Prediabetes

A condition in which the blood sugar level is slightly higher than normal but not yet alarmingly high enough to be categorized as type 2 diabetes is called Prediabetes.

If you are showing signs of prediabetes that is left untreated or without a medical interference, it may already start contributing to the damage of your heart and circulatory system.

As long-term prediabetes is most likely to become type 2 diabetes in about 10 years or less. Being diagnosed with prediabetes is actually a good opportunity to make healthy lifestyle changes so that it will not lead to a full blown type 2 diabetes.

You would need to make dietary adjustments by eating heathy foods in moderation, engaging in regular physical activity or exercise which will help you lose weight if necessary or maintain your idea weight if already achieved.

Starting the right interventions early would facilitate the normalization of your blood sugar level.

Prediabetes does not have any signs and symptoms unless blood sugar level is checked which will appear higher than normal. But checking the blood sugar level may have arisen due to another condition since it is not part of the basic vital signs.

Since prediabetes has no symptoms then you would need to be knowledgeable of the early signs and symptoms of type 2 diabetes which means that the prediabetes has progressed.

One possible early sign of type 2 diabetes is darkening of certain areas of the body, called acanthosis nigricans, such as the neck, armpits, elbows, knees and knuckles.

Additional warning signs that diabetes has developed are as follows: increased need to drink or thirst, frequent urination, fatigue, and blurred vision.

If you are concerns that you might have diabetes due to family history or your possible lifestyle then it is important for you to be knowledgeable about the symptoms of diabetes which will prompt you to see a doctor should you observe such symptoms manifesting.

Other predispositions to the development of type 2 diabetes from prediabetes are:

• being overweight which means that you have a body mass index above 25
• lack of physical activity at age 45 or older
• you have a family history of diabetes
• you are African-American, Hispanic, American Indian, Asian-American or a Pacific Islander, occurrence of gestational diabetes when you were pregnant or when you delivered a baby who weighed more than 9 pounds (4.1 kilograms)
• you have polycystic ovary syndrome which is characterized by an irregular menstrual cycle
• excessive growth and obesity, you have an elevated blood pressure,
• and your high-density lipoprotein (HDL) cholesterol is below 35 milligrams per deciliter (mg/dL) (0.9 millimoles per liter, or mmol/L) or a triglyceride level is above 250 mg/dL (2.83 mmol/L)

Upon consulting a doctor about possibly having diabetes, a blood glucose screening may be performed.

Continuous studies are still being conducted to find out the exact cause of prediabetes as currently it is still not a known or definite fact.

Although having a family history and genetics, as some studies found that some genes are associated with insulin resistance, seem to predispose an individual to the development of prediabetes.

Other factors that plays an important role in the development of prediabetes are excess fat, or abnormally high level of fat, and inactivity of lack of regular physical activity.

A known fact is that individuals with prediabetes have impaired capacity to process glucose which results to the build-up in the bloodstream instead of facilitating normal cell function for muscles and other tissues.

Majority of the body’s glucose content is from the food we eat, specifically from carbohydrates. The broken down particles of sugar in the bloodstream brought about by digestion is used to fuel cell function, entry of sugar to the cell to perform its intended function is facilitated by insulin.

When you eat, your pancreas discharges insulin into your bloodstream which causes decreased sugar level in the blood as it acts as a transporter of sugar to the cell to be use as a source of energy for cell functions. When a person has prediabetes, this normal process is slowly being impaired which leads to an increase blood sugar level since sugar is not transported to the cells.

This happens when there is a decrease secretion of insulin by the pancreas or your cells become unaffected to the normal action of insulin or may be both.

There are several diagnostic tests that can be performed to confirm prediabetes.

Upon seeing your family doctor, you might be referred to an endocrinologist which is a doctor that specializes in diabetes treatment. To be able to maximize the time spent with the doctor and not waste any time, here are some things to know about on how you can best prepare for your appointment.

Ask ahead of time if there is any restrictions that you would need to do prior to the appointment. If a fasting blood sugar test is to be performed, then you will be asked to not eat or drink anything for at least eight hours prior to your appointment.

Prepare a list of all the symptoms that you presenting and including all those that you feel may not be related to the condition, also write down the medications that you have taken or will be taking including supplements and vitamins.

For better management and coping with the condition, it is beneficial to understand it hence ask your doctor questions that you might find confusing or is concerned about regarding prediabetes, and such questions may be as follows:

• What are the preventive measures that I can employ to stop prediabetes from turning to a type 2 diabetes?
• Is there a recommend treatment? If there are available medications, what are the side effects?
• How will I manage prediabetes with my other underlying condition including treatment?
• What is the recommended physical activity or exercise per week that I would need to employ?
• Would there be any dietary restrictions?
• Can I still eat desert and other food with sugar?
• Would it help to consult with a dietician?
• Are there available reading materials that I can take home and study?
• What other resources would you recommend for me to better understand Prediabetes?

As part of the doctor’s assessment, questions would also be asked to you such as:

• Has there been any changes in weight lately?
• Do you have a routine physical activity?
• If so, what is the duration and frequency of your exercise regimen?
• Is there anyone in your family that has diabetes?

According to the American Diabetes Association, the following individuals should undergo blood glucose screening as they are at a higher risk of developing prediabetes or type 2 diabetes, people who at 45 years old or even younger, obese individuals which have a body mass index of 25, an inactive person with a family history of diabetes or prediabetes, have a history of gestational diabetes or those who have given birth to a baby that weights 9 pound or heavier, have a history of an underlying condition such as polycystic ovary syndrome, hypertension, abnormally high cholesterol levels. There are several diagnostic tests that can be performed to confirm prediabetes.

Diagnostic tests include (a) Glycated hemoglobin (A1C) test, is a blood test that shows your average blood sugar level for the past two to three months. The significance of this test is to see the percentage of blood sugar attached to the oxygen-carrying protein in red blood cells (hemoglobin).

An increased blood sugar levels, leads to more hemoglobin with sugar attached. A normal A1C should be below 5.7 percent as an A1C level of 5.7 to 6.4 percent is considered prediabetes. A level of 6.5 percent or higher on two consecutive blood tests confirms diabetes.

Pregnancy or having an unusual form of hemoglobin (known as a hemoglobin variant) will provide inaccurate A1C results.

Another test to confirm prediabetes is (b) Fasting blood sugar test, would require a blood sample to be drawn after you have fasted for at least 8 hours or overnight.

A normal blood sugar level is lower than 100 milligrams per deciliter (mg/dL) or 5.6 millimoles per liter (mmol/L). A blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) would confirm prediabetes which is called impaired fasting glucose (IFG). While, a blood sugar level of 126 mg/dL (7.0 mmol/L) or more may signify diabetes mellitus. (c) Oral glucose tolerance test is not the diagnostic test of choice except for pregnant women.

Blood will be drawn after fasting for at least eight hours or overnight after which you'll be asked to drink a sugary solution, and your blood sugar level will be measured again after two hours. After the test, a blood sugar level less than 140 mg/dL (7.8 mmol/L) is normal.

While prediabetes will be suspected if the blood sugar level is from 140 to 199 mg/dL (7.8 to 11.0 mmol/L) which is called impaired glucose tolerance (IGT). A blood sugar level of 200 mg/dL (11.1 mmol/L) or more is considered as having diabetes mellitus.

After undergoing tests and your blood sugar level is within the normal range then your doctor will recommend further screening every three months to monitor changes.

Prediabetes treatment is characterized by a healthy lifestyle plan, managed by you and your doctor.

A key management for prediabetes is engaging into healthy lifestyle that aims to improve your blood sugar level by bringing it to the normal range and prevent progression of the condition to a full-blown type 2 diabetes.

However, in some instances although the person with prediabetes lose weight they still develop type 2 diabetes and this may be due to a few factors.

Recommended management to prevent prediabetes from developing to type 2 diabetes include:

• Eating healthy foods. It is best to have foods that are low in fat and calories and high in fiber such as fruits, vegetables and whole grains.
• Look for ways to consume healthier food options which can be referred to as Mediterranean-style diet.
• Getting more physical activity.
• Develop a routine physical activity, with the goal of 30 to 60 minutes of moderate physical activity most days of the week.
• Strive not to have more than two days go by without some physical activity.
• Look for ways to be more mobile such as take a brisk walk daily, ride your bike, and swim laps.
• If your schedule will not permit a long workout then take smaller sessions spread out during day

The American Diabetes Association also recommends resistance training, such as weightlifting, at least twice a week. If you're overweight, it is recommended to lose about 5 to 10 percent of your body weight or about 10 to 20 pounds (4.5 to 9 kilograms) especially if you weigh 200 pounds (91 kilograms), as this will help decrease the risk of developing type 2 diabetes.

To maintain your ideal weight, aim to permanently employ the life style changes that you have started such as eating healthily and moderately and regularly engaging in exercise.

Look for ways to motivate yourself by go back to why you are making the changes as well as looking forward to the benefits of losing weight, such as a healthier heart, more energy and improved self-esteem and over-all comfort of living.

There are instances wherein medication would need to be prescribed such as oral diabetes drug called metformin (Glucophage)if you're doctor believes that you are at a greater risk of having diabetes.

This includes people whose body mass index is over 35, people who are younger than 60 years and women with a history of gestational diabetes. Additional medications that may be prescribed are those that would help control cholesterol and high blood pressure.

Major predisposition to prediabetes is unhealthy lifestyle habits hence making better and healthy lifestyle choices will prevent the development of prediabetes. Also it will prevent the progression to type 2 diabetes.

You would need to choose healthier food options, engage in regular physical activity or exercise and lose weight if not within your idea weight.

Once you have started making healthy decisions on nutrition and exercise, it would be best to permanently make it as a new lifestyle choice.

The available alternative remedies for prediabetes are as follows:

• cassia cinnamon,
• chromium,
• coenzyme Q10,
• ginseng,
• glucomannan,
• guar gum,
• gymnema,
• magnesium,
• prickly pear cactus,
• soy and stevia.

There have been reports on their positive effect to prevent progression of prediabetes to type 2 diabetes.

Although some of the remedies have shown promise in the early stage of studies but there are still no definitive report on its effectivity, Hence if you have plans of using alternative remedies it would be best to talk to your doctor first if it will not be contraindicated with your other medications and also be advised of its possible side effects if any.

You can follow some of these lifestyle tips to reduce your prediabetes:

• choose healthier carbohydrates such as fruits, vegetables and whole grains,
• keep food in proportion,
• get enough fiber that can be found in oats and beans to slow down the rise in the blood sugar,
• exercise regularly to help with weight loss.

The same factors that increase the risk of developing type 2 diabetes increase the risk of developing prediabetes, including:

• Being overweight is the main risk factor for prediabetes, since the more fatty tissue you have the more resistant your cells become to insulin.
• Inactivity, since physical activity helps you control your weight resulting to the cells increased sensitivity to insulin.
• Age. Prediabetes can happen at any age but people who are 45 years old and order are more at risk to it.
• Family history. The risk of prediabetes is greater if a parent or sibling has type 2 diabetes.
• Race. Although the reason is unknown but certain races are more predisposed to developing prediabetes, including African-Americans, Hispanics, American Indians, Asian-Americans and Pacific Islanders.
• Gestational diabetes. You are at a greater risk of developing prediabetes if you have experienced gestational diabetes while pregnant.
• Polycystic ovary syndrome, puts women at risk of developing prediabetes.
• Sleep problems. People who work changing shifts or night shifts, possibly causing sleep problems, also may have an increased risk of prediabetes or type 2 diabetes.
• Additional medical conditions related to diabetes include: High blood pressure and High cholesterol level.