Prediabetes (Borderline Diabetes): Signs and Symptoms, Causes, Risks, Complications, Diagnosis, Treatment and Prevention.

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1Overview

Prediabetes is the precursor stage before diabetes mellitus type 2, a chronic disease wherein the blood sugar becomes high. Prediabetes means that the blood sugar level is greater than normal but not high enough to be categorized as type 2 diabetes.

Without lifestyle modifications, regular exercise and a healthy diet, people with prediabetes are at an increased risk of developing full-blown diabetes, which can be hard to treat and may require treatment.

What Is Diabetes?

Diabetes is a medical condition wherein the body’s ability to produce or respond to insulin, a hormone that’s needed to transport glucose to the cells throughout the body, is impaired or altered. As a result, glucose does not adequately penetrate the cells where they’re supposed to go into. This leads to an increased level of glucose or sugar circulating in the blood.

Diabetes is a serious disease that needs immediate medical attention. Increased blood sugar levels can cause a broad spectrum of complications that can involve the extremities, brain, heart, kidneys and the eyes.

Prediabetes And Diabetes By The Numbers

Diabetes mellitus is the leading cause of disability and death across the globe. In 2011, the prevalence of diabetes was 8 percent worldwide. By 2030, this number is expected to increase to 10 percent.

China has the greatest number of people living with diabetes with 90 million or 9 percent of the population, the World Health Organization (WHO) reports. According to the American Diabetes Association (ADA), 29.1 million Americans or about 9.3 percent of the population had diabetes in 2012.

Alarmingly, out of the 29.1 adults who have diabetes, 21 million were diagnosed while 8.1 million are not aware they have the condition. Regarding prediabetes, 86 million Americans who are 20 years old and above had prediabetes in 2012, which increased from 79 million in 2010. Today, the numbers are continuously growing at an alarming rate.

In the United States, diabetes is the 7th leading cause of death in 2010, with a staggering 69,071 deaths wherein the diabetes is the underlying cause of mortality. Moreover, 234,051 deaths were linked to diabetes as the underlying contributing cause of mortality.

2Signs and Symptoms

Prediabetes has no apparent symptoms. The disease may have vague and scattered signs or symptoms that mimic other diseases. Some people may experience symptoms linked to insulin resistance like polycystic ovarian syndrome and acanthosis nigricans, which appear as thick, dark and velvety patches of skin found on the elbows, knees, neck, knuckles, and armpits.

It is also important to watch out for the signs and symptoms of diabetes. Diabetes develops very slowly. When you have prediabetes, you may not experience any symptoms at all. However, you may notice the following symptoms when your blood glucose shoots up.

  • Being hungrier than usual
  • Unexplained weight loss, even if you’re eating more
  • Tastier than normal
  • You urinate more frequently
  • Fatigue
  • Blurred vision

These are all the symptoms of diabetes, but you may experience them even when you have prediabetes.

3Causes

The exact cause of prediabetes is still unknown. However, many studies have linked family history and genetics in the development of this condition.

Prediabetes develops when your body begins to have a problem in using the hormone called insulin. Insulin plays a pivotal role in transporting glucose from the food digested to the different parts of the body. The various cells in the body use glucose as their primary energy source.

In prediabetes, the body either doesn’t make enough insulin, or it can’t use it properly, which is called insulin resistance. When your body can’t produce enough insulin, or it’s insulin resistant, glucose can’t enter the cells, leading to an increased level of sugar in the blood,

4Risk factors

Health experts are still in the process of studying the exact cause of prediabetes, but just like diabetes, many factors increase the risk of developing prediabetes.

Weight

Being overweight or obese is a primary risk factor for prediabetes. The more fatty tissue you have, especially in the abdomen, the more likely you’ll develop prediabetes because these cells are more resistant to insulin.

Waist Size

People who have bigger bellies and have more fats in the central part of the body are more likely to have insulin resistance. The risk increases for men with waist measurements of more than 40 inches and women with sizes bigger than 35 inches.

Lack of Physical Activity

The less active you are, the higher the risk of developing prediabetes. Regular exercise helps you maintain a healthy weight, use up glucose as energy and make the cells more insulin sensitive.

Age

Age is a major risk factor for prediabetes. At age 45, the risk of acquiring this disease increases. This is because people at this age tend to exercise less, gain weight and lose muscle mass.

Family History

The risk of prediabetes increases if you have a brother, sister or parent with type 2 diabetes.

Other risk factors include gestational diabetes, race, sleep and having polycystic ovary syndrome. Other conditions that may also increase the likelihood of developing prediabetes are high blood pressure, elevated levels of triglycerides and low levels of high-density lipoprotein (HDL), which is the good cholesterol.

5Complications

The American Heart Association (AHA) reports that the complications associated with prediabetes are the same with type 2 diabetes. When you have prediabetes, you are more likely to suffer from the high glucose levels in the blood damaging various organs, including important ones.

Heart and Blood Vessels

Prediabetes and Type 2 diabetes may increase the risk of having heart and cardiovascular diseases like kidney disease, heart attack, atherosclerosis, stroke and peripheral artery disease.

Blindness

Eye damage is a common complication of diabetes, and this may lead to permanent vision loss if it’s not treated immediately.

Nerve Damage

Chronic high blood sugar levels can damage the nerves and may result to diabetic neuropathy. As a result, the patient may experience numbness in the feet, toes, hands, and fingers.

Foot Damage

In prediabetes, the prolonged high blood sugar levels may damage the nerves and blood vessels. These may impede the blood flow to the lower extremities. Even small wounds or cuts may take longer to heal. In some cases, amputations have been done because of tissue death.

Kidney Disease

The kidneys work by filtering blood. Due to the increased levels of blood sugar, it may damage the kidneys and in the long run, may cause serious health complications like renal failure, which is potentially fatal.

6Diagnosis

Doctors may look at the signs and symptoms of prediabetes and diabetes for a diagnosis. However, some tests are needed to be done for confirmation.

Fasting Plasma Glucose (FPG)

The FPG blood tests measure the blood glucose level at a single point, and this is usually done in the morning, after fasting for at least 8 hours. Fasting is the method of abstaining from all food or water.

The normal results should be between 70 and 100 mg/dL (3.9 and 5.6 mmol/L). Any level between 100 and 125 mg/dl may indicate prediabetes and more than that is diabetes.

Random Blood Sugar (RBS)

In random blood sugar (RBS) testing, blood sugar levels below 140 mg/dl are considered normal. It is used to check glucose levels. It is usually done by pricking the finger to draw a small drop of blood. It’s commonly partnered with the management of diabetes through insulin injections.

Glycated Hemoglobin (A1C) Test

Glycated hemoglobin (A1C) test aims to measure the average sugar levels in the blood over the past three months. It measures the percentage of blood sugar on hemoglobin, the protein in red blood cells that carry oxygen.

7Treatment

The primary goal of prediabetes is to maintain healthy glucose levels and prevent the progression to diabetes. The majority of the treatment options for prediabetes are simple lifestyle modifications – diet, exercise and reduce the exposure to bad habits like smoking.

The treatment will focus mainly on losing weight, getting active and eating healthy foods. These simple yet effective lifestyle changes will eventually reverse prediabetes and prevent it from becoming full-blown diabetes, which is harder to curb.

These lifestyle changes will help prevent other health problems associated with increased blood sugar levels such as stroke and heart disease

You may be given medications (Metformin) along with the treatment options.

8Prevention

To prevent prediabetes from progressing to diabetes, here are simple ways.

  • Eat healthy foods. Choose foods that are low in calories, fats and are high in fiber. Eat the whole grains, fruits, and vegetables.
  • Exercise regularly. Make sure you aim to have at least 30 minutes to one hour of moderate physical activity each day. The American Heart Association (AHA) recommends at least 150 hours of moderate exercise per week.
  • Lose weight by maintaining a healthy diet and exercising regularly. Losing excess fats can reduce the risk of diabetes, and other health problems like heart disease and hypertension.
  • Don’t smoke and stop, if you’re smoking.
  • Take medications as needed. Metformin is the drug of choice to reverse prediabetes and prevent it from worsening.