What is Pre Diabetes?
It wasn’t until recently that patients with impaired fasting glucose were not considered pre diabetic. This term was eventually defined because it was recognized that there was a large group of people who had abnormally high glucose levels but did not meet the diagnostic criteria for type 2 diabetes. These patients with high sugar levels, or hyperglycemia, were known to be at serious risk for developing type 2 diabetes later in life. For this reason, the term prediabetes was born to describe these patients so that a plan for management and prevention of type 2 diabetes could be developed.
Pre Diabetes Symptoms and Diagnosis
Prediabetes is another term that is used to describe impaired fasting glucose levels. Patients with pre diabetes often do not have any physical symptoms. This diagnosis is made from laboratory screening for abnormally high blood sugar. Patients with prediabetes have abnormally high sugar readings that are not high enough to be considered diabetic.
Patients are diagnosed with pre diabetes when one of the following criteria are met:
- Fasting blood glucose levels fall between 100 and 125 mg/dl
- Post prandial readings range between 140 and 199 mg/dl
- Hemoglobin A1c readings fall between 5.7% and 6.4%
This pattern of elevated sugar levels is suggestive of developing insulin resistance in the body. Over time, these patients could progress to type 2 diabetes are the pancreas eventually fails to keep up with the demands of the insulin production, resulting in rising glucose levels.
Now That I Have Pre Diabetes, Will I Develop Type 2 Diabetes?
A diagnosis of prediabetes does not mean that the patient will certainly develop type 2 diabetes. However, it does indicate that the patient is at increased risk for developing type 2 diabetes. Studies have found that the risk of developing type 2 diabetes can be best predicted by following the results of the a1c blood test.
Research has found that the risk of developing type 2 diabetes within 5 years of diagnosis of prediabetes is as follows:
- Up to 25%: If hemoglobin a1c measurements fall between 5.5 and 6.0%
- 25-50%: If hemoglobin a1c measurements range between 6.0 and 6.5%
Pre Diabetes Treatment Plan
To prevent the progression to type 2 diabetes, patients who are diagnosed with prediabetes should be referred to a nutritionist or a certified diabetic educator for information about proper pre diabetes diet and exercise plan. Patients with pre diabetes can manage their condition and reduce their risk of type 2 diabetes through the following:
- Weight Loss: All pre diabetic patients should aim to lose weight. Patients should set a minimum goal of 7% reduction of weight that is achieved through a combination of dietary changes and exercise!
- Exercise: To keep the heart healthy and reduce weight, pre diabetic patients should try to get at least 150 minutes of aerobic exercise every week.
- Medication: Medications are only prescribed to a pre diabetic patient if there are significant risk factors for heart disease or stroke. The only medication that is approved for use in pre diabetes treatment is Metformin. Metformin works well to reduce blood sugar levels and prevent progression to type 2 diabetes in high risk patients.
- Monitoring: All patients with prediabetes should see their doctor routinely for blood pressure monitoring and routine blood work. This blood work will screen the patient for worsening fasting blood sugar levels and rising hemoglobin a1c. This blood work should be done at least once per year to monitor for worsening sugar metabolism.
Pre diabetes is an increasingly common condition that is very important because it identifies patients who are at risk for developing type 2 diabetes. By discovering this risk factor early, patients can lower their likelihood of progression to type 2 diabetes and limit their risk for complications from diabetes.