What is pre-diabetes?

The first step for managing pre-diabetes is understanding what a pre-diabetes diagnosis means. Treatment may include lifestyle changes, such as diet, exercise, and medication.

If you receive a pre-diabetes diagnosis, it means you have a higher-than-normal blood sugar level. But it’s not high enough to qualify as a diagnosis of diabetes.

According to a 2014 review, long-term data suggest that lifestyle changes may decrease the risk of pre-diabetes progressing to diabetes for as long as 10 years. An earlier study showed that 5% to 10% of people’s pre-diabetes progresses to diabetes every year.

Pre-diabetes can also lead to other health conditions, including heart disease and stroke. But you can reverse pre-diabetes. Read on to learn more about this diagnosis and what you can do.

Other names

A doctor or healthcare professional may refer to pre-diabetes as the following:

• impaired glucose tolerance (IGT), which means you have higher-than-normal blood sugar after a meal

• impaired fasting glucose (IFG), which means you have higher-than-normal blood sugar in the morning before eating

• haemoglobin A1C (HbA1c) level between 42 to 47 mmol/mol 6.0% to 6.4%

What are the symptoms of pre-diabetes?

Pre-diabetes has no clear symptoms. Some people may experience a condition called acanthosis nigricans, which is a sign of insulin resistance. It involves the development of dark, thick, and often velvety patches of skin. It can be associated with polycystic ovary syndrome (PCOS).

This discoloration usually occurs around your:

·       elbows

·       knees

·       neck

·       armpits

·       knuckles

If you’ve received a diagnosis of pre-diabetes, it’s important to talk with a doctor if you experience:

·       increased thirst

·       increased urination, especially at night

·       tiredness

·       blurry vision

·       sores or cuts that won’t heal

These are symptoms typical of type 2 diabetes and may indicate that your pre-diabetes has progressed to type 2 diabetes. A doctor can order a series of tests to confirm this.

Risk factors for pre-diabetes

Pre-diabetes can occur in anyone, but certain factors can increase your chances of developing the condition.

Research suggests that pre-diabetes is strongly linked to lifestyle factors and genetics. Here are some of the main risk factors for pre-diabetes:

·       Age: People older than 45 years of age are at a higher risk of pre-diabetes.

·       Body weight: If you have a body mass index (BMI) of more than 25, a doctor may want to screen for pre-diabetes.

·       Waist size: Having more fat around your waist than your hips can increase your risk of pre-diabetes. You can measure this risk factor by checking if your waist is 40 inches or more if you’re a person assigned male at birth and 35 inches or more if you’re a person assigned female at birth.

·       Race and ethnicity: Research has shown that pre-diabetes occurs at higher rates in people who are of African and Asian ancestry and heritage. However, it’s important to note that resource disparities, such as access to care, may likely factor into this higher prevalence.

·       Diet: Regular consumption of red meat, processed meat, and sugar-sweetened beverages could increase your risk of developing pre-diabetes.

·       Physical inactivity: Not only can getting regular exercise help you keep up a moderate weight, but it can also lower your risk of pre-diabetes.

·       Family history: If you have an immediate relative with type 2 diabetes, you may be at a higher risk of developing pre-diabetes.

·       Tobacco use: In addition to increasing your risk of insulin resistance, smoking may also be associated with an increase in waist size, which is another risk factor of pre-diabetes.

·       Medical history: Certain conditions, including sleep apnoea, gestational diabetes, PCOS, high blood pressure, and increased cholesterol or triglyceride levels may be linked to a higher risk of insulin resistance and pre-diabetes.

Preventing type 2 diabetes

Losing even just 5% to 7% of your body weight if you have overweight can significantly lower your risk of developing type 2 diabetes. Other factors, including high stress levels and smoking, can also contribute to the development of type 2 diabetes. Making lifestyle changes is one of the most effective ways to keep up a moderate weight and prevent type 2 diabetes.

Here are a few tips to get started:

·       Eat more fibre-rich foods, such as whole fruits, non-starchy vegetables, nuts, seeds, whole grains, and legumes.

·       Limit your intake of sweets and sugary beverages, including soda, sweet tea, and sports drinks.

·       Aim for at least 150 minutes of physical activity per week, or about 30 minutes daily for 5 days per week.

·       If you smoke, consider quitting.

·       Manage your stress levels with meditation, yoga, deep breathing, and other techniques to lower stress.

How to treat pre-diabetes

Treating pre-diabetes can also be thought of as preventing type 2 diabetes. If a doctor gives you a diagnosis of pre-diabetes, they’ll recommend certain lifestyle changes.

A study called the Diabetes Prevention Program showed an approximate 58% reduction of risk in people who kept up with these changes in the long term.

The most common ways to manage pre-diabetes are:

·       keeping up a diet that’s rich in fibre

·       exercising regularly

·       keeping up a moderate weight

·       taking medication if a doctor prescribed it

Some people with diabetes choose to use complementary and alternative medicine treatments to manage their condition. Complementary medicine and treatments can include taking supplements, meditation, and acupuncture. Always check with a doctor before starting any treatments because they may interact with your medication.

Low carbohydrate diet

Research suggests that a low-carbohydrate diet could help improve your blood glucose management, insulin resistance, and weight. Although most available research is focused on type 2 diabetes rather than pre-diabetes specifically, it may be fair to assume that a low carbohydrate diet could also be beneficial for those with pre-diabetes. Low-carbohydrate diets generally restrict your carbohydrate intake to less than 26% of total daily calories, or about 130 g of carbohydrates per day. Talk with a doctor before making major changes to your diet.

A more moderate consideration would be around the choice of carbohydrates to consume. There are many complex carbs that are packed with fibre but are much slower to digest and don’t result in a fast blood sugar spike. In addition, they can also feed the good bacteria in our gut which will have an added bonus by releasing anti-inflammatory by-products across the body.

Complications

If you don’t get treatment, pre-diabetes can develop into type 2 diabetes and other conditions, such as:

·       heart disease

·       stroke

·       nerve damage

·       kidney damage

·       eye damage

·       foot damage, in which poor blood flow may lead to amputation

·       skin infections

·       trouble with hearing

·       Alzheimer’s disease

The good news is that pre-diabetes is reversible with long-term lifestyle changes. Pre-diabetes is reversible. You can prevent or slow the development of pre-diabetes and diabetes by making lifestyle changes, including keeping up a moderate weight.

According to one 2017 review, each 2.2 lbs. of weight loss could lower the risk of type 2 diabetes by 16% for people with pre-diabetes.

A heart-healthy lifestyle includes the following:

Eating nutrient-rich foods

Be sure to include plenty of nutrient-dense, whole foods in your diet and limit your intake of highly processed foods and sugar-sweetened beverages.

Fibre-rich foods, such as fruits, vegetables, and whole grains, can be especially beneficial to help you reach your health goals.

Exercising

You can lower your risk of diabetes by regularly staying active. Doing 30 minutes of any activity that raises your heart rate to your target rate, such as walking, most days of the week is recommended.

Ways to incorporate physical activity into your daily schedule can include:

·       riding a bike to work

·       walking instead of riding the bus or driving

·       going to a gym

·       participating in recreational sports with a team

Getting 30 minutes of exercise per day and losing 5% to 7% of your weight can lower your risk of type 2 diabetes progression by more than 58%, according to the CDC.

Takeaway

If left untreated, pre-diabetes can cause several health issues, including type 2 diabetes, heart disease, and stroke. But it’s reversible and can be treated by making lifestyle changes. In addition to following a health-promoting, well-rounded diet, getting regular physical activity and taking medications as prescribed by a doctor can help prevent pre-diabetes from progressing.

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