Prediabetes: A Major Public Health Threat

Formerly called borderline diabetes until 1979, prediabetes refers to serum blood sugar levels that are higher than normal, but not high enough to indicate true diabetes. Specifically, a fasting reading of 100-125 mg/dl qualifies for a diagnosis of prediabetes.

In the US alone, this alteration in metabolism has truly reached epidemic proportions affecting an estimated 79 million Americans which works out to one in four. More worrisome is that this number only continues to climb. This is a major public health threat because prediabetes is a direct precursor to diabetes which raises risk factors for developing heart disease, stroke, blindness and other life altering conditions by a factor of 2-4 times.

Risk factors For Acquiring Prediabetes

Why this borderline disease occurs isn't entirely understood by researchers, although there are particular risk factors, which are contributory.

Most risk factors arise from a patient’s lifestyle and include sleeping less than six hours daily, age, eating excessive amounts of sugary foods, obesity, as well as lack of exercise. Specific races are most at risk, including Asian Americans, Hispanics/Latinos and non-Hispanic Blacks. Other risk factors include high triglycerides and low HDL rates as well as being diagnosed with polycystic ovarian syndrome or cardiovascular disease. Patients with psychiatric illnesses such as schizophrenia who are on multiple psychotropic drugs, additionally have a high prevalence of prediabetes.

How Prediabetes Is Diagnosed

The diagnosis of prediabetes can be made using several methods: a fasting blood glucose test, an oral glucose tolerance test and a random test. The first method requires fasting for a 24-hour interval after which a blood glucose reading is subsequently taken. Any reading between 100 to 125 mg/dL is considered positive. The second method requires drinking a glucose solution that is standardized. In this case, a reading between 140 to 200 mg/dL would indicate prediabetes. The third method involves a random fingerstick sample, which if over 140mg/dl, indicates the presence of the disease.

Prediabetes is frequently asymptomatic and the can only be properly diagnosed by checking blood sugar levels. Some people however develop symptoms of true diabetes including increased thirst and urination, unexplained weight reduction or gain, slow healing from small wounds like cuts and bruises as well as a general sense of malaise.

Recommendations

Several recent studies have assessed the function of drugs and lifestyle changes for the treatment of this borderline disease. This includes regular physical activity at least 5 times per week, improving dietary choices to include more fruits and vegetables, moving away from an acidic diet to a more alkalinized one, eliminating fast food (especially trans fats), and only eating complex carbohydrates. These smart choices can have a major impact on reducing the chances that the prediabetic state will progress into full blown diabetes mellitus.

Compared to other disease processes, prediabetes is unique in that there is a "window" which allows for lifestyle changes which can ward off progression to true diabetes in 80% of cases. It’s the body’s way of saying, "hey, wake up, you need to make some major changes if you don’t want to develop full blown diabetes."

Disclaimer: The information contained herein is for educational purposes only and should not be considered medical advice. Please consult your health care provider for recommendations on how best to manage any medical condition.