What is pre-diabetes?
Pre-diabetes, also commonly referred to as borderline diabetes, is a metabolic condition and growing global problem that is closely tied to obesity.
If undiagnosed or untreated, pre-diabetes can develop into type 2 diabetes; which whilst treatable is currently not fully reversible.
Pre-diabetes is characterised by the presence of blood glucose levels that are higher than normal but not yet high enough to be classed as diabetes.
For this reason, pre-diabetes is often described as the “gray area” between normal blood sugar and diabetic levels. In the UK, around 7 million people are estimated to have pre-diabetes and thus have a high risk for developing type 2 diabetes.
The increasing number of new cases of pre-diabetes presents a global concern as it carries large scale implications towards the future burden on healthcare. Between 2003 and 2011, the prevalence of pre-diabetes in England alone more than tripled, with 35.3% of the adult population, or 1 in every 3 people having pre-diabetes.
What does this mean?
Pre-diabetes is where your blood sugars are above what is considered the normal range but lower than the Diabetes range.
HBA1c is a blood test which measures the glucose (sugar) that is attached to the red blood cells. Because red blood cells survive for three months, the HBA1c gives us a good idea of what your blood sugar control has been like over a three-month period, so we cannot blame the raised blood sugars on a recent period of overeating.
HBA1c of 42 to 47 puts you in the Pre-diabetes range.
HBa1c of 48 and above puts you in the Diabetic range.
Being Pre-diabetic means that you are insulin resistant and are likely to progress to develop Diabetes over the following years if no significant lifestyle changes are made
Is this bad news?
Not at all!
By identifying that you are at risk of Diabetes, you now have the opportunity to make lifestile changes hich can prevent you from progressing to developing Diabetes.
Through lifestyle changes, we are observing that many patients are actually getting their blood sugar levels back into the normal range and also achieving weight loss.
What would these lifestyle changes involve?
We generally recommend reducing or cutting out as much as possible consumption of sugar (sucrose) and refined processed carbohydrates (which break down to glucose in the body – foods like bread, pasta, rice, cereals etc.
Addressing movement, sleep and stress management are also key areas that are equally important
Please contact the practice to request a New Prediabetes appointment with the practice nurse and you will be given information and support on making these changes.
Please also read the eat real food leaflet – which gives you some information on how to get started.
The important thing is to take action and make this an opportunity to make changes to prevent developing Diabetes
Pre-diabetes is a critical stage in the development of diabetes, for it is at this point that lifestyle choices can be made to turn it around. Early, decisive action can slow down or even halt the development of type 2 diabetes.
What are the symptoms of pre-diabetes?
Many people have pre-diabetes but are completely unaware of it. This is because the condition often develops gradually without any warning signs or symptoms. In many cases, the sufferer only learns of their borderline diabetic state once the symptoms of type 2 diabetes start to appear.
Testing for pre-diabetes
The amount of sugars in the blood is detected by either a fasting plasma glucose test or an HbA1c and may be used to diagnose type 2 diabetes or pre-diabetes.
The following results indicate the presence of pre-diabetes:
- Fasting plasma glucose:5 mmol/L to 6.9 mmol/L
- HbA1c: 42 to 47 mmol/mol (6.0 to 6.4%)
If your results are above the upper limits for pre-diabetes, your GP may either diagnose you with type 2 diabetes or take another test in the near future to confirm whether you have diabetes. If you have symptoms of diabetes but have an HbA1c of below 42 mmol/mol (6.0%), you may be given a glucose tolerance test (GTT).
If you are diagnosed with pre-diabetes, you can attend a pre-diabetes education program which clearly set out the steps you need to take to lower your risk of developing type 2 diabetes.
Can I stop pre-diabetes developing into type 2 diabetes?
The good news is that cases of pre-diabetes that are identified early on can be reversed, preventing them from progressing into full-blown type 2 diabetes. Each year in the UK, 5% to 10% of people diagnosed with pre-diabetes go on to develop type 2 diabetes.
The two principle factors for consideration are making changes to your diet and increasing physical exercise which is appropriate for your lifestyle. By making these changes, blood sugar levels can be returned to normal.
What is Real Food?
We believe that health is achieved by tending to our 4 pillars of health – Food, Movement, Sleep and Stress Management. Lifestyle change is one of the most powerful tools we have at our disposal to combat disease to restore heath and optimise wellbeing. Personal empowerment to take control of your health is the cornerstone of lifestyle medicine.
As a practice we support lifestyle changes to manage chronic disease and to lose weight. We believe that eating real food is a core part of this.
What if I am frail and elderly?
It usually takes several years to progress from Pre-diabetes to Diabetes.
If you are aged 80 years and over, you probably do not need to make significant changes to your lifestyle unless you wish to.
However, if you wish to get support in making lifestyle changes, please request an appointment with the Diabetes Nurse
Go to My Diabetes My Way for further information
GESTATIONAL DIABETES
As a practice we have recently been made aware of some updated guidance relating to women who were diagnosed with gestational diabetes during a previous pregnancy.
This new guidance identified a link between women who have had gestational diabetes and the potential risk of developing type 2 diabetes in later life. It involves an annual blood test called your HbA1c that helps monitor for the development of type 2 diabetes (T2DM)
T2DM is an increasingly common diagnosis and it is important to have it detected and treated to prevent complications in the future from undiagnosed and uncontrolled high blood sugar.
Your HBA1C is a blood test which measures an average sugar level which is a sensitive test to look for T2DM.
In Lanarkshire these results are:
- Normal levels would be less than 43.
- Levels of 43-47 are ‘pre diabetes’ which means there is a potential to go onto T2DM,
- 48 and over are diagnostic of T2DM.u.
Information on Gestational Diabetes can be found online at
www.gestationaldiabetes.co.uk/preventing-type-2www.diabetes.or