If you have been diagnosed with prediabetes (A1c between 5.7%-6.4%, or a fasting blood sugar between 100-126mg/dL), it is important to know that although it is a major risk factor of/precursor to type 2 diabetes, it is much more significant than that. As obesity rates are on the rise, so are rates of prediabetes and diabetes. According to the NIH, 97 million people in the United States are estimated to have prediabetes, or 1 in 3 people – and 50% of those people will develop type 2 diabetes within 5-10 years.
The processes in the body that lead to the complications from uncontrolled type 2 diabetes actually start during the prediabetes stage. There are detrimental physical changes already happening during prediabetes, as blood sugar levels are higher than normal, but not yet as high as when you have diabetes. During prediabetes there is elevated blood sugar, insulin resistance (your body is less able to use the insulin that your pancreas is producing), dysfunction of the beta cells (the insulin-producing cells of the pancreas), leading to less insulin production), inflammation, decreased incretin effect (hormonal process that stimulates a blood sugar lowering effect), overproduction of glucose by the liver, endothelial vasodilation dysfunction, endothelial fibrinolytic dysfunction, among others. These processes lead to serious complications, which can manifest even before a diagnosis of type 2 diabetes is made.
Adverse health effects that can begin taking place during prediabetes are: the beginning stages of atherosclerosis, increased risk of thrombotic events (stroke, heart attack), changes in cellular structure which makes insulin less able to do its job of getting glucose out of the blood and into the cells, limitation of the cells to store fat, which causes the body to store fat in the liver and muscles which can lead to liver disease over time, damage to kidney cells, damage to eyes (one study found that retinopathy – damage to the vessels of the eyes due to elevated sugar was detected at a rate of 12.6% in people with diabetes, and 7.6% in people with prediabetes). Other issues linked with prediabetes are sexual dysfunction, sleep disturbances, restless leg syndrome, peripheral neuropathy, dysregulation of the gut microbiome which can lead to irritable bowel disease, impaired immune function, and many other issues such as snoring, sleep apnea, tooth loss, increased fracture risk, increased platelet activation (increases risk of blood clotting), CVF, cardiac events.
What can you do? Know your risk factors for developing prediabetes/diabetes:
- Age – older than 45
- Overweight/obesity -losing 5-10% of your body weight can significantly reduce your risk
- Gender
- Smoking
- History of gestational diabetes
- Family history – parent or sibling with t2dm
- Hypertension
- High cholesterol
- Sedentary lifestyle. Try to get a minimum of 150 minutes of moderate-intensity exercise per week, or 75 minutes of vigorous-intensity exercise and weight/strength training 2 days/week. Always ask your doctor before starting any exercise program
- Race/ethnicity – Black, Asian, Latino/Hispanic, Native American, and Pacific Islanders are at greater risk.
If you have any risk factors, it is important to talk to your doctor, ask questions, and get your A1c checked. The current ADA guidelines for people who do not have prediabetes or diabetes to have their A1c checked every 3 years, unless you have risk factors or symptoms. Ask your healthcare provider how often you should have yours checked.
Prediabetes, when caught early and treated actively with lifestyle changes and/or diabetes medications, can be significantly improved or reversed.
References:
Prediabetes Deserves More Attention: A Review – PMC (nih.gov)
Tools to Know Your Risk | ADA (diabetes.org)
60-Second Risk Test for Type 2 Diabetes| ADA
All Blogs are written by Professionals in the fields of Nutrition, Human Development and Diabetes.