Prediabetes Care and Management

Prediabetes—a subtle yet critical stage that lies between normal blood sugar levels and the definitive diagnosis of type 2 diabetes.

This stage serves as an urgent signal for proactive action and informed choices. Despite its elusive nature, this phase offers substantial potential for intervention and lifestyle changes, potentially altering the course of preventing prediabetes from becoming diabetes.

What is prediabetes?

Prediabetes manifests when blood sugar levels exceed normal ranges but not high enough for a diabetes diagnosis. Adults with prediabetes often do not exhibit signs or symptoms of diabetes, though their blood sugar levels are higher than normal.

Typically, normal blood glucose levels range from 70 – 99 mg/dL (3.9 – 5.5mmol/L). In those with prediabetes, blood glucose levels are usually elevated between 110 mg/dL and 125 mg/dL (5.6 – 6.9 mmol/L). Despite being higher, these levels do not meet the criteria for a diabetes mellitus diagnosis. Consequently, many individuals are unaware that they have prediabetes.

What are the signs and symptoms of prediabetes?

Most individuals with prediabetes often do not display symptoms. However, in a small number of cases where symptoms do occur, they might include:

• Increased appetite
• Unexplained loss of weight
• Elevated BMI (Body Mass Index)
• Weakness or fatigue
• Sweating
• Blurred vision
• Delayed healing of wounds or bruises
• Recurring skin infections or gum bleeding

What causes prediabetes?

Hyperglycaemia triggers the pancreatic beta cells to produce and release insulin. Prolonged exposure to high insulin levels reduces the responsiveness of insulin receptors, which are responsible for opening glucose channels and allowing glucose to enter cells.

When insulin receptors function poorly, hyperglycaemia worsens, perpetuating metabolic disturbances and leading to the development of type 2 diabetes and metabolic syndrome.

In prediabetes, this process is less advanced than in diabetes mellitus but represents an initial step in a potentially dangerous metabolic cascade. 

What are the risk factors for prediabetes?

Risk factors for insulin resistance or those with high-risk diabetes include:

• Overweight or obesity
• Family history of diabetes (parent, sibling)
• Physical inactivity
• Health conditions like high blood pressure and high cholesterol levels
• History of gestational diabetes
• Polycystic ovary syndrome (PCOS)

The good news is that while unchangeable risk factors like family history, age, or ethnicity exist, lifestyle modifications with eating habits, weight management and physical exercise can drastically reduce the risk of developing insulin resistance or prediabetes.

How is prediabetes diagnosed?

Prediabetes is identified by three testing methods used to pinpoint individuals with a heightened risk of developing type 2 diabetes.

1. HbA1C

• The A1C Test Measures average blood sugar levels over the past 2 to 3 months
• Normal HbA1c: less than 5.7%
• Prediabetes HbA1c: 5.7%–6.4%
• Diabetes HbA1c: 6.5% or higher

2. Fasting blood glucose test

• Typically done in the morning after an eight-hour fast and measures blood sugar levels
• Normal blood sugar levels: 3.9 – 5.5mmol/L
• Prediabetes blood sugar levels: 5.6 – 6.9 mmol/L
• Diabetes blood sugar levels: 7mmol/L or higher

3. Oral glucose tolerance test

• Measures blood sugar before and two hours after drinking a sugary drink
• Normal: less than 7.8 mmol/L
• Prediabetes: 7.8 mmol/L and 11.0 mmol/L
• Diabetes: 11.0 mmol/L or higher

How is prediabetes treated and managed?

Studies have found that having prediabetes is linked to higher mortality and increased rates of cardiovascular events (an extra 7.36 cases per 10,000 person-years for mortality and 8.75 cases per 10,000 person-years for heart disease over 6.6 years).

This is an excellent reminder not to take prediabetes lightly, as risk factors for diabetes can significantly impact one's life. Diabetes will affect every major organ in the body, leading to significant complications and nerve damage that could even result in amputation.

The great news is intentional lifestyle changes for diabetes prevention work. It is proven that you can reverse prediabetes and delay the onset of diabetes.

Beginning with lifestyle changes, one should:

• Increase physical activity ( ≥150 min/week)
• Practice calorie restriction by eating a healthier diet
• Lose 5% - 10% of body weight
• Quit or reduce smoking
• Manage stress

Medications like Metformin may also be recommended to assist in managing prediabetes. 

Is prediabetes reversible?

Yes, prediabetes is often reversible with lifestyle changes and appropriate interventions. By adopting the strategies mentioned above, many people with prediabetes can return their blood glucose levels to a normal range, reducing their risk of progressing to type 2 diabetes.

How to prevent prediabetes?

A three-part strategy can keep many people from developing diabetes. It includes:

• Weight loss
• Increased physical activity
• A healthier diet

By incorporating these into your daily routine, you can significantly reduce your risk of developing prediabetes and promote overall health.

Make an appointment at Pantai Hospitals

Embrace the empowerment found in small yet impactful lifestyle changes. Whether it is through mindful dietary adjustments, regular physical activity, or seeking timely medical guidance, every step you take today is an investment in your future vitality. Remember, it is not just about preventing the progression of diabetes but about fostering a life brimming with health and vitality.

Consult your doctor today, seek support from loved ones, and embark on this journey toward improved well-being.

Get in touch with us to book an appointment today for diabetes screening tests or visit your nearest Pantai Hospital for a consultation.