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Prediabetes occurs when blood sugar levels rise above normal but are not yet high enough for a diabetes diagnosis. This stage is a critical threshold between normal blood sugar levels and the onset of type 2 diabetes. Adults with prediabetes often show no symptoms, despite having elevated blood sugar.
Causes of prediabetes
Hyperglycaemia prompts the pancreatic beta cells to produce and release more insulin. Over time, constant exposure to high insulin levels reduces the effectiveness of insulin receptors, which are essential for allowing glucose into cells.
When these receptors do not function properly, hyperglycaemia worsens, leading to further metabolic disturbances and increasing the risk of developing type 2 diabetes and metabolic syndrome.
In prediabetes, this process is less advanced but marks the beginning of a potentially dangerous metabolic cascade. Normal blood glucose levels typically range from 70-99 mg/dL (3.9-5.5 mmol/L), but in prediabetes, they are usually between 110-125 mg/dL (5.6-6.9 mmol/L). Although elevated, these levels do not yet qualify for a diabetes diagnosis, leaving many people unaware they have prediabetes.
Prediabetes is a crucial warning sign, signalling the need for immediate action and informed choices. While it may seem subtle, this phase offers a significant opportunity for intervention and lifestyle changes, which could prevent the progression to diabetes.
Signs and symptoms of prediabetes
Most individuals with prediabetes often do not display symptoms. However, in a small number of cases, symptoms that occur include increased appetite, unexplained weight loss, elevated BMI (body mass index), weakness or fatigue, sweating, blurry vision, delayed healing of wounds or bruises, and recurring skin infections or gum bleeding.
Risk factors for prediabetes
Unchangeable risk factors include:
- Family history (parent or sibling with diabetes)
- Age
- Ethnicity
Modifiable risk factors include:
- Being overweight or obesity
- Sedentary lifestyle or physical inactivity
- Pre-existing health conditions like high blood pressure, high cholesterol levels, polycystic ovary syndrome (PCOS)
- History of gestational diabetes (during pregnancy)
Diagnosis of prediabetes
Prediabetes can be identified by three testing methods:
| Test | Purpose | Results |
| HbA1C |
Measures average blood sugar levels over the past 2 to 3 months |
|
| Fasting blood glucose test |
Typically done in the morning after an eight-hour fast and measures blood sugar levels |
|
| Oral glucose tolerance test |
Measures blood sugar before and two hours after drinking a sugary drink |
|
Treatment and management of prediabetes
Studies have shown that prediabetes is associated with a higher risk of mortality and increased rates of cardiovascular events, with an additional 7.36 deaths and 8.75 heart disease cases per 10,000 person-years over 6.6 years.
This highlights the importance of not overlooking prediabetes, as the risk factors can have a significant impact on one’s life. Diabetes can affect every major organ in the body, leading to serious complications and nerve damage, potentially resulting in amputation.
The good news is that intentional lifestyle changes can effectively prevent diabetes. Prediabetes is often reversible with lifestyle changes and appropriate interventions, and the onset of diabetes can be delayed. Many people with prediabetes can return their blood glucose levels to a normal range, reducing their risk of progressing to type 2 diabetes.
Lifestyle modifications such as improving eating habits, managing weight, and increasing physical activity can significantly reduce the risk of developing insulin resistance or prediabetes. To get started, consider making the following changes:
- Increase physical activity (≥150 min/week)
- Practice calorie restriction by eating a healthier diet
- Lose 5% - 10% of body weight
- Quit or reduce smoking
- Manage stress
In some cases, medications like Metformin may also be recommended to help manage prediabetes.
Prevention of prediabetes
A three-part strategy for prediabetes prevention includes weight loss, be more physically active, and eating healthier. By incorporating these practices into your daily routine, you can significantly reduce your risk of developing prediabetes and promote overall health.
Make an appointment at Gleneagles Hospitals
Take charge of your health with small but powerful lifestyle changes. Whether it is through mindful eating, regular exercise, or timely medical advice, each step you take today is an investment in your future well-being. It is not just about preventing diabetes but also about cultivating a life full of health and vitality.
Contact us to book an appointment for diabetes screening tests or visit your nearest Gleneagles Hospital for a consultation.
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