed and treated by altering your food and lifestyle habits.

Following a healthy, balanced diet, engaging in regular physical exercise, and taking your medicines as directed by your doctor can help avoid the progression of Prediabetes.

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