Pre-Diabetes: Bad News and Good News

By Gigi Dawood, DO

Diabetes—these days it has become almost a household disease. It discriminates against no one; young and old, family or friends, most people know at least one person with the disease. But have you heard about pre-diabetes?

This is a less known condition, but just as important to discuss because of all the potential complications it presents, including progressing to diabetes itself. Pre-diabetes is what the name suggests, a state where one’s blood glucose levels are higher than they normally should be. Some may call it “borderline” diabetes. Physicians commonly refer to this state as Impaired Glucose Tolerance or Impaired Fasting Glucose.

The American Diabetes Association estimates that there are now 54 million people with pre-diabetes. Often pre-diabetes has no signs or symptoms. In fact, millions of people have diabetes and don’t know they do because they have no symptoms, or they happen gradually. Diagnosing pre-diabetes is important because having abnormal blood sugars can increase your risk of developing type 2 diabetes, and cardiovascular disease. If you have the diagnosis of pre-diabetes, your risk for heart disease or stroke increases by 50%. Every year about 10% with pre-diabetes develop the actual diagnosis of diabetes. Because pre-diabetes has no obvious signs or symptoms, blood tests are required to look for the abnormal sugars.

As of January 2010, the American Diabetes Association has started to recommend the A1c blood test as another means of diagnosing diabetes and pre-diabetes. An A1c of 5.7 to 6.4% would indicate pre-diabetes and an A1c of 6.5% or higher would indicate diabetes. The advantage of this blood test is that it can be done at any time of day, without fasting. It reflects a person’s average blood glucose levels over the previous three months.

There is good news, too! Progression to type 2 diabetes and all of its related complications, such as heart, kidney, and eye damage, can be prevented. By increasing physical activity, eating less, and maintaining a healthy weight you can bring your blood glucose levels to normal. Regular exercise is beneficial for weight control and the utilization of excessive glucose in the bloodstream. Exercise also makes your cells more sensitive to insulin which is a natural hormone that is made in your body that brings glucose into your cells.