What is prediabetes and how is it diagnosed?


Prediabetes is a term used to indicate the presence of higher than normal blood glucose levels.

If identified early, the onset of diabetes can be delayed and even prevented. But how can this be achieved? Are there signs or symptoms that indicate its presence? What can be done to avoid this condition? Here we review everything about prediabetes.

Although blood sugar levels are high in prediabetes, they are not high enough to be diagnosed as diabetes.

Diabetes is a chronic disease that affects the use of glucose, the main type of sugar in the blood, whose function is to act as a source of energy or fuel for the body.

To distribute glucose between cells, and thus provide them with energy, our body uses a hormone called insulin, produced by the pancreas. When this is not enough or does not work properly, it gives rise to the different types of diabetes:

  • Diabetes type 1: is an autoimmune disease, which occurs because the immune system mistakenly attacks and eliminates the insulin-producing cells in the pancreas.
  • Type 2 diabetes: represents more than 90% of diabetes cases. In this type the body is not able to use insulin properly.
  • Gestational diabetes: appears in pregnant women who have never had diabetes. When this occurs, the baby is at increased risk for health complications. Although gestational diabetes usually goes away after delivery, it can increase the mother’s or child’s risk of developing type 2 diabetes in the future.

How prediabetes is diagnosed

The exact cause(s) of prediabetes is not known, although family history and genetics appear to be important factors. What is clear is that people with prediabetes can no longer process sugar properly.

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  • Common questions about type 2 diabetes

Generally, this condition has no warning signs, although in some cases certain symptoms may indicate prediabetes:

  • Increased thirst.
  • Increased hunger.
  • Numbness or tingling of the feet and hands.
  • Fatigue.
  • Frequent infections.
  • Sores or wounds that are slow to heal.
  • Frequent urination.
  • Darkening of the skin, mainly in the neck, armpits and groin.
  • Unintentional weight loss.
  • Blurry vision.

Therefore, the best way to know if you have prediabetes or diabetes is by testing for them. Although health professionals commonly advised performing these tests around the age of 45, this recommendation changed due to the increasing incidence of diabetes.

Currently, anyone with risk factors such as being overweight, a family history of diabetes, sedentary habits, or high blood pressure, cholesterol, or triglycerides is advised to get tested. There are different options to know if there is prediabetes:

blood sugar test

For this analysis, a blood sample is taken after fasting for at least eight hours or, preferably, an overnight fast. Depending on the results of the analysis, it is considered:

  • Normal: fasting blood glucose level below 100 milligrams per deciliter (mg/dl).
  • prediabetes: fasting blood glucose level between 100 and 125 mg/dL.
  • Diabetes: fasting blood glucose level of 126 mg/dL or higher.

Glycosylated Hemoglobin Test

The glycosylated hemoglobin test, also known as A1c or HbA1c, is used to find out the average blood glucose level for the last three months. To do this, the percentage of blood glucose bound to the oxygen-carrying protein in red blood cells, called hemoglobin, is measured.

The higher the blood glucose level, the greater the amount of hemoglobin with sugar. Is considered:

  • Normal: A1c or HbA1c level below 5.7%.
  • prediabetes: A1c or HbA1c level between 5.7 and 6.4%.
  • Diabetes: A1c or HbA1c level of 6.5% or more.
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Experts warn that certain conditions can make this test inaccurate, such as having an unusual type of hemoglobin or being pregnant.

Oral glucose tolerance test

The glucose tolerance test, also known as the oral glucose tolerance test, is used to measure the body’s response to glucose. Although it is used to detect type 2 diabetes, it is commonly used to diagnose prediabetes and gestational diabetes.

A blood sample is taken after fasting for at least eight hours or overnight, then a sugar solution is given and the blood glucose level is measured after a couple of hours. Is considered:

  • Normal: blood glucose level less than 140 mg/dl.
  • prediabetes: blood glucose level between 140 and 199 mg/dl.
  • Diabetes: blood glucose level of 200 mg/dl or more.

How prediabetes is treated

To control or prevent prediabetes, experts recommend adopting a healthy lifestyle. Incorporating these habits can also help delay or prevent the onset of type 2 diabetes:

keep a healthy weight

Being overweight, especially when it is distributed in the abdominal area, increases the risk of developing diabetes. Specialists advise losing between 5 and 10% of the excess weight, not regaining it and maintaining it in the long term. This can also provide protection against other types of health problems.

have a healthy diet

Eating the right foods is helpful in controlling your blood glucose level and helping you lose excess weight. Among the best options are:

  • Fruits and vegetables: citrus fruits, berries, apples, pineapples, grapes, kiwis, green leafy vegetables, such as chard, spinach, broccoli or kale and other non-starchy options.
  • Fiber: herbs and spices, such as cilantro or oregano, legumes, such as lentils, peas, peanuts, and beans, or fruits and grains.
  • healthy fats: fish, such as tuna, mackerel, salmon, sardines, and trout, flaxseed or flaxseed oil, nuts, chia seeds, canola, olive, or soybean oils, and avocado.
  • infusions: cinnamon, turmeric, fenugreek, hibiscus, or ginger.
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In the same way that some foods are beneficial to prevent diabetes, others can favor its appearance or worsen it. Limit or eliminate from the diet:

  • Added sugars (which are usually present in processed foods).
  • Refined products, such as flour or white rice.
  • Soft drinks, sodas or industrial juices.
  • Red meat, especially processed meat, and sausages.
  • Do exercise

    Physical activity fulfills a double function for people with prediabetes, since it increases the consumption of glucose by the body, and stimulates the muscle fibers, favoring the transport of sugar into the cells. Try bicycling, swimming, or even walking.

    Although all types of movement are shown to be positive when it comes to preventing type 2 diabetes, the greatest benefits are seen in activities of moderate intensity.

    Experts warn that sedentary or overweight people who start exercising, start from lower to higher intensity, to avoid complications.

    To avoid the use of tobacco

    Nicotine and certain chemicals found in cigarettes damage cells, cause inflammation, affect insulin response, and increase the risk of increased abdominal fat, all risk factors for type 2 diabetes.

    Take the necessary medications

    If you have prediabetes and are at high risk of developing type 2 diabetes, your doctor may recommend certain medications, such as metformin (Glumetza). Drugs to control cholesterol and high blood pressure may also be prescribed.

    Remember: If prediabetes is not treated, it can progress to type 2 diabetes, which implies a higher risk of developing other health complications:

    • Stroke.
    • High cholesterol.
    • Nerve damage.
    • Eye damage, including loss of vision.
    • Heart disease.
    • fatty liver disease
    • Renal disease.
    • Arterial hypertension.
    • Amputations.
    • Sources consulted: American Diabetes Association, US National Library of Medicine, Mayo Clinic, National Institute of Diabetes and Digestive and Kidney Diseases.





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