Description

Pre-Diabetes means that you have higher than normal blood sugar level. It is not high enough to be considered type 2 diabetes, however. But without lifestyle changes, adults and children with prediabetes are at high risk of developing type 2 diabetes.

If you have prediabetes, the long-term damage of diabetes, especially the heart, blood vessels and kidneys — may already be starting. There is good news, however. The progression of prediabetes to type 2 diabetes is not inevitable.

Eat healthy foods, make physical activity part of your daily routine and stay at a healthy weight can help to bring your blood sugar level back to normal. The same lifestyle changes that can help prevent type 2 diabetes in adults might also help to take the children's blood sugar levels back to normal.

Symptoms

Prediabetes typically has no signs or symptoms.

A possible sign of prediabetes is the darkening of the skin in certain parts of the body. Affected areas are the neck, the armpits and the groin.

Classic signs and symptoms that suggest that you have moved from prediabetes to type 2 diabetes include:

  • Increased thirst
  • Frequent need to urinate
  • Increased hunger
  • Fatigue
  • Blurred vision
  • Numbness or tingling in the hands or feet
  • Frequent infections
  • Slow-healing sores
  • Unintentional weight loss

When to see a doctor

Consult your health care provider if you are concerned about diabetes or if you notice any of type 2 diabetes signs or symptoms. Ask your health care provider about your blood sugar detection if you have any of the risk factors for diabetes.

Causes

The exact cause of diabetes is unknown. But the family history, and genetics seems to play an important role. What is clear is that people with prediabetes don't process sugar (glucose) is accounted.

Most of the glucose in your body comes from the food that you eat. When food is digested, the sugar enters the bloodstream. Insulin allows the sugar to enter the cells and decreases the amount of sugar in your blood.

Insulin is produced by a gland located behind the stomach called the pancreas. The pancreas releases insulin into the blood when you eat. When your blood sugar level starts to drop, the pancreas inhibits the secretion of insulin in the blood.

When you have diabetes, this process doesn't work as well. As a result, instead of feeding the cells, sugar builds up in the bloodstream. This can occur because:

  • The pancreas can not produce enough insulin
  • Your cells become resistant to insulin and does not allow the same amount of sugar

Risk factors

The same factors that increase the chances of developing type 2 diabetes also increase the risk of prediabetes. These factors include:

  • Weight. Being overweight is a primary risk factor for prediabetes. The more fatty tissue you have — especially in the interior, and between the muscle and the skin around your abdomen — the most resistant cells become to insulin.
  • The size of the waist. A large waist size can indicate insulin resistance. The risk of insulin resistance goes up for men with a waist of more than 40 inches and women with a waist size over 35 inches.
  • Of the diet. The consumption of red meat and processed meat, and consumption of sugar-sweetened beverages, is associated with an increased risk of prediabetes.
  • The inactivity. The less active you are, the greater your risk of prediabetes.
  • Age. Although diabetes can develop at any age, the risk of prediabetes increases after the age of 35.
  • The history of the family. The risk of pre-diabetes increases if you have a parent or sibling with type 2 diabetes.
  • Race or ethnic origin. Although it is not clear why some people — including Black, Hispanic, American Indian and Asian-American people — are more likely to develop prediabetes.
  • Gestational diabetes. If you had diabetes during pregnancy (gestational diabetes), you and your child are at higher risk of developing prediabetes.
  • The polycystic ovary syndrome. Women with this common condition characterized by irregular menstrual periods, excess hair growth and obesity have a higher risk of prediabetes.
  • The dream. People with obstructive sleep apnea, a condition that disrupts sleep repeatedly — have a higher risk of insulin resistance. People who are overweight or obese have a higher risk of developing obstructive sleep apnea.
  • The smoke of the tobacco. Smoking can increase the resistance to insulin and may increase the risk of type 2 diabetes in people with prediabetes. Smoking also increases the risk of diabetes complications.

Other conditions associated with an increased risk of prediabetes include:

  • High blood pressure
  • Low levels of high-density lipoprotein (HDL) cholesterol, the "good" cholesterol
  • High levels of triglycerides, a type of fat in the blood

The metabolic syndrome

When certain conditions occur with obesity, which are associated with insulin resistance, and may increase your risk of diabetes and heart disease and stroke. A combination of three or more of these conditions is often called metabolic syndrome:

  • High blood pressure
  • Low levels of HDL
  • High triglycerides
  • High levels of sugar in the blood
  • Great waist size

Complications

The pre-Diabetes has been associated with long-term damage, including the heart, blood vessels and kidneys, even if you have not progressed to type 2 diabetes. Pre-Diabetes is also linked to an unknown (silent) heart attacks.

Prediabetes can progress into type 2 diabetes, which can lead to:

  • High blood pressure
  • High cholesterol
  • Heart disease
  • Stroke
  • Kidney disease
  • Damage to the nerves
  • Fatty liver disease
  • Damage to the eyes, including the loss of vision
  • Amputations

Prevention

Healthy life style can help to prevent diabetes and its progression to type 2 diabetes, even if there is diabetes in your family. These include:

  • Eat healthy foods
  • Stay active
  • Losing excess weight
  • Control your blood pressure and cholesterol
  • No smoking

Diagnosis

The American Diabetes Association (ADA) recommends that screening for diabetes for the majority of the adults begin at the age of 35. The ADA advises screening for diabetes before the age of 35 if you are overweight and have additional risk factors for prediabetes or type 2 diabetes.

If you have had gestational diabetes, your doctor will probably check your blood sugar levels at least once every three years.

There are several blood tests for pre-diabetes.

The glycosylated hemoglobin (A1C) test

This test indicates your average blood sugar level over the past 2 to 3 months.

In general:

  • Below 5.7% is normal
  • Between 5.7% and 6.4% are diagnosed with prediabetes
  • 6.5% or higher on two separate tests indicates diabetes

Certain conditions can make the A1C test inaccurate — such as if you are pregnant or have an uncommon form of hemoglobin.

Sugar test, fasting blood

A blood sample is taken after you have not eaten for at least eight hours or overnight (fast).

Blood sugar values are expressed in milligrams of sugar per deciliter (mg/dL) or millimoles of sugar per liter (mmol/L) of blood. In general:

  • Less than 100 mg/dL (5.6 mmol/L ) is normal
  • Of 100 to 125 mg/dL (5.6 to 6.9 mmol/L ) is diagnosed with prediabetes
  • 126 mg/dL (7.0 mmol/L ) or higher on two separate tests is diagnosed with diabetes

Test Oral glucose tolerance

This test is used less often than the others, except during pregnancy. You will need to fast overnight and then drink a sugary liquid in the primary care provider's office or laboratory tests. Blood sugar levels are tested periodically for the next two hours.

In general:

  • Less than 140 mg/dL (7.8 mmol/L ) is normal
  • 140 to 199 mg/dL (7.8 to 11.0 mmol/L ) is consistent with pre -
  • 200 mg/dL (11.1 mmol/L ) or higher after two hours suggests diabetes

If you have pre-diabetes, your health care provider will usually check your blood sugar levels at least once a year.

Children and prediabetes tests

Type 2 diabetes is increasingly common in children and adolescents, probably due to the increase of obesity in childhood.

The ADA recommends the pre-tests for children who are overweight or obese, and who have one or more risk factors for type 2 diabetes, such as:

  • Family history of type 2 diabetes
  • Be of one race or ethnic origin associated with an increased risk
  • Low birth weight
  • Born of a mother who had gestational diabetes

The ranges of blood sugar level is considered normal, prediabetes, and diabetes are the same for children and adults.

Children who have pre-diabetes should be tested annually for type 2 diabetes — or more often if the child experiences a change in their weight or have signs or symptoms of diabetes, such as increased thirst, increased urination, fatigue, or blurred vision.

Treatment

Healthy lifestyle can help you bring your blood sugar level back to normal, or at least keep it from rising to the levels observed in type 2 diabetes.

To prevent prediabetes progression to type 2 diabetes, try the following:

  • Eat healthy foods. A diet high in fruits, vegetables, nuts, whole grains, and olive oil was associated with a lower risk of prediabetes. Choose foods that are low in fat and calories and high in fiber. Eat a variety of foods to help you achieve your goals without compromising on taste and nutrition.
  • Be more active. Physical activity helps to control your weight, uses the sugar for energy and helps the body use insulin more effectively. Try to do at least 150 minutes of moderate exercise or 75 minutes of aerobic activity, vigorous week, or a combination of moderate and vigorous exercise.
  • Losing the excess weight. If you are overweight, losing just 5% to 7% of their body weight — about 14 pounds (6.4 kilograms) if you weigh 200 pounds (91 kilograms) — can significantly reduce the risk of type 2 diabetes. To maintain your weight in a healthy range, focus on permanent changes in your eating and exercise habits.
  • Stop smoking. Quitting smoking can improve the way insulin works, improving their level of sugar in the blood.
  • Take the medication as needed. If you are at high risk of diabetes, your doctor may recommend metformin (Glumetza). Medications to control cholesterol and high blood pressure can also be prescribed.

The children and the treatment of prediabetes

Children with diabetes should follow the lifestyle changes recommended for adults with type 2 diabetes, including:

  • Lose weight
  • Eat less refined carbohydrates and fat, and more fiber
  • The reduction of portion sizes
  • Going out to eat less often
  • Spending at least an hour each day in physical activity

Medication is usually not recommended for children with prediabetes unless lifestyle changes are not the improvement of the levels of sugar in the blood. If you need drugs, metformin is generally the recommended medicine.

Alternative medicine

Many of the alternative therapies have been touted as the possible ways to treat or prevent type 2 diabetes. But there is no definitive evidence that any of the alternative treatments are effective. The therapies that have been said to be useful in type 2 diabetes and are also likely to be safe, include:

  • Cinnamon Cassia
  • Flaxseed
  • Ginseng
  • Magnesium
  • Oats
  • Soy
  • Xanthan gum

Talk with your health care provider if you are considering dietary supplements or other alternative therapies to treat or prevent pre-diabetes. Some supplements or alternative therapies may be harmful if combined with certain prescription medications. Your health care provider can help you weigh the pros and cons of each alternative therapies.

Preparing for your appointment

It is likely to start by seeing your primary care provider. He or she may refer you to a specialist in the treatment of diabetes (endocrinologist), a dietitian or a certified diabetes educator.

Here's some information to help you prepare for your appointment.

What you can do

Before your appointment, follow these steps:

  • Ask about any pre-appointment restrictions. You may need to fast for at least eight hours before your appointment so that your health care provider may measure their level of sugar in the blood on an empty stomach.
  • List of the symptoms that I had and for how long.
  • List of all the medicines, vitamins, and supplements you are taking, including the dosage.
  • List of key personal and medical information, including other conditions, recent life changes and stressors.
  • Prepare questions to ask your health care provider.

Some basic questions to ask include:

  • How can I prevent prediabetes from becoming type 2 diabetes?
  • Do I need to take the medication? If so, what side effects can I expect?
  • I have other health conditions. How can I best manage them together?
  • How much do I need to exercise every week?
  • Should I avoid any type of food? I still eat sugar?
  • I need to see a dietitian?
  • Can you recommend any of the local programs for the prevention of diabetes?

What to expect from your doctor

Your health care provider is likely to ask a series of questions, such as:

  • Has your weight changed recently?
  • Do you exercise regularly? If so, for how long and with what frequency?
  • Do you have a family history of diabetes?
Symptoms and treatment of Prediabetes