As we know the prevalence of diabetes is rising rapidly. This is particularly true in case of prediabetes which is not exactly a disease per se but is a condition in which blood sugar levels are higher than normal. The increase in prevalence is estimated to be >470 million people worldwide by the year 2030.
Prediabetes can be a risk of developing type 2 diabetes mellitus and other related health issues as well, if not managed with appropriate interventions. It might not show any symptoms beforehand, which is why it is important to have regular blood sugar testing. It is observed in a 13-year study (British Whitehall II study) that, two pathological abnormalities such as insulin resistance and beta-cell dysfunction can exist even before the onset of diabetes (diagnosed after 13 years).
Diagnosis
According to WHO, diabetes is measured in two states, impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) based on a 2-h oral glucose tolerance test.
Those having IFG in the range of 100-125 mg/DL, IGT in 140-199 mg/dL range along with another clinical variable, hemoglobin A1c (A1c), which shows the average glucose levels over the last 3 months in the range of 5.7-6.4% have prediabetes. WHO has termed prediabetes as ‘Intermediate Hyperglycaemia’.
Common Symptoms
Although prediabetic people often don’t have symptoms, a few of the subtle symptoms that are not necessarily present but can be noticed are
- Increased thirst
- Itchy skin
- Frequent urination
- Blurry vision
- Fatigue
- Recurring infections, and
- Abnormal hunger levels – Hyperphagia or polyphagia
With no glucose uptake by cells, there will be no or less production of energy in the cells. This process triggers excessive hunger (hyperphagia), due to which abnormally high amounts of foods are consumed and sometimes in more intervals (polyphagia).
Polyphagia is an abnormally increased appetite, often accompanied by excessive hunger and the urge to eat more than usual hyperphagia, on the other hand, refers to an excessive or insatiable appetite, regardless of whether it is normal or abnormal.
Risks Leading To Prediabetes
Other risk factors that lead to prediabetes include being overweight or obese, having a family history of diabetes, gestational diabetes, being physically inactive, and having other lifestyle conditions such as high blood pressure or high cholesterol.
Are There Any Treatments For Prediabetes?
Making lifestyle modifications has shown a 40-70% reduction in the risks leading to diabetes. Treatment for prediabetes typically involves making lifestyle changes that may include losing weight (every 1 kg reduction in weight reduces the risk by 16%; Hamman et al., 2006), increasing physical activity, and making dietary changes (such reducing fat intake to <30%, of which <10% being saturated fat, avoiding high sugary foods, etc). Depending on the case, along with the above modifiable factors, medications may also be prescribed to help manage blood sugar levels.
Prediabetes is a warning call to reverse the blood sugar levels to normal (normoglycemia) and avoid a myriad of associated diseases.
Author: Praveena Kuchipudi (INFS Faculty)
References
- Rett, K. and Gottwald-Hostalek, U. (2019) ‘Understanding prediabetes: definition, prevalence, burden and treatment options for an emerging disease’, Current Medical Research and Opinion, 35(9), pp. 1529–1534. doi: 10.1080/03007995.2019.1601455.
- Tabák, A. G. et al. (2012) ‘Prediabetes: A high-risk state for developing diabetes’, Lancet, 379(9833), p. 2279. doi: 10.1016/S0140-6736(12)60283-9.
- Zand, A., Ibrahim, K. and Patham, B. (2018) ‘Prediabetes: Why Should We Care?’, Methodist DeBakey Cardiovascular Journal, 14(4), p. 289. Doi: 10.14797/MDCJ-14-4-289.
- Tabák, A. G., Jokela, M., Akbaraly, T. N., Brunner, E. J., Kivimäki, M., & Witte, D. R. (2009) ‘Trajectories of glycaemia, insulin sensitivity, and insulin secretion before diagnosis of type 2 diabetes: an analysis from the Whitehall II study’, Lancet (London, England), 373(9682), pp 2215–2221. doi: 10.1016/S0140-6736(09)60619-X.
