India has been referred to as the world’s capital of diabetes, given the rising number of diabetes cases in the country over the years. Research indicates that our country is close to hitting a mark of 69.9 million diabetics by 2025 and 80 million by 2030. Given these statistics, it is not surprising how often we hear about the serious health ramifications of diabetes. However, there is little focus on prediabetes, which is a precursor to type 2 diabetes.

What is prediabetes?

Prediabetes is a health condition wherein the blood sugar (glucose) level is higher than normal but not elevated enough to be diagnosed as type 2 diabetes. If individuals with prediabetes do not make significant lifestyle changes, they are highly likely to develop type 2 diabetes. Moreover, the long-term health effects of diabetes, especially on the heart, blood vessels, and kidneys may already begin with the onset of prediabetes. However, the good news is that the progression of the condition from prediabetes to type 2  diabetes can be prevented with timely intervention.

How does prediabetes develop?

Your body gets sugar (glucose) from the foods and drinks you consume, which gives it the energy to perform its functions. During digestion, sugar enters your bloodstream, and in order for the sugar to be directed to the cells from the blood, your body needs insulin, which is a hormone secreted by the pancreas. Insulin allows glucose to enter the cells, where it is used to produce energy. 

In the case of type 2 diabetes, the pancreas produces insulin. However, insulin becomes less effective in its function of helping the cells utilize glucose for energy production.

Prediabetes is a preliminary state of type 2 diabetes. The body starts showing signs of resistance to the action of insulin but the blood glucose levels are not frankly high enough to be termed diabetic levels. This stage has almost no or very few symptoms and is often missed during routine check-ups. 

Risk factors of prediabetes

It is possible for individuals with prediabetes to not show any symptoms. This may be the reason why prediabetes usually goes undetected until it progresses to type 2 diabetes. Therefore, it is recommended that people who are at a high risk of prediabetes should consult their physician and regularly check their blood sugar levels.

The factors that increase the risk of developing type 2 diabetes may also raise the risk of developing prediabetes. These include:

1. Being overweight 

Being overweight or obese is a major risk factor for prediabetes. The presence of a higher amount of visceral fat, which is the fat found around the organs, especially in your abdomen, has been associated with insulin resistance.

2. Age

The risk of developing prediabetes may be higher after the age of 45.\

3. Family history

A family history of diabetes, especially if you have a parent or siblings with diabetes, increases your risk of developing prediabetes.

4. Gestational diabetes

A history of gestational diabetes (diabetes during pregnancy)  may increase your likelihood of developing prediabetes.

5. Polycystic ovary syndrome (PCOS)

PCOS, a condition that is often characterized by being overweight or obese, can heighten the risk of prediabetes.

6. Physical inactivity

Regular physical activity is key to maintaining good health and healthy body weight. So, if you do not do physical activities and exercise daily, the probability of you getting prediabetes is much higher.

Other risk factors for developing prediabetes include having a diet high in processed foods, red meat, and sweetened beverages. Additionally, inadequate sleep and smoking may contribute towards increasing your risk of prediabetes.

Also Read: Diabetes and Its Long-term Complications

Diagnosis of prediabetes

A blood test is required for detecting prediabetes. The American Diabetes Association (ADA) recommends that adults must undergo screening regularly once they reach the age of 45. However, if you are overweight and have any of the other risk factors for prediabetes, it is advisable to start screening before the age of 45.

A fasting blood sugar test is a common test used to check blood sugar levels. In this test, a blood sample is collected after fasting overnight or for at least eight hours. Fasting blood sugar levels between 100mg/dL-125mg/dL are considered to be indicative of prediabetes. Another test, which is widely used in investigating and managing diabetes these days, is Hemoglobin A1C (HbA1c). An HbAic level between 5.7% to 6.4% indicates prediabetes

Management of prediabetes

The primary way to treat prediabetes and prevent its progression to type 2 diabetes is by making healthy lifestyle choices. Here are a few effective ways to manage prediabetes:

1. Follow a nutritious diet

Managing your diet is the primary way to treat type 2 diabetes. Include more foods, such as fresh fruits and vegetables, whole grains, and items low in saturated fat, and cut down or avoid processed foods in your diet.

 2. Be physically active

An important factor in maintaining good health is to be physically active regularly. Aim to get at least 150 minutes of moderate-intensity physical activity every week, which should be divided throughout the week. So, attempt to do at least 30 minutes of physical activity five days a week.

If you are overweight or obese, make sure that you lose the excess weight and maintain a healthy body weight. Making nutritious dietary changes and doing regular exercise is an ideal way to accomplish this objective.

3. Get regular eye check-ups

Prediabetes and type 2 diabetes can increase your risk of developing eye-related problems or vision loss. If diagnosed with prediabetes, consult an ophthalmologist, especially if you notice blurry vision or any vision changes.

4. Quit smoking

Smoking may increase your risk of developing type 2 diabetes. Therefore, if you are diagnosed with prediabetes, smoking may further increase your likelihood of developing diabetes. So, it is suggested to stop this habit.

5. Handle stress wisely 

Research indicates that chronic stress may suppress your immune system and cause hormonal changes that can alter the function of insulin, contributing to your risk of developing type 2  diabetes. It is important to identify the source or cause of stress and adopt effective stress management techniques like meditation, exercise,  or hobbies such as reading and gardening. Seek counseling if you are overwhelmed and need help.

6. Manage other disorders

If you suffer from any chronic health conditions like high cholesterol levels or high blood pressure, ensure that you consult your physician and take medications as directed by them. If you suffer from any sleep disorders, seek the assistance of a medical practitioner to treat them promptly. It is because getting adequate sleep is important for weight loss and maintaining good health.

Also Read: Hypertension: When Did You Last Check Your Blood Pressure?

Although prediabetes may not sound alarming, it is a serious health condition, which, if left untreated can progress to type 2 diabetes. It can also increase your risk of developing cardiovascular diseases like stroke. However, there is no need to panic, as prediabetes is a highly manageable condition if you take effective steps. Making real, sustainable, and healthy lifestyle changes at the earliest can help you control your blood sugar levels and prevent its progression to type 2 diabetes.

References
1. Prediabetes. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/21498-prediabetes (accessed Oct 5, 2021).
2. Prediabetes – Your Chance to Prevent Type 2 Diabetes. Centers for Disease Control and Prevention.   https://www.cdc.gov/diabetes/basics/prediabetes.html#:~:text=Prediabetes%20is%20a%20serious%20health,t%20know%20they%20have%20it. (accessed Oct 5, 2021).
3. Prediabetes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/prediabetes/symptoms-causes/syc-20355278 (accessed Oct 5, 2021). 
4. Pandey SK, Sharma V. World diabetes day 2018: Battling the Emerging Epidemic of Diabetic Retinopathy. Indian J Ophthalmol 2018; 66: 1652-3.