Prediabetes: Hidden blood sugar

PREDIABETES, ALSO called impaired fasting or impaired glucose tolerance, is a metabolic disorder characterised by abnormally high blood sugar levels (glucose) but not high enough to be diagnosed as Type 2 diabetes yet. Unfortunately, prediabetes is silent and may not clue us in on its presence. Without a change in lifestyle, it could progress irreversibly to Type 2 diabetes within five years. As with diabetes, prediabetes is also a risk factor for heart disease and stroke. While statistics on prediabetes are not available in Jamaica, the Centres for Disease Control and Prevention report that about 96 million American adults are living with prediabetes which implies that about one in three adults are prediabetic. Only, about 20 per cent of those with prediabetes are aware that they have it which results in missed opportunities to delay or prevent the onset of Type 2 diabetes. One in every eight Jamaicans are diabetic which places a significant burden on our healthcare and economic resources. This rate is rapidly growing; therefore, a national health focus is to prevent this trending progression through increased awareness and promoting healthy lifestyles.

WHAT CAUSES PREDIABETES?

Prediabetes is a first step in the metabolic disturbances of Type 2 diabetes. It starts off with your cells responding abnormally to insulin (a hormone which allows your body’s cells to uptake glucose and utilise it for energy) resulting in high blood sugar levels. Consequently, your pancreas(the organ which makes insulin) produces an increased amount of insulin to fuel the cells but eventually, the pancreas is no longer able to keep up with the increased insulin demand. This results in prediabetes and later progression to Type 2 diabetes. However, the good news is that progression to Type 2 diabetes is preventable and can be controlled by lifestyle modifications and/or treatment.

RISK FACTORS

Genetics and family history are significant factors in the development of prediabetes. The same factors that increase predisposition to Type 2 diabetes may also increase the risk for prediabetes such as:

i. Being overweight and obese

ii. Having a parent or sibling with diabetes

iii. Gestational diabetes

iv. Giving birth to a large baby over nine pounds

v. Having polycystic ovarian syndrome

vi. Being physically inactive

vii. Having high blood pressure and high blood cholesterol levels

viii. Chronic stress

If you have any of these risk factors, it might be worthwhile to consult with your doctor to check your blood sugar levels annually.

WHAT ARE THE SYMPTOMS OF PREDIABETES?

There are no clear symptoms associated with prediabetes, therefore, prediabetes may go undetected for years until there is progression to Type 2 diabetes. However, some people may notice a dark discolouration of the skin in the form of thick velvety patches. This discolouration is usually observed around the elbows, knees, neck, armpits, groin, and knuckles which is typically a sign of insulin resistance.

PROGRESSION TO TYPE 2 DIABETES

Classic signs and symptoms which may indicate that you have progressed to Type 2 diabetes include:

i. Excessive urination

ii. Excessive thirst

iii. Increased appetite

iv. Frequent vaginal yeast infections

v. Blurry vision

vi. Feeling a lot more tired than usual

vii. Slow healing cuts or bruises

viii. Unexplained weight loss

If you notice any of these symptoms, you should check with your healthcare provider for screening, since diabetes can lead to the development of chronic complications such as diabetic foot, amputations, blindness, kidney problems, nerve problems, heart attack and stroke.

WAYS YOU CAN REDUCE YOUR CHANCES OF PROGRESSING TO TYPE 2 DIABETES

Fortunately, the diagnosis of prediabetes offers you a chance to prevent the onset of Type 2 diabetes. If you are diagnosed with prediabetes, you must lead an active life. You should incorporate aerobic activity such as exercising, brisk walking, running, swimming, or cycling for at least 30 minutes a day for five days per week. Muscle building through strength training exercises like lifting weights and resistance bands are also recommended at least twice per week. Research findings suggest that strength training lowers blood glucose levels and improves the cells response to insulin.

Additionally, maintaining a healthy body weight is useful if you are overweight. Studies show that losing five to ten per cent of body weight in obese or overweight subjects may help to restore normal blood glucose levels. It is advised that you include fruits, vegetables, lean protein, and whole grains in your diet while reducing saturated fats and sugars.

Quitting smoking is another way to keep diabetes at bay as smoking increases the risk of developing Type 2 diabetes by up to 30 per cent compared to non-smokers. These measures may be useful to restore normal blood glucose levels and reduce your chance of progressing to Type 2 diabetes. It is also important to note that while lifestyle modifications can work for some people, others may need medication. Therefore, a diagnosis of prediabetes offers a window of opportunity to prevent diabetes.

Melisa Anderson Cross is a clinical chemistry lecturer in the College of Health Sciences at the University of Technology, Jamaica.