Prediabetes
What is Prediabetes?
Prediabetes is a precursor before the diagnosis of diabetes mellitus. Adults with prediabetes often may show no signs or symptoms of diabetes but will have blood sugar levels higher than normal. The normal blood glucose level is between 70 mg/dL to 99 mg/dL. In patients with prediabetes, you can expect to see blood glucose levels elevated between 110 mg/dL to - 125 mg/dL. However, these levels do not meet the required criteria for a diagnosis of diabetes mellitus. For this reason, many people are not aware that they are living with prediabetes.
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In addition to type 2 diabetes, prediabetes is a risk factor for the development of cardiovascular disease, and stroke. Once diagnosed with prediabetes patients should be checked for progression to type 2 diabetes regularly.
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The following factors put the person at greater risk:
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Overweight or obesity (especially around belly)
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Family history of diabetes mellitus
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Diabetes during pregnancy (gestational diabetes)
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Hypertension
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Physical inactivity
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Dyslipidemia with levels of HDL cholesterol less than 40 mg/dL (men) or less than 50 mg/dL (women) or triglycerides more than 150 mg/dL
What are the symptoms of prediabetes?
Majority of the patients with prediabetes do not experience any symptoms and hence appropriate screening and monitoring especially in individuals with family history is needed. In the minority of patients who do experience symptoms, they can be as follows:
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Increased appetite
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Unexplained weight loss/weight gain
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High BMI
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Weakness
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Fatigue
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Sweating
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Blurred vision
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Slow healing cuts or bruises
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Recurrent skin infections/gum bleeding
The single sign of prediabetes is elevated blood glucose on a blood test that is not high enough to be classified as type 2 diabetes mellitus.
Treatment / Management
The most important management in prediabetes is a lifestyle change and weight loss.
Approximately 70% of people with prediabetes will go on to be diagnosed with diabetes mellitus. However, this is not inevitable. Prediabetes managed appropriately can prevent diabetes mellitus and lower the risk of cardiovascular disease.
Some patients will need to take some medications. These patients include those that have failed to maintain adequate lifestyle therapy or are at high-risk for developing type 2 diabetes. The most common medications used for prediabetes is metformin, which will help prevent the development of diabetes mellitus.
What is Insulin Resistance?
Everyone has glucose, a type of sugar, in their blood at all times. Sugar is a source of energy—it can supply the cells in your body with the energy they need to perform critical functions, ranging from powering your brain to fueling your muscles during high intensity exercise.
When eating a typical Indian diet, most of the sugar in your blood comes from a particular food source—carbohydrates, also called carbs. Starchy foods such as bread, potatoes, pasta, rice, baked goods and table sugar are commonly referred to as carbs, but “carbs” actually refers to a type of molecule inside these foods. There are also high levels of carbohydrate molecules in most fruit, fruit juices and sugary beverages.
During digestion, your body breaks down these chains of sugar units into pieces that it can absorb. That’s why when you eat foods containing carbs, it raises your blood glucose.
The Role of Insulin
Once this sugar has been absorbed into your bloodstream, it needs to get inside your cells. That’s where insulin comes into play. Insulin is a chemical messenger produced by your body. Insulin helps move the sugar from out of your blood into your cells, so that it can be used for energy.
So each time you eat and your blood sugar rises, your body releases insulin in order to move the sugar into the cells. But if for some reason the body stops responding to the signal of insulin, then the sugar cannot adequately enter your cells, and so it stays in your blood. This causes high blood sugar.
Insulin Resistance
Type 2 diabetes is caused by insulin resistance, a condition in which cells stop responding properly to the signal of insulin. While the root causes of insulin resistance are not fully understood, the bottom line is that adding more insulin does not fix the underlying problem. While your insulin will still rise in response to eating food, since your cells are not responding to its signal, your blood sugar cannot be moved into cells effectively. This leaves you with both high blood sugar and high insulin.
Insulin resistance is associated with many health problems in addition to type 2 diabetes and prediabetes, including metabolic syndrome, polycystic ovary syndrome (PCOS), atherosclerotic heart disease, fatty liver disease, and more.
How is prediabetes reversed?
Our Personalized Health Coaching Program offers a proven approach to combat insulin resistance and prediabetes. Through personalized guidance for nutrition, exercise and other lifestyle modifications, we empower individuals to reclaim control over their metabolic health.
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Join us on this transformative journey towards optimal metabolic health.