Pre-Diabetes

Pre-diabetes, also known as impaired glucose tolerance or borderline diabetes, is a condition where blood sugar levels are higher than normal but not high enough to be classified as diabetes.

What is Pre-Diabetes?

Pre-diabetes is a metabolic condition characterized by insulin resistance, where the body's cells become less responsive to insulin, a hormone produced by the pancreas that regulates blood sugar levels. As a result, glucose builds up in the bloodstream instead of being absorbed by the cells, leading to high blood sugar levels.

Symptoms of Pre-Diabetes

Pre-diabetes often does not exhibit noticeable symptoms, and many people may not even realize they have the condition. However, some possible symptoms include:

• Increased thirst and hunger
• Frequent urination
• Blurred vision
• Slow healing of cuts and wounds
• Tingling or numbness in the hands and feet
• Recurring skin, gum, or bladder infections

Risk Factors for Pre-Diabetes

Certain factors increase the risk of developing pre-diabetes, including:

• Obesity or being overweight
• Physical inactivity
• Family history of diabetes
• Age (45 or older)
• Gestational diabetes or giving birth to a baby weighing over 4 kg
• Polycystic ovary syndrome (PCOS)
• Sleep apnea
• Certain ethnicities, such as African American, Hispanic/Latino, American Indian, or Asian American

Diagnosis of Pre-Diabetes

Pre-diabetes is typically diagnosed through a:

• Fasting plasma glucose (FPG) test: measures blood sugar levels after an overnight fast
• Oral glucose tolerance test (OGTT): measures blood sugar levels after consuming a sugary drink
• Hemoglobin A1c (HbA1c) test: measures average blood sugar levels over the past 2-3 months

Treatments for Pre-Diabetes

The primary goal of treating pre-diabetes is to prevent the development of type 2 diabetes and reduce the risk of cardiovascular disease. Treatment options include:

• Lifestyle modifications:
  • Weight loss (if overweight or obese)
  • Regular physical activity (at least 150 minutes/week)
  • Healthy eating habits, such as a balanced diet with plenty of fruits, vegetables, whole grains, and lean protein sources
• Medications:
  • Metformin: may be prescribed for people with pre-diabetes who are at high risk of developing type 2 diabetes or have a history of gestational diabetes
• Monitoring and follow-up:
  • Regular blood sugar checks to monitor progress
  • Annual HbA1c tests to assess average blood sugar control
  • Lipid profiles and blood pressure checks to monitor cardiovascular risk factors

Complications of Untreated Pre-Diabetes

If left untreated, pre-diabetes can increase the risk of developing:

• Type 2 diabetes
• Cardiovascular disease (heart attacks, strokes, and peripheral artery disease)
• Kidney damage
• Nerve damage (neuropathy)
• Eye problems (retinopathy)
• Foot damage (ulcers, infections, and amputations)

Prevention of Pre-Diabetes

To reduce the risk of developing pre-diabetes, it is essential to:

• Maintain a healthy weight through a balanced diet and regular physical activity
• Avoid smoking and limit alcohol consumption
• Get enough sleep (7-8 hours/night) and practice stress-reducing techniques, such as meditation or yoga
• Monitor blood sugar levels regularly, especially if you have a family history of diabetes or are at high risk