Diabetes Mellitus (DM) is a disease caused by a high level of sugar in the bloodstream. This occurs due to a low level of insulin hormone or resistance to insulin hormone which regulates the blood sugar level. If not managed properly, DM may lead to complications such as damage to eyes, kidneys or nerves.
According to the World Health Organization, 422 million adults had DM in 2014. That accounts for 6% of the world population.
Pre-diabetes is a condition in which blood sugar level is slightly higher than normal but not high enough to confirm type 2 DM. So, doctors consider pre-diabetes as a warning sign for DM.
But the good news is, it is always possible to reverse pre-diabetes status from developing into type 2 DM.
In the US, about 86 million people over 20 years have pre-diabetes. Worldwide, one out of three people has pre-diabetes.
Pre-diabetes has no specific signs or symptoms. A few features suggestive of the condition are:
- Discoloration of skin on the neck, groin, knuckles, armpit, etc.
- Unexplained tiredness
- Excessive thirst
- Frequent urination
- Unexplained weight loss
- Blurred vision
- Slow healing wounds, cuts sores and recurring infections
- Dry mouth
- Itchy skin
The risk factors for pre-diabetes are as same as for type 2 DM. They are as follows.
1. A family history of type 2 DM among your parents or siblings is a significant risk factor.
2. Overweight; especially increase the waist measurement.
The healthy Body Mass Index (BMI) is between 18.5 – 24.9 Kg/m2. BMI over 25 Kg/m2 increases pre-diabetes and diabetes risk.
Similarly, a waistline of a >40 inches in a male and >35 inches in a female increase the risk of pre-diabetes and type 2 DM.
3. Low level of physical activities and sedentary lifestyle is a risk factor
4. Smoking increases the risk of pre-diabetes and diabetes.
5. Polycystic ovarian syndrome increases the risk of having pre-diabetes due to increased insulin resistance in the female.
6. Gestational DM during pregnancy
increases the risk of developing pre-diabetes and type 2 DM later in life.
7. Race/ Ethnicity
Examples –African Americans, Mexican Americans, American Indians, Native Hawaiians, Pacific Islanders and Asian Americans.
8. Age over 45 years
As we grow older, the risk of developing pre-diabetes and type 2 DM also increases.
9. Sleep disorders may cause insulin resistance, which may lead to pre-diabetes status.
10. High blood pressure and high cholesterol levels are also risk factors.
Pre-diabetes status has no symptoms or signs. Doctors commonly find it accidentally during regular medical check-ups or when they investigate blood for another health condition.
The tests to diagnose pre-diabetes are the same as for type 2 DM. It is essential to carry out the tests in a slandered way for accurate diagnosis.
1. Fasting blood glucose level
It is measured after 8-10 hours of fasting. The results interpret as follows.
- o <100mg/dL – normal blood sugar level
- o 100 – 125mg/dL – impaired fasting blood sugar level (pre-diabetes)
- o >125mg/dL – may consider as DM (need two values in separate occasions to confirm)
2. Oral glucose tolerance test
Following 8 hours of fasting, can take the first blood sample. Then you have to drink a glucose solution, and then take another blood sample after two hours. [Dr YA3] Test values interpret as follows:
- o <140mg/dL – normal sugar level
- o 140 – 199mg/dL – impaired glucose tolerance (pre-diabetes)
- o >200mg/dL – diagnose as DM
3. Glycated hemoglobin level (HbA1C)
This test reflects the average blood sugar level in our blood during the last 3 months. The test result interprets as below:
- o <5.6% we consider as normal
- o 5.7 – 6.4% consider as pre-diabetes
- o >6.5% it confirms DM
Results from the above blood tests can confirm one’s diabetes status.
Now the question is “I have pre-diabetes status. Would I get diabetes in the near future?”
The answer is “NO”. The American Diabetes Association states that “It is possible to prevent pre-diabetes from developing into type 2 DM by modifying our lifestyle”.
Let us find out the ways to reduce the risks of developing DM from pre-diabetes status or normal blood sugar levels.
- Healthy food habits
We have to plan our diet well. The plan should include the reduction of high calorie and fatty food intake. They are butter, full cream milk, fast food, biscuits, cakes and any other type of ‘junk food’. Instead, increase the consumption of high fiber vegetables, fruits, green leaves and whole-grain meals.
- Regular physical activities
Regular moderate exercises such as brisk walking, cycling and swimming at least 30 minutes per day will help you to prevent DM.
When we do exercises, our cells need more glucose. Because of the requirement, glucose molecules go inside the cells with little help of insulin. That will lead our body to become less insulin resistance.
Physical activities also help us to reduce stress and feel fresh.
- Weight reduction
If you are overweight or obese, Changes to lifestyle, healthy food and exercises will inevitably lead to weight reduction. Weight loss enhances insulin action and reduces insulin resistance.
Reduction of 5 – 10% of your body weight will do a great job to reduce the risk of developing pre-diabetes and DM.
- Reduce stress
Long term stress triggers hormones that increase our appetite resulting in many bad outcomes. Meditation, music, travelling, exercises, etc. could help with reducing stress levels.
- Maintaining blood pressure and cholesterol level healthy is also vital to prevent developing pre-diabetes and type 2 DM.
If we adhere to a healthy lifestyle, we can prevent developing type 2 DM from pre-diabetes in the majority of cases. Some would be even able to reverse pre-diabetes status to healthy blood glucose levels.