Understanding borderline diabetes: Signs & symptoms

What is borderline diabetes?

Some people use the term “borderline diabetes” to refer to pre-diabetes or insulin resistance. Pre-diabetes is a term used by medical professionals and is a condition that may occur before a person develops type 2 diabetes.

Also known as impaired fasting glucose or glucose intolerance, pre-diabetes occurs when your blood sugar levels are higher than normal, but they’re not quite high enough to be considered a sign of diabetes.

During the pre-diabetes phase, your pancreas still produces enough insulin in response to ingested carbohydrates. But the insulin is less effective at removing the sugar from the bloodstream, so your blood sugar remains high. This condition is called insulin resistance. 

If you have pre-diabetes, you should know you’re not alone. In 2019, it was estimated that 96 million adults in the United States were diagnosed with pre-diabetes, which translates to around 1 in 3 adults. Having pre-diabetes doesn’t mean you’ll definitely develop diabetes. But it’s important to make positive behavioural changes to your diet and lifestyle to prevent the condition from progressing. In fact, it’s estimated that between 15% to 30% of people with pre-diabetes will develop diabetes within the next 3-5 years if no lifestyle changes are made.

Early warning signs

Someone with insulin resistance in its early stages can develop type 2 diabetes if it continues long enough. But pre-diabetes doesn’t usually cause any symptoms and only 20% of people with pre-diabetes even know they have it.

Borderline diabetes risk factors

Any of these risk factors can increase your chances of developing pre-diabetes:

·       having overweight or obesity

·       being physically inactive

·       being age 45 or older

·       having high blood pressure or high cholesterol levels

·       having a close family member with type 2 diabetes

·       having a history of heart disease, stroke, gestational diabetes, or polycystic ovary syndrome

Determining if you have borderline diabetes

Pre-diabetes is a silent condition, so getting a regular wellness check-up is important for early detection. If you think you might have borderline diabetes, it’s best to discuss your concerns with a doctor. If your GP suspects you may have pre-diabetes, they’ll most likely perform a HbA1c test.

HbA1c is an indicator of your blood sugar control over the past 3 months, so it’s often a better overall picture than a single fasting blood sugar check. An HbA1c level between 42 to 47 mmol/mol or 6.0% to 6.4% indicates a diagnosis of pre-diabetes.

Potential complications of borderline diabetes

High blood glucose levels, especially if they’re left untreated, can affect other systems in your body. This can leave you vulnerable to a variety of health risks and chronic health conditions. For example, uncontrolled diabetes can lead to:

·       vision loss

·       nerve damage

·       kidney damage

·       cardiovascular disease

The high insulin levels that come with insulin resistance can cause additional problems.

How to reduce risk

A large, multicenter research study called the Diabetes Prevention Program looked into how lifestyle changes could help prevent diabetes. What they found should give people at risk of diabetes a lot of hope. With modest weight loss and exercise, study participants reduced their risk of developing diabetes by 58% over 3 years. Therefore, making changes to your diet and lifestyle can be especially beneficial for those with pre-diabetes and may help support blood sugar control and overall health.

Balanced diet

Focus on nutrient-dense foods like fruits, vegetables, lean proteins, and good fats. When choosing grains, be sure to choose complex carbohydrates, like whole grains. You should also aim to limit your intake of added sugars, like those in processed baked goods or sugar-sweetened beverages. Foods high in added sugar can raise blood sugar levels and are also often lacking in important nutrients. 

Physical activity

Aim for 150 minutes of exercise each week, or around 30 minutes of exercise for 5 days per week. This can include a variety of activities, including walking, biking, swimming, hiking, or dancing. But remember, don’t panic! Simply choose a type of exercise you enjoy, whatever it may be. Engaging in an exercise you enjoy will only encourage you to consistently maintain a level of exercise no matter what normal hurdle you’ve previously put in front of you. Sometimes it’s about mindset. Think of movement as opposed to the word “Exercise.” By simply moving more, you’ll command a greater use of glucose and energy and encourage greater glucose sensitivity and insulin sensitivity.

Maintain a moderate weight

Though you can develop pre-diabetes at any size, being overweight or obese can increase the risk. Talk with your GP or dietitian about whether making changes to your diet or exercise routine may be beneficial to help you reach or maintain a moderate weight and reduce your risk of developing diabetes.

Medications

If you do have pre-diabetes, a doctor may prescribe a medication, like metformin. This can also help increase insulin sensitivity and keep blood glucose levels in check.

Start today

Talk with your GP before starting any diet or lifestyle changes. It’ll give you the best chance of preventing diabetes in the first place while also avoiding any potential complications from uncontrolled diabetes. Keep in mind that being diagnosed with pre-diabetes doesn’t have to mean you’ll develop diabetes. In fact, making moderate adjustments to your diet and lifestyle can help prevent pre-diabetes from progressing while also improving your overall health.

Extracts taken from Kelly Wood, MD from https://www.healthline.com