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Symptoms and Treatment of Prediabetes

By Kelly Close

Updated July 28, 2008

(LifeWire) - Normally, the food we eat is broken down and converted to glucose (sugar). Insulin, a hormone produced by the pancreas, helps glucose move from the bloodstream and enter the cells where it is used as an energy source for the body. However, if the body does not produce enough insulin or uses the amounts it has ineffectively, glucose levels in the bloodstream rise. When blood sugar levels are higher than normal, but not quite as high as those of a person with diabetes, the condition is known as prediabetes.

Prediabetes almost always precedes type 2 diabetes. High blood sugar levels are not only linked to type 2 diabetes, but to an increased risk of heart disease and stroke. Prediabetes was formerly referred to as impaired fasting glucose (IFG) or impaired glucose tolerance (IGT). Although the condition hasn't changed, but the name was changed because prediabetes is a more apt term than IFG or IGT. It better conveys the risks of the condition, perhaps motivating individuals to take action.

What Are the Symptoms of Prediabetes?

Prediabetes does not really have any overt symptoms. The American Diabetes Association (ADA) recommends that those who fit into any of the following categories be checked for prediabetes.

  • Those who are 45 years old (or older) and overweight
  • Those with any of these risk factors for diabetes:
    • High blood pressure
    • Low HDL ("good") cholesterol (This transports cholesterol out of the blood)
    • High LDL ("bad") cholesterol (This keeps cholesterol in the blood)
  • Those with a family history of diabetes
  • Those who have a personal history of gestational diabetes (greatly elevated blood sugar during pregnancy in nondiabetic women) or have given birth to a child who weighed more than 9 pounds at birth
  • Members of ethnic groups (including American Indians, African Americans, Latinos, Asian Americans and Pacific Islanders) who are at higher risk for type 2 diabetes

Symptoms of diabetes may include excessive thirst, blurred vision, uncharacteristic chronic fatigue and the frequent desire to urinate. Insulin resistance is also common in people with prediabetes. The National Institutes of Health has some excellent information on both insulin resistance and prediabetes available on its Web site.

Anyone who is concerned about prediabetes should talk to his or her health care provider.

How Is Prediabetes Diagnosed?

When a health care provider suspects prediabetes, he or she performs a fasting plasma glucose (FPG) test or an oral glucose tolerance test (OGGT). Both involve a blood glucose test in the morning before any meal, including liquids. Blood glucose levels help health care providers determine if a patient has prediabetes. A fasting blood glucose level between 100mg/dL (milligrams per deciliter) and 125 mg/dL is the accepted range for a diagnosis of prediabetes. The normal fasting blood glucose level is 100mg/dL and the cutoff for diagnosis of diabetes is 126mg/dL or above. A reading of 100mg/dL can be thought of as 0.1 g of sugar for every tenth of a liter of blood.

The OGGT additionally requires a blood glucose test two hours after drinking a sugary drink, which a health care professional can provide. The two-hour blood glucose range for someone with prediabetes is between 140mg/dL and 199mg/dL.

The ADA recommends that people be tested every three years if their blood glucose levels are normal. People who have prediabetes should be tested for diabetes every one to two years.

Prediabetes and Children

The ADA has not yet come out with a recommendation indicating that at-risk children - including those who are obese, have a family history of diabetes or are from the aforementioned ethnic populations - should be tested for prediabetes. No conclusive scientific evidence has shown that type 2 diabetes can be delayed or prevented for this group. Advice about children can be obtained from a health care provider.

Prediabetes and Metabolic Syndrome: What's the Link?

When prediabetes is also associated with lipid abnormalities, abdominal obesity and hypertension, is is commonly called metabolic syndrome.

How Is Prediabetes Treated?

Preventing or significantly lowering the risk of developing type 2 diabetes is possible with regular exercise and modest weight loss. Diabetes does not have a cure, but there is a very good chance of curing prediabetes with timely intervention.

People with prediabetes have a 50 percent greater risk than others of heart disease or stroke. It is important for them to talk to their health care professionals about cardiovascular risk factors, such as high blood pressure, high cholesterol and tobacco use.

LifeWire, a part of The New York Times Company, provides original and syndicated online lifestyle content. Kelly L. Close is Editor-in-Chief of diaTribe (www.diatribe.us), a free online newsletter for people eager to learn more about better managing diabetes. She is also founder and principal of Close Concerns, Inc., a consulting firm devoted to the business of diabetes. Kelly's passion for the field comes from her extensive professional work as well as from her personal experience as a patient with type 1 diabetes for over 20 years. In addition to her roles at diaTribe and Close Concerns, Kelly also sits on the board of the San Francisco Bay Area JDRF chapter and on the Children With Diabetes Foundation.
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