What is pre-diabetes?
Pre-diabetes means that your blood glucose (sugar) level is higher than normal but not quite high enough for you to be diagnosed with diabetes or require frequent use of diabetes testing supplies, such as a diabetes meter. It does mean that you are at a higher risk of developing type 2 diabetes sometime in the future. The American Diabetes Association estimates that there are about 57 million people in the United States with pre-diabetes and that the incidence in children and adolescents is also rising.
How is pre-diabetes diagnosed?
Pre-diabetes is diagnosed by doing one of three blood tests: an A1 C test, fasting plasma glucose (FPG) test or an oral glucose tolerance test (OGTT). The A1C test can be done anytime of the day and does not require that you fast as do the other two tests. The A1C can determine what your blood glucose level has been running for about the past three months. The A1C is reported as a percentage and a level of 5.7% to 6.4% means that you have prediabetes. An A1C level under 5.7% is normal and a level of 6.5% and over indicates diabetes. The FPG requires an overnight fast and is usually done first thing in the morning before you have anything to eat or drink. A blood glucose level of 100 mg/dL to 125 mg/dL is in the pre-diabetes range. If your FPG is under 100mg/dL it is considered normal but 126 mg/dL and over is considered diabetes. The OGTT takes a little longer and you will need to fast overnight and then drink a sweet liquid. Your blood glucose level is checked before and 2 hours after drinking the liquid. Normal blood glucose is under 140 mg/dL 2 hours after drinking the liquid. If you have pre-diabetes, your 2 hour blood glucose level will be 140 mg/dL to 199 mg/dL and a level of 200 mg/dL and over indicates diabetes. Your health care provider will determine which of these tests is right for you.
Is pre-diabetes the same as borderline diabetes or "a touch of sugar"?
There are clearly defined numbers today to determine if your blood glucose level is normal or if you have pre-diabetes or diabetes. The terms borderline or "touch of sugar" are very general and don't really have a specific meaning. These terms are being used less frequently and are truly incorrect in their description. The term pre-diabetes more clearly states that your blood glucose is higher than normal and that you are at risk for developing diabetes.
What causes pre-diabetes?
Pre-diabetes can be caused by a number of factors. The risk factors for pre-diabetes are the same as the risk factors for type 2 diabetes: age, being overweight, inactivity, a parent or sibling with diabetes, a history of gestational diabetes (diabetes of pregnancy) or having had a baby over 9 lbs. at birth. If you are an African American, Native American, Asian American, Pacific Islander or Latino/Hispanic, you also have a higher risk of developing pre-diabetes or diabetes.
Let's Take a Closer Look
Pre-diabetes
When your blood glucose (sugar) rises, for instance after you eat, an organ called the pancreas senses the rise in the blood glucose. Special cells in the pancreas release a hormone called insulin. The insulin travels to the bloodstream and helps the excess glucose in the blood enter the cells where it is used to produce energy. Sometimes the body can't utilize the insulin effectively and not enough of the glucose gets transferred into the cells, so the level of glucose in the blood rises. This is called insulin resistance. In many people with pre-diabetes, the pancreas is not able to produce enough insulin to overcome this resistance. Your liver could also be overproducing glucose causing higher blood glucose levels.
Preventing Diabetes
Research has shown that preventing or delaying the progression from pre-diabetes to diabetes is possible. Doing so may allow the individual to avoid frequent use of diabetes testing supplies, such as an ACCU Chek meter or insulin pump products. A major study called the Diabetes Prevention Program proved that type 2 diabetes can be prevented or delayed by making lifestyle changes, specifically developing healthier eating patterns (here are some great diabetes recipes) and becoming more active. This study showed that 30 minutes of physical activity a day along with a loss of 5 - 10% of total body weight prevented the progression to diabetes by 58%. For a person who weighs 200 pounds, a weight loss of 10 to 20 pounds can make a difference! Although taking medication for pre-diabetes can help prevent the progression to diabetes, the study showed that weight loss, diet and exercise actually worked better. Weight loss will also help lower abnormal lipid levels, such as cholesterol, that are frequently seen in people with pre-diabetes.
Set Goals, Start Small and Build
Start by looking at what you are currently doing. What and how often are you eating? Are you physically active, do you spend a lot of time sitting and watching television, playing video games or using a computer for long periods of time? Next, think about some small changes that you can make such as making healthier food choices, eating more fruits and vegetables and cutting down on the amount of snack foods that you eat. What about activity? Spend less time on screen activities such as television and computer, move around more, take stairs instead of elevators, and try 2 or 3 short walks a day. Start small and gradually build on your successes. Invite a friend or family member to join in. Every positive change that you make, no matter how small it seems, can have an impact on your health and your future. Set small daily or weekly goals for yourself. Don't start with, "I will walk 2 miles every day this week" if you haven't been walking before. Instead, start with, "I'll walk 10 minutes a day at least 3 days this week". Set goals for the amount of screen time you'll allow yourself each day or how many servings of fruits or vegetables you'll try to include in your diet. When you've had success at reaching a goal, set a new goal or build on previous ones. Before you know it you'll be doing more than you thought possible!