Diabetes, a chronic condition characterized by elevated levels of blood glucose, builds up over a period of time, and generally starts with a ‘prediabetes’ phase. In this stage, blood glucose levels are higher than normal but not high enough to be considered type 2 diabetes. Pre-diabetes can be a significant health problem as it could develop into full-blown type 2 diabetes, and could also increase the risk of heart diseases. But the silver lining is that the progression to type 2 diabetes can be delayed or even prevented just by making simple yet effective lifestyle changes.
What is prediabetes?
Prediabetes is an early warning sign that one might be heading towards developing type 2 diabetes. In a pre-diabetic individual, the body does not produce enough insulin or the cells cannot use insulin effectively (insulin resistance). Insulin is a hormone necessary to transport glucose into the cells through the bloodstream, where it is metabolized for energy. Prediabetes is often associated with high insulin resistance, and as a consequence, too much glucose remains in the blood without getting into the cells.
While the normal range for fasting blood glucose level is 100mg/dL or less, prediabetes is marked by a fasting blood glucose level between 100 and 125mg/dL. When this level crosses 125mg/dL, the condition is diagnosed as type 2 diabetes.
What are the signs and symptoms of prediabetes?
Prediabetes is often called a ‘silent condition’ as people can have it for years without showing any signs or symptoms. It is often diagnosed during routine blood tests or medical screening. However, being overweight is the most common marker, and another possible sign is darkened skin on certain parts of the body, such as the neck, armpits, elbows, knees, and knuckles.
Though people with prediabetes have slightly higher blood glucose levels, their body continues to produce more insulin. The resulting high insulin levels can cause lethargy, sleepiness, especially after a meal, and weight gain around the abdomen. When sugar levels increase further and reach close to type 2 diabetes level, one may experience signs like frequent urination and increased thirst.
What causes prediabetes?
Researchers are not sure of the exact cause for the insulin regulation process to become impaired. A few contributing factors include:
- Being overweight and having excess fat around the abdomen increases the risk for prediabetes because the extra fat tissue can make the body more insulin resistant. A large waist size of more than 40 inches in men and 35 inches in women is linked to insulin resistance.
- Lack of physical activity increases the risk of prediabetes. Being active helps manage weight, improves glucose control, and helps in utilizing insulin more effectively.
- The risk of prediabetes increases if there is a history of type 2 diabetes in the family (parent or sibling).
- Though diabetes can occur at any age, the risk of developing prediabetes increase after 45 years of age.
- Gestational diabetes (diabetes during pregnancy) increases the risk of developing prediabetes for the mother. It also increases the child’s future diabetes risk.
- People with polycystic ovary syndrome, a condition characterized by obesity, irregular menstruation cycles, and excessive hair growth in women, have a higher risk of prediabetes.
- Sleep disorders such as obstructive sleep apnea increase the risk of prediabetes.
- Smoking can be a factor that causes prediabetes, as nicotine is linked to increased insulin resistance.
Additionally, when health problems like high blood pressure, low HDL (good) cholesterol, and high triglycerides (a type of fat) occur along with obesity, they are associated with insulin resistance, which can trigger prediabetes.
Can prediabetes be reversed?
Yes, prediabetes can be reversed. Not everyone with prediabetes will develop full-blown type 2 diabetes. Studies report that about 25% of people with prediabetes develop type 2 diabetes over three to five years and the percentage significantly increases over the long term.
It is necessary to get blood glucose tested if one has any of the risk factors for prediabetes. Lifestyle factors are the primary causes, and one can take control of prediabetes by maintaining an ideal weight, consuming a healthy diet, and increasing physical activity.
How can prediabetes be reversed?
Healthy lifestyle choices to lower blood sugar levels and decrease the risk of developing type 2 diabetes include:
- Reducing weight – Even a modest weight loss of about 5% to 7% can significantly improve blood glucose control and reverse prediabetes.
- Increasing physical activity – Moderate activity of at least 150 minutes per week, which is 30 minutes for 5 days a week, is recommended to keep type 2 diabetes at bay.
- Consuming a healthy diet - A diet that includes whole grains, fruits, vegetables, and healthy fats; and eating regularly scheduled meals throughout the day can also prevent type 2 diabetes.
Other factors include:
- Reducing stress
- Quitting smoking
- Limiting alcohol intake
Sometimes, the doctor may recommend medications to prevent prediabetes from progressing to type 2 diabetes.
While lifestyle modifications can successfully reverse prediabetes, more than 90% of people with prediabetes are not aware that they have it. Hence, people with risk factors for diabetes like obesity and those with a family history of diabetes must get their blood glucose levels tested regularly (generally annually, or as recommended by the doctor). Early diagnosis of prediabetes can help manage the disease and potentially prevent or delay type 2 diabetes and its complications such as heart issues and stroke.
Consult an endocrinologist for any queries related to diabetes or pre-diabetes.