1. Introduction
We're sure you have heard of diabetes by now, or know someone who has been diagnosed with diabetes, and you are here for a reason. But what is Pre-diabetes?
At Imperial College London Diabetes & Endocrine Centre we can help you understand more about both prediabetes and diabetes and how to manage the condition for you or a loved one if diagnosed.
2. Prediabetes, its Progression and Complications
Prediabetes is an intermediate stage between normal glycemia (normal blood glucose levels) (1) and type 2 diabetes, where blood sugar levels are higher than normal but not yet high enough to be classified as diabetes. The term prediabetes is used to identify those individuals who are at risk for future diabetes. Prediabetes is also associated with a high burden of cardiometabolic risk factors and is associated with poor outcomes (2) overall in health, particularly long-term if left untreated, mainly because it can develop into Type 2 Diabetes. Diabetes on the other hand is the condition where our bodies have trouble managing blood sugar levels (and by sugar we mean glucose again, just like in prediabetes) (3).
There are certain blood glucose ranges that are internationally set for our normal glucose range based on age, other diseases, complications, pregnancy and such factors (4). Our body usually can maintain elevated blood glucose levels (yes, even if we want a doughnut!), through complex biological mechanisms. Many hormones are involved, but one of the main hormones primarily responsible for this regulation, is insulin. When our bodies get to the stage where there is no more insulin endogenously (inside our bodies), your doctor will prescribe insulin therapy, and we have to inject it (exogenously, from outside the body) to inside of the body to replace the insulin we no longer have and to mimic natural hormone regulation of glucose in our bodies.
If left untreated, prediabetes might not feel like a big deal, but it’s setting you up for a future full of complications — some of which can be serious. Think heart disease, stroke, kidney damage, nerve problems, and vision issues. If you think of prediabetes as the ‘before’ picture, diabetes is the ‘after’ — so let’s act before it’s too late. But how do we know if we have prediabetes?
3. How Do I know I Have Prediabetes?
Signs & Symptoms
Here’s the tricky part. Unlike diabetes, there are often no symptoms. Prediabetes is a bit cheeky like that. There are subtle signs and signals that can be easily missed if you are not looking for them. For example:
To make matters even more tricky, many people don’t experience any symptoms at all. So, the real key is getting tested. That’s the best way to find out!
Diagnosis
How do doctors figure out if you have prediabetes? The most important test is the measurement of your blood sugar (glucose). The three main tests are:
4. Treating and Managing Prediabetes
Let’s remember that prediabetes comes before diabetes, and it really wants us to pay attention to our body before we get diabetes permanently. While medication isn't usually necessary for prediabetes, some people might be prescribed Metformin (a diabetes medication) to help manage blood sugar (glucose). However, if you can make lifestyle changes and reverse prediabetes, you might avoid needing medication altogether.
It's like being at the top of a hill — you’re not quite at the bottom, but you’re very close to rolling down that slope, and if you catch ourself at the right point, and follow your treating physician’s advice and the clinical teams of Dieticians and Diabetes Educators, there is a good chance of treating prediabetes and stopping its progression to Type 2 diabetes.
So, prediabetes doesn’t have to become diabetes. You can hit the brakes before it’s too late and take charge of your health:
5. The Good News
While serious, it doesn’t mean you’re set to a future filled with needles and restrictive diets. In fact, if you catch it early, you can reverse it. Prediabetes is a physiological state that you can imagine is more like an early warning system for diabetes. It clearly says to us “Hey, pay attention!”
Prediabetes is not the end of the world. Sure, it can be a wake-up call, but it’s also a chance to make meaningful changes to your health. Many people with prediabetes manage to keep their blood sugar in check and prevent diabetes — and you can, too. With a little effort and a lot of positive choices, you can live a healthy, happy life without worrying about what might come next. For some people with prediabetes, early treatment as well as moderate lifestyle changes can actually return blood glucose (blood sugar) levels to a normal range, effectively preventing or delaying type 2 diabetes. Ask your doctor plenty of questions and listen to their answers. Increase your daily physical activity. Start eating healthy. And your life can be yours again (1).
6. Concluding Words
Don’t wait for a wake-up call. Make the changes now and start living your healthiest life!
At Imperial College London Diabetes & Endocrine Centre, we understand that there is so much information out there and we want to help improve the understanding of this information, and to ensure we translate this into accurate, correct and useful practical everyday life knowledge.
You have the power to stop prediabetes in its tracks!
References:
Prediabetes is diagnosed through a blood test. Doctors typically check your fasting blood sugar levels, A1C levels, or perform an Oral Glucose Tolerance Test to determine if your blood sugar is higher than normal.
Normal A1C levels are below 5.7%. If your A1C is between 5.7% and 6.4%, you are considered to be in the prediabetes range. An A1C level above 6.4% indicates diabetes.
Yes, stress can lead to increased cortisol levels, which can cause blood sugar spikes. Managing stress through relaxation techniques can help keep your blood sugar levels in check.
Highly processed foods, sugary snacks, white bread, and soda can cause blood sugar spikes. It is better to opt for whole foods such as vegetables, lean proteins, and whole grains.
Fasting can be safe for some individuals, but it is best to consult a doctor. Skipping meals can cause blood sugar dips or spikes, so it is important to approach fasting with caution.
Aim for at least 30 minutes of moderate-intensity activity, such as brisk walking, five days a week. Additionally, strength training twice a week is beneficial.
To lower your risk for prediabetes, focus on eating a healthy diet, exercising regularly, maintaining a healthy weight, and managing stress. Regular checkups can also help catch early signs.
Bananas and grapes are safe to consume in moderation, but dates are higher in sugar. It is best to eat fruits with a low glycemic index and control portions.
After being diagnosed with prediabetes, start by making small lifestyle changes such as eating healthier, getting more physical activity, and considering working with a healthcare professional to create a personalised plan.
Yes, in many cases, prediabetes can be reversed with the right lifestyle changes, including weight loss, healthy eating, and regular exercise, allowing you to return to normal blood sugar levels.
