What is Pre-diabetes?
Pre-diabetes is diagnosed when your blood sugar level is higher than normal, but not high enough to be diagnosed as type 2 diabetes. It is potentially reversible. People with pre-diabetes usually don't have any symptoms, however they are at risk of serious health consequences.
Diabetes on the other hand is a chronic condition that is diagnosed when your blood sugar level is above a certain cutoff threshold. It is generally not a reversible condition and you have a much high risk of serious health complications when you progress from pre-diabetes to full-blown diabetes.
Why do we get Pre-Diabetes/Diabetes?
Normally, sugars (or carbohydrates) are absorbed from the gut into the blood and from there a hormone called insulin which is made in the pancreas gland lets the sugar into cells where it can be used for energy. If there is not enough insulin or the body does not respond normally to the insulin, sugar cannot go from the bloodstream into the cells and hence though there is a lot of sugar around, the body is unable to use it as energy. Over a long time, the high sugar levels are toxic to nerves and blood vessels, leading to diabetic complications.
The term "diabetes' encompasses several types of diabetes - Type 1 diabetes, Type 2 diabetes and Gestational Diabetes. Type 1 diabetes usually affects younger people or children - the pancreas fails due to an autoimmune problem and no insulin is made at all - insulin injections are needed. In type 2 diabetes, the pancreas hasn't failed completely. It still makes some insulin, but it does not make enough and in addition, the body may be resistant to it, meaning that there is not enough insulin to meet demand or it doesn't work properly. When the failure is bad enough, this is when a person with type 2 diabetes has to go on insulin injections.
In general this article is talking about people with type 2 diabetes.
Pre-diabetes is diagnosed when your blood sugar level is higher than normal, but not high enough to be diagnosed as type 2 diabetes. It is potentially reversible. People with pre-diabetes usually don't have any symptoms, however they are at risk of serious health consequences.
Diabetes on the other hand is a chronic condition that is diagnosed when your blood sugar level is above a certain cutoff threshold. It is generally not a reversible condition and you have a much high risk of serious health complications when you progress from pre-diabetes to full-blown diabetes.
Why do we get Pre-Diabetes/Diabetes?
Normally, sugars (or carbohydrates) are absorbed from the gut into the blood and from there a hormone called insulin which is made in the pancreas gland lets the sugar into cells where it can be used for energy. If there is not enough insulin or the body does not respond normally to the insulin, sugar cannot go from the bloodstream into the cells and hence though there is a lot of sugar around, the body is unable to use it as energy. Over a long time, the high sugar levels are toxic to nerves and blood vessels, leading to diabetic complications.
The term "diabetes' encompasses several types of diabetes - Type 1 diabetes, Type 2 diabetes and Gestational Diabetes. Type 1 diabetes usually affects younger people or children - the pancreas fails due to an autoimmune problem and no insulin is made at all - insulin injections are needed. In type 2 diabetes, the pancreas hasn't failed completely. It still makes some insulin, but it does not make enough and in addition, the body may be resistant to it, meaning that there is not enough insulin to meet demand or it doesn't work properly. When the failure is bad enough, this is when a person with type 2 diabetes has to go on insulin injections.
In general this article is talking about people with type 2 diabetes.
(picture from https://www.medicinehow.com/what-is-diabetes/)
Why should I care?
Having pre-diabetes increases your risk of getting diabetes, heart disease and stroke. It's important to know if you have it because it can be reversed and its complication can be averted
What can I do?
If you have been diagnosed with pre-diabetes, lifestyle adjustments, such as a healthy diet, increasing your physical activity and losing weight can prevent or delay the onset of diabetes and its complications.
If you are diagnosed with diabetes, regular follow-up, effective treatment and monitoring is vital to reduce or prevent complications and to detect them early when they occur.
Screening
Regular screening for diabetes and pre-diabetes is recommended every 3 years for those aged 40 years and above. If you are at higher risk you may need to screen earlier than this - discuss with your family doctor.
Screening involves a fasting blood sugar test. If it is abnormal a repeat fasting blood sugar test (if in the diabetic range) or an OGTT (oral glucose tolerance test - if in the pre-diabetic range) may be done.
Am I at Risk?
You have an increased risk of type 2 diabetes if you:
When diabetes is uncontrolled, the high sugar levels damage nerves and blood vessels which supply the body's organs. This leads to the complications of diabetes such as;
The good news is that with early diagnosis, good diabetic control, and monitoring, these complications can be prevented completely, or delayed. Your doctor will be able to advise you if you need to go for screening and if you have diabetes or pre-diabetes, will be able to plan with you to manage the condition effectively.
Why should I care?
Having pre-diabetes increases your risk of getting diabetes, heart disease and stroke. It's important to know if you have it because it can be reversed and its complication can be averted
What can I do?
If you have been diagnosed with pre-diabetes, lifestyle adjustments, such as a healthy diet, increasing your physical activity and losing weight can prevent or delay the onset of diabetes and its complications.
If you are diagnosed with diabetes, regular follow-up, effective treatment and monitoring is vital to reduce or prevent complications and to detect them early when they occur.
Screening
Regular screening for diabetes and pre-diabetes is recommended every 3 years for those aged 40 years and above. If you are at higher risk you may need to screen earlier than this - discuss with your family doctor.
Screening involves a fasting blood sugar test. If it is abnormal a repeat fasting blood sugar test (if in the diabetic range) or an OGTT (oral glucose tolerance test - if in the pre-diabetic range) may be done.
Am I at Risk?
You have an increased risk of type 2 diabetes if you:
- Are aged 40 and above
- Have a sedentary lifestyle
- Have a close relative such as a parent, or sibling with diabetes
- Are overweight or obese (BMI >23.0 Kg/M2 for asians of >25.0 Kg/M2 for caucasians)
- Have high blood pressure and/or cholesterol
- Have a history of gestational diabetes (diabetes during pregnancy)
- Have pre-diabetes (which may also also be known as IFG (impaired fasting glucose) or IGT ( impaired glucose tolerance)
When diabetes is uncontrolled, the high sugar levels damage nerves and blood vessels which supply the body's organs. This leads to the complications of diabetes such as;
- Heart disease/heart attack
- Stroke
- Eye damage, which can eventually lead to blindness
- Kidney damage, leading to kidney failure and need for dialysis
- Nerve damage - can cause gastrointestinal problems, sensory problems, and erectile dysfunction.
- Diabetic foot disease - diabetic nerve damage normally affects the longest nerves in the body first - those that go to the feet. When you can't feel your feet due to nerve damage, minor trauma from everyday tasks goes unnoticed and because there is no pain, you carry on using the feet making the injuries worse. Add to this the poor wound healing due to compromised blood vessels and it's not hard to see why it's easy for foot ulcers and gangrene to develop, needing amputation in some cases.
The good news is that with early diagnosis, good diabetic control, and monitoring, these complications can be prevented completely, or delayed. Your doctor will be able to advise you if you need to go for screening and if you have diabetes or pre-diabetes, will be able to plan with you to manage the condition effectively.