Pre-diabetes means that your blood sugar level is higher than normal but not yet high enough to be classified as type 2 diabetes. Often it causes no symptoms but without lifestyle intervention pre-diabetes is likely to become type 2 diabetes in 10 years or less. If you have pre-diabetes long-term damage to your heart and circulatory system may already have started.
However there is good new! This can be the opportunity for you to improve your lifestyle and your general health. Progression from pre-diabetes to type 2 diabetes isn't inevitable, and the changes in lifestyle will reduce the risk of many other diseases.
Changes, such as eating healthy foods, taking regular exercise and maintaining a healthy weight can often bring your blood sugar level back to normal.
Who should get tested?
Ask your doctor if you're concerned you are increased risk of diabetes or if you notice any signs or symptoms suggesting diabetes such as increased thirst and frequent urination, fatigue, or blurred vision.
You are at more risk if
- You're overweight, with a body mass index above 25, especially above 30, or if you can “pinch more than an inch”
- You're inactive
- You're age 45 or older
- You have a family history of type 2 diabetes
- You're Black Caribbean, Asian or a Pacific Islander
- You developed gestational diabetes when you were pregnant or gave birth to a baby who weighed more than 9 pounds (4.1 kilograms)
- You have polycystic ovary syndrome — a condition characterized by irregular menstrual periods, excess hair growth and obesity
- You have high blood pressure
The exact cause of pre-diabetes is unknown although genetics appears to play an important role. Excess fat, especially abdominal, and inactivity also seem to be important factors.
What is clear is that people who have pre-diabetes aren't quite processing sugar (glucose) properly anymore. This causes sugar to build up in the bloodstream instead of doing its normal job of fuelling the cells that make up muscles and other tissues.
Most of the glucose in your body comes from the foods you eat, specifically foods that contain carbohydrates. Any food that contains carbohydrates, such as potato, rice, pasta and bread/flour, can affect your blood sugar levels, not just sweet foods.
During digestion, sugar enters your bloodstream, and with the help of insulin, it enters the body's cells where it is utilized as a source of energy.
When you have pre-diabetes this process begins to work improperly. Instead of fuelling your cells sugar builds up in your bloodstream. This occurs when your pancreas doesn't make enough insulin, or your cells become resistant to the action of insulin, or both.
Other conditions associated with diabetes include:
- High blood pressure
- Low levels of HDL, or the "good," cholesterol
- High levels of triglycerides — a type of fat in your blood
When these conditions occur alongside obesity they are associated with resistance to insulin. The combination of three or more of these conditions is often referred to as the metabolic syndrome.
Progression to type 2 diabetes is the most serious consequence of untreated pre-diabetes because type 2 diabetes can lead to other complications, such as:
- High blood pressure
- High cholesterol
- Heart disease
- Kidney disease
If you have pre-diabetes ongoing surveillance will be suggested. For example, your doctor will recheck your HbA1c and BP at least once a year. Cholesterol and other lipids may also need attention.
If you have pre-diabetes healthy lifestyle choices can help you bring your blood sugar level back to normal or at least keep it from rising toward the levels seen in type 2 diabetes. However, some people will progress to type 2 diabetes even if they lose weight. Recommendations to help keep pre-diabetes from progressing to type 2 diabetes include:
- Eating healthy foods. Choose foods low in fat and calories, and be careful of too much sugars and carbohydrates. Focus on vegetables and whole grains. This type of diet may be referred to as a Mediterranean-style diet.
- Getting more physical activity. Aim for 30 to 60 minutes of moderate physical activity most days of the week, keeping warm and a little puffy as you do it. Try not to let more than two days go by without some exercise. For example take a brisk walk, ride your bike, swim lengths. If you can't manage at least 30 minutes in one go break it up into smaller sessions spread throughout the day.
- Losing excess pounds. If you're overweight losing just 5 to 10 percent of your body weight can significantly reduce the risk of developing type 2 diabetes. To keep your weight in a healthy range work on permanent changes to your eating and exercise habits. Motivate yourself by remembering the benefits of losing weight, such as a healthier heart, more energy and improved self-esteem.
Healthy lifestyle choices can help you prevent pre-diabetes and its progression to type 2 diabetes even if diabetes runs in your family. There are also many other health benefits from making these choices.
- Eat healthy foods.
- Get more physical activity.
- Lose the excess pounds.
- Have an annual BP check and blood test for diabetes
Remember, the more you practice the luckier you get!