According to the Centers for Disease Control and Prevention (CDC), over 98 million American adults have prediabetes, but more than 84% are unaware of it. To put that into perspective, 1 in every 3 adults have prediabetes!
Prediabetes occurs when blood glucose levels are higher than normal but not yet high enough to be classified as diabetes.
Being undiagnosed, many continue with unhealthy habits that worsen the condition. Recognizing and managing prediabetes early can prevent its progression to diabetes and its gamut of complications.
What is Prediabetes?
Prediabetes is a condition where blood sugar levels are higher than normal but not high enough for a diabetes diagnosis. Often, people with prediabetes are unaware of their condition. It is also the final train station before progressing to full-blown type 2 diabetes if left unmanaged. Pre-diabetes is caused by either the inability of the pancreas to produce sufficient insulin, or the inability of the body to respond appropriately to insulin- insulin resistance. Insulin can be likened to a key that opens the door on the cells for sugar to come in. When insulin function is deficient, high levels of sugar keep circulating in the blood causing pre-diabetes. Studies have shown that most people with prediabetes will develop type 2 diabetes within a decade! This is except they take active steps towards a healthier lifestyle.
Insulin resistance is a significant factor in prediabetes. Here, the body's cells do not respond effectively to insulin, the hormone that ordinarily drives glucose to go into cells. This defiance to insulin then leads to the sugar accumulating in the bloodstream, causing elevated blood sugar levels. This condition often develops gradually and can be asymptomatic, making early detection challenging.
Despite its often occurring with no symptoms, prediabetes can lead to significant health issues if not addressed. Some of the serious health problems associated with type 2 diabetes are heart disease, kidney failure, blindness, and damage to the nerves which can result in the amputation of a toe, foot, or whole leg.
Symptoms, if present, are usually mild and easily overlooked, such as frequent urination, increased thirst, and blurred vision.
Subtle Symptoms
• Frequent Urination and Thirst:
Prediabetes can be a silent condition, often presenting with no noticeable symptoms. However, some individuals may experience subtle signs like frequent urination and increased thirst. These symptoms occur because the body is trying to expel excess glucose through urine.
• Fatigue and Blurred Vision:
Other common signs include fatigue and blurred vision. These symptoms can be mistaken for regular tiredness or aging, which, unfortunately, delays diagnosis and treatment. It is, therefore, crucial to pay attention to these signs and seek medical advice for proper diagnosis.
Risk Factors for Prediabetes
• Obesity:
Excess weight, particularly around the abdomen, increases insulin resistance, making it harder for the body to manage blood sugar levels effectively. Abdominal obesity is defined as waist circumference measuring greater than 40 inches for men and greater than 35 inches for women, even when the body mass index is normal. Obesitydiseases and inflammation.
• Lack of Exercise:
A sedentary lifestyle contributes to weight gain and insulin resistance. This is common as most people work at the desk, ride on cars or buses and generally just do not move their body enough throughout the day. Regular physical activity helps maintain a healthy weight and improves insulin sensitivity.
• Family History:
Individuals with a family history of diabetes are at a higher risk of developing prediabetes due to genetic predisposition. If one of your parents has diabetes, you have a higher chance of developing diabetes as well.
• Age:
The risk of prediabetes increases with age, particularly for individuals over 45. As people age, they tend to be less active, gain weight, and lose muscle mass, which can contribute to insulin resistance.
• Ethnicity:
Certain ethnic groups, including African Americans, Hispanics, and Native Americans, are more prone to developing prediabetes due to genetic and lifestyle factors.
• Diabetes During Pregnancy:
Women who have had gestational diabetes are at a higher risk of developing prediabetes later in life. And there is a higher chance the child will also develop prediabetes when they grow up.
• Previous Diagnosis of Heart Disease or Polycystic Ovary Syndrome (PCOS):
Individuals with a history of heart disease or PCOS have an increased risk of insulin resistance and prediabetes. This is why most PCOS guidelines involve the early commencement of Metformin, a biguanide oral hypoglycemic agent.
• High Blood Pressure:
• High Cholesterol:
• High Triglyceride Levels:
• Impaired Fasting Glucose or Glucose Tolerance in Previous Testing:
A history of elevated blood sugar levels in previous tests can be a future marker for a higher risk of developing prediabetes.
Why Bother: The Importance of Early Detection
Early detection of prediabetes is crucial to prevent the progression of type 2 diabetes and other complications. Prediabetes increases the risk of developing cardiovascular diseases, nerve damage, and kidney problems.
Recognizing and addressing prediabetes early can significantly reduce these risks. Getting the wake-up call might be all you need to save your limbs. Data have shown us that at the stage of pre-diabetes, the predominant pathology in the body is insulin resistance. At this phase, your pancreas is still capable of producing insulin, just that the cells can be unresponsive to it. Therefore, appropriate medications and lifestyle modification can reverse pre-diabetes.
How Do You Diagnose Prediabetes?
Healthcare practitioners diagnose prediabetes using specific tests that are highly specific and sensitive. They are not overtly invasive tests, which makes them ideal for screening a lot of people at the same time:
• Hemoglobin A1C Test:
The Hemoglobin A1C test measures average blood sugar levels over the past two to three months. According to the American Diabetes Association, a result between 5.7% and 6.4% indicates prediabetes. Figures higher than the upper limit are diagnostic of type 2 diabetes.
• Fasting Plasma Glucose (FPG) Test:
The Fasting Plasma Glucose (FPG) test measures blood sugar after an overnight fast. A level between 100 and 125 mg/dL suggests prediabetes.
• Oral Glucose Tolerance Test (OGTT):
The Oral Glucose Tolerance Test (OGTT) is unique. It involves drinking a sugary solution and measuring blood glucose levels after two hours. You are testing how much your body can handle the challenge of glucose influx and drive it into cells. Levels between 140 and 199 mg/dL indicate prediabetes.
Treatment Options for Prediabetes
First, the burning question on everyone’s mind is, can Prediabetes be reversed? Yes, prediabetes can often be reversed with lifestyle changes and proper management. By adopting healthier habits, individuals can improve their insulin sensitivity and lower blood sugar levels, reducing the risk of progression to type 2 diabetes. Early intervention is key to reversing prediabetes and maintaining long-term health.
1. Weight Loss
Achieving and maintaining a healthy weight is one of the central factors that helps to halt the progression of diabetes. Aiming for a calorie deficit through a balanced diet has been shown to help with weight loss. Diets such as the kale diet, Mediterranean diet, and others rich in fruits, vegetables, whole grains, and lean proteins are beneficial. These diets are not only nutritious but also help in weight management.
Also, medications like Ozempic (semaglutide) can assist in weight loss by suppressing appetite and promoting satiety. These medications can be particularly useful for those struggling to lose weight through diet and exercise alone. As a final point of call, there are a lot of Bariatric weight loss surgeries that have been documented to help shield those stubborn pounds.
2. Increased Activity
To combat a sedentary lifestyle, it’s important to stay active throughout the day. The World Health Organization (WHO) recommends taking at least 10,000 steps per day. Incorporating more movement into daily routines, such as walking during breaks or taking the stairs, can make a significant difference.
3. Exercise
Engaging in regular exercise is essential if you want to prevent diabetes. Aim for at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity activity per week, as recommended by health experts.
4. Medications for Diabetes
While there are no specific medications for prediabetes, certain diabetes medications can help manage blood sugar levels and prevent the progression of type 2 diabetes. These include:
• GLP-1 Receptor Agonists: Medications like Rybelsus (semaglutide) help lower blood sugar by enhancing insulin secretion and reducing appetite.
• SGLT2 Inhibitors: Drugs such as Jardiance (empagliflozin) and Farxiga (dapagliflozin) work by preventing glucose reabsorption in the kidneys, leading to lower blood sugar levels.
• Metformin: Often prescribed for diabetes prevention, metformin helps lower blood sugar levels by improving insulin sensitivity and reducing glucose production in the liver.
Expanding the Net
In 2021, the U.S. Preventive Services Task Force recommended lowering the initial screening age for prediabetes and type 2 diabetes to 35 for asymptomatic adults who are overweight or obese. This move is crucial as obesity is becoming an increasing public health concern. The aim is to identify more individuals at risk earlier, allowing for timely intervention and prevention.
Expanding screening efforts can help catch prediabetes in its early stages. This thus prevents the progression of type 2 diabetes and associated health complications.
To Summarize
Prediabetes is a growing concern, often undiagnosed and leading to serious health complications if left unmanaged. Awareness of risk factors, symptoms, and the importance of early detection is crucial in preventing the progression of diabetes. By adopting healthy lifestyle changes and seeking regular health screenings, individuals can manage and reverse prediabetes, reducing their risk of developing more severe health conditions.
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