Prediabetes
Prediabetes simply means that you have a higher than normal blood sugar level. However, it is not high enough to be considered type 2 diabetes yet. Without lifestyle changes, prediabetes can progress to type 2 diabetes. An estimated 84 million Americans over the age of 20 are currently living with prediabetes, but 90% don’t know they have it.
What are the possible symptoms of prediabetes?
Prediabetes typically doesn’t have any signs or symptoms. One possible sign of prediabetes is darkened skin in certain areas like the neck, armpits, knees, elbows, and knuckles.
Classic signs and symptoms that you have moved from prediabetes into type 2 diabetes include:
• Increased thirst
• Frequent urination
• Excess hunger
• Fatigue
• Blurred vision
What causes prediabetes?
Image Credit: https://ct-stem.northwestern.edu/curriculum/preview/174/page/1/
The exact cause of prediabetes is unknown, but family history and genetics appear to play a role. A lack of regular physical activity and being overweight with excess fat around your abdomen also seem to be important factors.
According to the Mayo Clinic, people with prediabetes don’t process sugar
(glucose) properly anymore. As a result, sugar builds up in the blood instead of giving energy to other cells that make up muscles and other tissues.
Most glucose in the body comes from the food that we eat. When food is
digested, sugar enters the bloodstream and requires insulin to move it into the cells of the body. Insulin is produced in the pancreas and is sent to the bloodstream when you eat. As the insulin circulates, it allows sugar to enter the cells lowering the sugar in the bloodstream. As the blood sugar levels drop, the pancreas slows down the secretion of insulin into the blood.
When you have prediabetes, this process doesn’t work as well. The pancreas may not make enough insulin or cells become resistant to insulin and don’t allow as much sugar in. So instead of providing energy, sugar builds up in the bloodstream.
What are the risk factors for prediabetes?
The same factors that increase your risk of type 2 diabetes also increase the risk of prediabetes. Factors include:
• Weight – Being overweight is the primary risk factor for prediabetes. The more fatty tissue you have, especially inside and between the muscle and skin around your abdomen, the more resistant your cells become to insulin.
• Waist size – A large waist size can indicate insulin resistance. The risk of insulin resistance goes up for men with waists larger than 40 inches and for women with waists larger than 35 inches.
• Diet – Eating red meat and processed meat, and drinking sugar-sweetened beverages, is associated with a higher risk of prediabetes. A diet high in fruits, vegetables, nuts, whole grains and olive oil is associated with a lower risk of prediabetes.
• Inactivity – The less active you are, the greater your risk of prediabetes. Physical activity helps you control your weight, uses up sugar for energy and makes the body use insulin more effectively.
• Age – Although diabetes can develop at any age, the risk of prediabetes increases after age 45.
• Family history – Your risk of prediabetes increases if you have a parent or sibling with type 2 diabetes.
• Race or ethnicity – Although it's unclear why, certain people — including Black, Hispanic, American Indian and Asian American people — are more likely to develop prediabetes.
• Gestational diabetes – If you had diabetes while pregnant (gestational diabetes), you and your child are at higher risk of developing prediabetes. If you've had gestational diabetes, your doctor will likely check your blood sugar levels at least once every three years.
• Polycystic ovary syndrome – Women with this common condition — characterized by irregular menstrual periods, excess hair growth and obesity — have a higher risk of prediabetes.
• Sleep – People with obstructive sleep apnea — a condition that disrupts sleep repeatedly — have an increased risk of insulin resistance.
• Tobacco smoke – Smoking may increase insulin resistance. Smokers also seem to carry more weight around the middle.
Other conditions that are commonly associated with prediabetes include:
• High blood pressure
• Low levels of high-density lipoprotein (HDL) cholesterol (the “good” cholesterol)
• High level of triglycerides – a type of fat in your bloodstream
When these conditions occur with obesity, it is associated with insulin resistance. The combination of 3 or more of these conditions is called metabolic syndrome.
When should you get tested for prediabetes?
Speak with your healthcare provider about getting tested if any of the above apply to you and if you have any of the following:
• Have had an unusual blood sugar reading
• Have heart disease
• Show signs of insulin resistance, which means your body makes insulin but doesn't respond to it the way it should. These include darkened areas of skin, trouble concentrating, and more fatigue or hunger than usual.
What are the complications of prediabetes?
The most serious consequence of prediabetes is progression to type 2 diabetes. Type 2 diabetes can lead to:
• High blood pressure
• High cholesterol
• Heart disease
• Stroke
• Kidney disease
• Nerve damage
• Vision problems, possibly loss of vision
• Amputations
Prediabetes has been linked with unrecognized (silent) heart attacks and can damage your kidneys.
How can you prevent prediabetes?
Healthy lifestyle choices can help prevent prediabetes and its progression to type 2 diabetes. Try to do the following:
• Eat healthy foods
• Get at least 150 minutes of moderate aerobic physical activity a week, or about 30 minutes on most days of the week
• Lose excess weight
• Control your blood pressure and cholesterol
• Don't smoke
Prediabetes is reversible by making healthy lifestyle choices to get to a healthy weight, controlling blood pressure and cholesterol, and getting plenty of physical activity. Get your blood sugar out of the prediabetes range and keep it that way.
Sources:
https://www.mayoclinic.org/diseases-conditions/prediabetes/symptoms-causes/syc-20355278
https://www.webmd.com/diabetes/what-is-prediabetes
https://ct-stem.northwestern.edu/curriculum/preview/174/page/1/