Prediabetes, Borderline Diabetes, etc.
Also known as chemical diabetes, potential diabetes, sugar disregulation or borderline diabetes.
This is a diagnosis given to people who are found to have blood glucose levels that are higher than normal but are not yet high enough to be termed diabetic.
I am going to digress a little here - this is a hobbyhorse of mine! I have a problem with this terminology, pre-diabetes. I do not profess to be an expert but surely if the definition of a diabetic is someone with high glucose levels then anyone who has persistent high levels anywhere above what is considered normal is, well, - diabetic?
Diabetes is a progressive disease and whether you catch it at the beginning, the middle or, God help you, the end, why not call it what it is and not try and comfort people with euphemisms?
I have never heard of any doctor referring to a woman in her first weeks of pregnancy as 'pre-pregnant' even if he is aware that the news will be unwelcome!
Also, are we not getting hung up on numbers here? If you fall on one side of a number you are pre-diabetic, on the other side you are diabetic. And to make matters worse the cut off point has been known to shift as new information comes along. The pre-diabetics of yesterday could well be the diabetics of today!
A case in point is the one test used for diagnosis, the Fasting Plasma Glucose Test (FPG).
Before 1997
a FPG reading of 110 - 140mg/dl (6.1 - 7.8 mmol/L) was considered pre-diabetic.
After 1997
this figure was changed to 100 - 126mg/dl (5.6 - 7 mmol/L).
I rest my case!
One argument put forward in favour of this term is that it works as a wake up call for the patient and encourages them to alter their lifestyle. In many cases I suspect it actually gives them a license to ignore it as it is 'not that serious yet'. Living with ones head in the sand is, after all, a very human trait.
Surely telling someone they have diabetes but it is in the early stages and with proper lifestyle changes will not develop into the 'serious with complications' stage then they would have even more motivation to change? Tirade over, lets get down to basics as generally accepted.
Risks of developing pre-diabetes.
These are basically the same as those for Type 2 diabetics.
1. Overweight/obese, especially around the stomach and abdomen.
2. A family history of diabetes.
3. Women who have had gestational diabetes during pregnancy.
4. High blood pressure (140/90 or higher).
5. Cholesterol HDL less than 35 mg/dl (0.90 mmol/L)
6. Triglyceride levels of 250 mg/dl (2.83 mmol/L) or higher.
7. People who have steroid induced high blood glucose.
8. Inactivity - lack of exercise.
There are two tests used for the diagnosis of pre-diabetes. These are the Fasting Plasma Glucose Test (FPG) and the Oral Glucose Tolerance Test (OGTT).
If your FPG results are -
100 - 125 mg/dl (5.6 - 7 mmol/L) then you are pre-diabetic.
If 127mg/dl (7mmol/L) or above you are diabetic.
If your OGTT results are -
140 - 190mg/dl (7.8 - 11mmol/L) then you are pre-diabetic.
If 200mg/dl (11.1mmol/L) or above then you rate diabetic.
The danger of being diagnosed with pre-diabetes is the likelihood of it progressing to full scale type 2 diabetes along with the greater risk of heart attack or stroke.
However all is not lost.......If you follow sensible life style changes then you may stop this in it's tracks. Heed this wake up call!!!
What one has to pay attention to here is that these are quite literally 'for life' changes. It is no use following them until your blood glucose levels are normal and then reverting back to your old way of life - the problem will return to bite you in the place that we all know probably presents all too large a target!
The changes required of you are as follows:-
1. Monitor your glucose daily to make sure it is staying under control.
2. Exercise. It does not have to be the whole gym circuit. Walking, swimming, dancing or cycling for example, for 30 minutes a day, will do wonders.
3. Eat more healthily, avoid too many refined carbohydrates as they turn into glucose in your body and push up your blood glucose levels.
4. Lose some weight. No necessity to look like a famine survivor, 5-7% of your body weight is good. That works out at around 10-15lbs for a 200lb person.
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