What is pre-diabetes?
When you have pre-diabetes, your blood glucose (sugar) is higher than normal, but not high enough to be diabetes. The problem is that this condition puts you in danger of getting type 2 diabetes. Diabetes is a very serious disease that can have bad effects on your health. Today nearly 29 million Americans have diabetes. But even greater numbers of Americans (about 86 million) have pre-diabetes. And the numbers continue to grow.
Is it a new condition?
Pre-diabetes is a new name for an old condition. It used to be called “impaired glucose tolerance” (IGT) or “impaired fasting glucose” (IFG). Some people have been told they have "borderline" diabetes. These terms mean that blood glucose levels are a bit raised. We know much more about this condition today and how it may lead to diabetes, so we now call it pre-diabetes.
Pre-diabetes is a Health Problem
Pre-diabetes makes it easier for your body to develop diabetes. Most people who have pre-diabetes develop type 2 diabetes within 10 years. But even pre-diabetes can have bad effects on your health. For example, people with pre-diabetes have 1.5 times more risk of heart and blood vessel disease. This includes high blood pressure, stroke, and heart attack.
Diabetes can be Prevented
When you have pre-diabetes and make lifestyle changes, you can prevent or delay diabetes. In a large study called the Diabetes Prevention Program, doctors looked at a large number of overweight people who were just a step away from diabetes. Here is what the study found: Losing weight and exercising delays diabetes. Just by losing 7 percent of your body weight and being active (moderate activity like brisk waling) for 150 minutes or more a week you can reduce your rate of getting diabetes by up to 58 percent.
How likely am I to get pre-diabetes?
Risk factors increase your chances of getting pre-diabetes and diabetes. The risk factors are the same for both. You are more likely to get pre-diabetes or diabetes if you:
- Are not physically active
- Have a first degree relative with diabetes (parent, brother or sister)
- Are a member of a minority group, including African American, Native American, Latino, or Pacific Islander
- Are overweight or obese
- Have high blood pressure
- Have high blood fats, called cholesterol (co-LESS-ter-all) and triglycerides (try-GLISS-er-ides)
- Had high blood glucose when pregnant; this is called gestational (jess-TAYshun-ol) diabetes
- Gave birth to a baby weighing more than 9 pounds
What symptoms should I look for?
Often there are no symptoms when you have pre-diabetes. You can have pre-diabetes without knowing it. You could even have diabetes and not know it. Millions of people do. Some of the symptoms of diabetes are:
- Extreme thirst
- Passing water (urinating) often
- Blurred vision
- Extreme tiredness for no known reason
How can I know if I have pre-diabetes?
Several tests can detect pre-diabetes. One is the FPG (fasting plasma glucose test). The other is the OGTT (oral glucose tolerance test). For either test, you must fast overnight. This means you can have no food or liquids for 8 hours before the test. If you have the FPG, your blood glucose is tested once. If you have the OGTT, your blood glucose is tested twice. It will be tested after you fast. Then you will drink a sugar-rich liquid, and your blood glucose will be tested 2 hours later.
FPG: Fasting Plasma Glucose (see first chart above)
Normal: under 100 mg/dl
Pre-diabetes: 100 to 125 mg/dl
Diabetes: 126 mg/dl or higher
OGTT: Oral Glucose Tolerance Test (see second chart at right)
2-hour test results:
Normal: under 140 mg/dl
Pre-diabetes: 140 to 199 mg/dl
Diabetes: 200 mg/dl or higher
An A1c (A-one-C) test is another way to tell if you are at risk to develop diabetes. This blood test shows your estimated average blood glucose level over 3 months. Normal A1c is less than 5.7%. If you have a level between 5.7% and 6.4%, you are at risk for developing diabetes. It is considered diabetes if this level is 6.5% or higher.
Should I be tested?
Ask your doctor about pre-diabetes testing. Your doctor will tell you if you should have a test. Here are the test guidelines from the American Diabetes Association (ADA): You should consider testing if you are:
- Over age 45
- Under age 45 and overweight
- Under age 45 and have 1 or more risk factors (see Page 1, “How likely am I to get pre-diabetes?”)
Testing is strongly recommended if you are:
- Over age 45 and overweight
How often should I be tested?
If your test results show blood glucose in the normal range, get tested every 3 years. If your test results show that you have pre-diabetes, get tested every 1 to 2 years.
What do I do for pre-diabetes?
When you have pre-diabetes, take steps to delay or prevent diabetes. It’s very important to change your diet and to exercise. Losing weight and getting more physical activity can make a big difference.
Take these steps:
- If you are overweight, try to lose 7 percent of your body weight. Reduce the number of calories in your diet. Lower the amount of fat in your diet.
- Increase your physical activity. You don’t need a fancy routine. Just move your body to burn calories. Take a brisk walk for 30 minutes every day. Play outdoors with your kids or grandkids. Work in the yard. Always check with your doctor before you start a new fitness program.
- Look for ongoing support programs in your area. This can help to keep you on track.
- Ask your doctor about the risk factors for heart disease or stroke. Smoking, high blood pressure, and high cholesterol are some of these risk factors. Ask about treatment or counseling for any risk factors you have.
Can I get help to manage pre-diabetes?
To manage pre-diabetes, you will need a plan. Talk to members of your health care team. They will help to design an overall plan for managing your pre-diabetes.
- Your primary doctor can provide testing and decide on the best way for you to prevent or delay diabetes.
- A diabetes educator can give you information on how to control your blood glucose levels.
- A dietitian can help you lose weight by finding a meal plan that can work well for you.
- An exercise physiologist (fizz-ee-ALLoh- jist) can design a physical activity plan to help you lose weight and gain energy.
Act now! If you act now, you can reduce your chance of diabetes, stroke, or heart disease in the future.
For more information on diabetes prevention, go to: http://www.diabetesprevention.pitt.edu/.
Revised July 2013