Prediabetes : a point of no return?

Diabetes is a condition where a person has high blood glucose levels due to problems with insulin production or utilization.

Insulin is an hormone produced by the Pancreas that helps to mop up glucose from the blood and mobilise it into tissues especially adipose (fatty) tissue and muscles.

Diabetes is a common word, but Prediabetes is less so.

The onset of type 2 diabetes is usually preceded by an asymptomatic preclinical state known as prediabetes.

Prediabetes is a condition where a person has higher than normal blood sugar level but not quite high enough to make a diagnosis of full blown type 2 diabetes. The progression from Prediabetes to diabetes may occur rapidly or over a couple of years depending on lifestyle modification.

The prevalence of prediabetes ranges in adults from 2.2% to 16.2% with a prevalence of 7.3% in sub-Saharan Africa.

It’s estimated that 90 percent of those with prediabetes are unaware that they have the condition. An estimated 86 million Americans have prediabetes, according to the Centers for Disease Control and Prevention. According to American Diabetes Association, Prediabetes alone increases the risk of heart disease and stroke by 50 percent. However, no statistics is available for the Nigerian population.

An international expert panel now recommends the A1C test ( which is the measure of blood glucose over the past two to three months ) to diagnose diabetes in everyone except pregnant women. Before now, diabetes was diagnosed by checking fasting or random blood glucose.

Researchers have shown that while one blood sugar test can be elevated at a particular time, the A1C test is a surer way of diagnosing diabetes. A1C of 5.6 and below is considered normal, 5.7-6.4 is termed Prediabetes and 6.5 and above is diabetes.

Checking fasting blood sugar is however still relevant and normal fasting blood sugar (before meal in the morning) levels is usually between 70-100 mg per dl. A blood sugar level between 100-125 is considered Prediabetes or Impaired fasting glucose while that from 126 and above is diagnosed Diabetes. Random blood sugar of less than 140 is considered normal, 140-199 is prediabetes while 200 and above is diabetes.

What Increases Your Risk of Prediabetes?

The eight risk factors identified by the American Diabetes Association include

Family history

Weight (especially abdominal)

Low physical activity

Age (more common in people above 45 years)

Race/ ethnicity ( More common in the African American, Hispanic/Latino, American, Indian, Asian American, or Pacific Islander)

A history of diabetes while Pregnant

Polycystic ovarian syndrome (presence of multiple cysts in the ovary)

Other factors like high blood pressure and high cholesterol levels.

Is Prediabetes Reversible?

It’s very possible for a reversal of a Prediabetic state by healthy diet and exercise. This shows a need for regular check up to regulate blood sugar early enough.

What can be done to reverse Prediabetes?

Loosing weight and increasing physical activity and health diet can reduce or prevent the rate of progression to diabetes. Diet and exercise should focusing on loosing 5-7 percent of weight .

An Harvard School of Public Health study showed that women who took a brisk 30-minute walk every day lowered their risk for diabetes by 30 percent.

Proper management of prediabetes is important to curb the imminent type 2 diabetes epidermic.

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