Our body gets access to sugar through the food we eat. The foods we eat get broken down into different components. which includes glucose. This glucose is present in the bloodstream. The bloodstream is not where the glucose is needed. The glucose is needed in our cells for storage and healthy functioning of the body. The hormone responsible for transporting the sugar from your bloodstream to the cells is called insulin. You must reverse prediabetes to avoid Type 2 Diabetes and metabolic syndrome.
However, in some conditions, this insulin’s function is impaired, either due to decreased production of insulin, or the body not responding well to insulin(insulin resistance).This impaired INSULIN FUNCTION COULD LEAD TO BUILDUP OF GLUCOSE IN THE BLOOD (HYPERGLYCEMIA). This build-up could result in Prediabetes or diabetes mellitus.
Research carried out in the United States between the year 1988 and 1994 revealed that 40.15 of the population of the US is diagnosed with Prediabetes. In 2011 and 2012, it was shown that 38% of Americans are diagnosed with diabetes. It is a prevalent disease in developed countries.
What is Diabetes Mellitus?
Diabetes mellitus is a metabolic and endocrine disease which is characterized by hyperglycemia for an extended period. It is an endocrine disease that causes the death of over 1.5 -5 million people per year. It presents itself majorly in the form of polyuria, polydipsia, and polyphagia.
Metabolic syndrome is a syndrome(combination of different conditions) that consists of a minimum of 3 out of the following medical conditions:
- Central obesity
- Hypertension
- Hyperglycemia
- Hyper; epidemic ( high serum triglycerides)
- Low level of high-density lipoprotein(good cholesterol)
Metabolic syndrome is a condition that has been linked to type 2 diabetes and increases the chances of an individual having type 2 diabetes.
Pre-diabetes, as the name implies pre(before), diabetes is also called borderline diabetes. It is a condition characterized by hyperglycemia, but the sugar is not high enough to be classified as diabetes.
Prediabetes is an indication that you are on your way to having diabetes. Prediabetes is very dangerous because, if it left untreated, it could lead to type 2 diabetes, which is irreversible. So medical practitioners always advises us to reverse the Prediabetes. You must reverse prediabetes to avoid Type 2 Diabetes and metabolic syndrome.
It is described as the grey area between normal blood sugar and diabetes mellitus. About 7 million people have been discovered to have Prediabetes in United Kingdom.
Between 2003 and 2011, it was found that 1 in every 3 people in the UK is predisposed to Prediabetes and type 2 diabetes.
Risk factors for Developing Prediabetes
- Obesity and being overweight: Most obese people have been discovered to have bad eating lifestyle and live a sedentary way of life. These bad food choice include eating a lot of junk and sugary foods, which can lead to hyperglycemia. Obesity is a high-risk factor for diabetes, metabolic syndrome, and type 2 diabetes mellitus. Picking healthy food choices and living an active lifestyle is not just to look good and keep fit, it can help you reduce your chances of having Prediabetes. Why ignore both, when you can have both by eating right. It was discovered that men with a waist size greater than 40 inches, and women with a waist size larger than 35 inches in size are predisposed to Prediabetes.
- Age: People over the age of 40 are at higher risk of developing Prediabetes when compared to people below the age of 40. People above age 40 are at greater risk, because the older we grow, the less frequently we exercise. It has been revealed that old people lose muscle mass faster, and exercise less often. This could contribute to this group of individuals having a higher chance of developing pre-diabetes.
- Hypertension: Increased blood pressure is a predisposing factor to various endocrine diseases such as prediabetes, metabolic syndrome and diabetes mellitus
- Hyperlipidemia: Increased fatty acid or reduced high-density lipoprotein is one of the most common risk factors for developing Prediabetes, especially if it is combined with obesity and sedentary lifestyle.
- Genetics: Individuals with a close relative with diabetes history are at a higher risk of developing Prediabetes.
- History of overweight baby delivery: Prediabetes is common in people with a history of delivery overweight baby or babies over 9 pounds by weight. Mothers with a prior history of gestational diabetes( diabetes that occurs during pregnancy) are also at high risk of having Prediabetes. The child involved is also at risk of having pre-diabetes.
- Race: It is more common in some races such as Native –American, African –Americans, Hispanics,pacific-islanders, Afro-Caribbean, and South Asians
- Diet lifestyle: Individuals that eat a lot of junk food, unhealthy processed foods or meats, sugary beverages, soft and fizzy drinks are at a higher risk of having prediabetes. However, it is advisable to substitute this food for more healthier versions such as fruits, vegetables, and salads.
- Sedentary lifestyle: individuals that work by sitting in one spot every day, or people with low level of physical activity are predisposed to having Prediabetes. An active lifestyle and physical activity increase our body,s metabolism, burning up the stored glucose and calories. Physical activities could range from walking to working out in the gym.
- Underlying medical condition: People with an underlying medical condition such as polycystic ovarian syndrome(PCOS) are at high risk of developing Prediabetes. PCOS is a condition characterized by increased numbers of enlarged ovaries, irregular menstrual period, hirsutism, and obesity. The obesity caused by PCOS is one of the primary risk factors for Prediabetes in women.
- Altered sleep pattern: Individuals with altered sleep patterns such as people suffering from various sleep disorders, or with jobs that involve a frequent change in shifts. The sleep disorders such as obstructive sleep apnea could improve the way the body responds to insulin(insulin resistance). Insulin resistance is a predisposition to obesity and prediabetes. Sleep disorders, altered sleep patterns, and changing work shifts frequently is a common risk factor for obesity and prediabetes.
Can I Stop Pre-Diabetes from Developing into Type2 Diabetes?
Yes, with lifestyle changes. You must reverse prediabetes to avoid Type 2 Diabetes and metabolic syndrome. According to the just concluded diabetes prevention program in the united kingdom, it was discovered that prediabetes could be reversed and prevented from developing into full type 2 diabetes by 2 major principles:
- Feeding habits: Prediabetes can be reversed and prevented from developing into type 2 diabetes, if the individual chooses safe food options. People suffering from Prediabetes are advised by medical practitioners to consume foods that are low in carbohydrates and sugars. They are recommended to eat more of vegetables, salads, and proteins. There is a saying that we are what we eat. Your body is a reflection of your consistent eating habits.
- Frequent exercise: Individuals that live a quiet lifestyle are predisposed to having pre-diabetes. Regular exercise and living an active lifestyle can help in reversing Prediabetes and preventing it from developing into type 2 diabetes
The combination of a healthy diet, frequent exercise and an active way of life, can help in reversing prediabetes and preventing it from developing into type 2 diabetes.
Signs and Symptoms of Prediabetes
- Darkened skin pigmentation: the skin of some specific body parts could become darkened in individuals suffering from Prediabetes. These particular parts include armpit, elbow, knuckles, knee, neck. These parts are darkened in color in people with Prediabetes.
Signs and Symptoms Prediabetes has Progressed to Type 2 Diabetes
- Polyuria: This includes increase frequency of urination. These people tend to go to the toilet to urinate more often than usual.
- Polydipsia: This is an increase in thirst that is common in individuals with prediabetes. These people feel the need to drink more water than usual.
- Chronic fatigue: Fatigue and chronic tiredness are one of the indicators that you have crossed the borderline between Prediabetes and type 2 diabetes. It is often an indicator for a progressed Prediabetes.
- Blurred vision: Pre-diabetes is a mild condition with hyperglycemia not severe enough to be classified as diabetes. Other body organs are often not affected. However, when individual notices the affectation of other body organs, especially the eyes in the form of blurred vision, it is an indication that the Prediabetes has progressed into type 2 diabetes mellitus.
When to See a Doctor
Consult a physician as soon as you notice any of the prediabetes signs and symptoms or any symptoms showing that the Prediabetes has developed into type 2 diabetes mellitus. You must reverse prediabetes to avoid Type 2 Diabetes and metabolic syndrome.
Diagnosis Criteria for Prediabetes and Diabetes
- Fasting blood glucose(FPG): Fasting blood glucose is the glucose level of the body in a fasted state. It is often done while the patient is fasting or without food. The values vary between healthy, prediabetic, and diabetic patients.
In healthy individuals, the FBG is <5,5mmol/l
In prediabetic patients, the FBG is 5.5mmol/l-7.0mmol/l
In diabetic patient: >7.0mmol/l
Check your fasting blood glucose to determine your health status and differentiate between Prediabetes and diabetes mellitus.
- Oral glucose tolerance test(OGGT): This is a test carried out to determine how your body metabolizes glucose after ingestion of glucose
Normal individuals: they have OGGT result of 7.8mmol/l
Prediabetic patient have OGGT result of 7.8-11.1mmol/l
Diabetic patients have an OGGT result of>11.1mmol/l
- Glycated Hemoglobin(HB1ac):. This is a form of hemoglobin treasure the plasma glucose concentration over an extended period of 3 months. It is usually done over the period of 3 months because erythrocyte has a lifespan of 4 months.
Io healthy patient the HB1ac level is,<42mmol/l or <6%
In prediabetic patient HB1ac level is 42mmol\l-47mmol\l or <6.0-6.4%
In diabetic patient, the HB1ac level is .6.4%
What is the Prediabetic Fasting Glucose Range?
In prediabetic patients, the FBG is 5.5mmol/l-7.0mmol/l
What is the A1C Range for Prediabetes?
In prediabetic patient HB1ac level is 42mmol\l-47mmol\l or <6.0-6.4%
How to Reverse Prediabetes with Diet and Nutrition?
The primary approach taken in reversing Prediabetes with diet and nutrition is to avoid and substitute sugary and processed food for whole food, grains, vegetables, and salad. It’s important to live an active lifestyle that includes consistent exercise for a minimum of 30 minutes daily.
Diet and Nutrition Tips for People Suffering from Prediabetes
These tips include:
- Eating healthy, no miracle diet could reverse Prediabetes, but making healthy eating a lifestyle can help you reverse Prediabetes or prevent it from developing into type 2 diabetes mellitus.
- Glycemic index: Glycemic index is a measure of how different types of food impacts our blood sugar level. The higher the glycemic index, the more dangerous they are for pre-diabetic patients.
Foods with high glycemic index include: Refined drinks and foods, white rice, white bread, potatoes, soft drinks and fruit juices
Food with medium glycemic index includes: brown rice and whole wheat bread
Foods with low glycemic index include: steel oats, vegetables, wheat pasta, wheat bread, corn, beans, and sweet potatoes
- Portion control: This is a proven diet method for people suffering from pre-diabetes, it involves eating a small piece of food but at a high frequency. The approach is to reduce the quantity or increase the rate. We know dieting and controlling portion of food can be difficult or tricky. The simple way to achieve this is by eating when hungry, stopping when you feel full, eating while sitting and take a walk often after eating.
- Increased intake of fiber-rich food: Prediabetic patients are advised to eat food that contain a lot of fiber such as whole wheat. Wheat pasta and bread.
- Substituting sugar for water: drinking a lot of water and eliminating sugary drinks and soft drinks can help in reversing Prediabetes. These drinks contains empty calories that increase the chances of an individual having Prediabetes.
What are the Best Prediabetic Treatments and Medications?
The major goal in the treatment of Prediabetes is to prevent it from developing into type2 diabetes and avoid other complications such as cardiovascular effects. The treatment plan includes:
- Low-risk patients: Lifestyle modicatificatuion with healthy diet and good exercise regimen is used for treating low-risk patient
- High-risk patients: Lifestyle modification, if not effective, it is combined with metformin and acarbose
- Non- responsive High-risk patients: Patients are not responding to lifestyle modification, metformin, or acarbose. Can be treated with Thiazolidinediones.
Having pre-diabetes is not the end of the world. Managing it on time can prevent it from developing into type 2 diabetes. You still have the chance to stop this disease. It is called Prediabetes for a reason. It means before diabetes. Following the tips above can traverse the pre-diabetes. You must reverse prediabetes to avoid Type 2 Diabetes and metabolic syndrome. If you have any symptoms or discomfort, consult the nearest doctor, therapist or endocrinologist near you.
References
Amy Hess-Fischl MS, C. (2017). Prediabetes. [online] EndocrineWeb. Available at: https://www.endocrineweb.com/conditions/pre-diabetes/pre-diabetes [Accessed 3 Oct. 2017].
Behl, M. (2017). Pre-Diabetes Diet Plan And Recipes – Five Mistakes You Shall Avoid. [online] Sepalika.com. Available at: https://www.sepalika.com/type-2-diabetes/pre-diabetes-diet-plan/ [Accessed 3 Oct. 2017].
Cherney, K. and Nall, R. (2017). The Right Diet for Prediabetes. [online] Healthline. Available at: https://www.healthline.com/health/diabetes/prediabetes-diet#overview1 [Accessed 3 Oct. 2017].
Orenstein, B. (2017). The Prediabetes Diet Everyone Should Follow. [online] EverydayHealth.com. Available at: https://www.everydayhealth.com/type-2-diabetes/prediabetes/diet/ [Accessed 3 Oct. 2017].
Sharma, M. and Garber, A. (2009). What is the best treatment for prediabetes?. Current Diabetes Reports, 9(5), pp.335-341.
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