Pre Diabetes Diagnosis: Where to Now?
Being told you have Pre Diabetes can be distressing, but it can also be an important wakeup call to improve your health and make lifestyle changes to reduce your risk of developing Type 2 Diabetes.
The Science – What is Pre Diabetes?
Pre Diabetes is a precursor to Type 2 Diabetes where not all of the symptoms to label a person as diabetic are present but where blood glucose levels are abnormally high. It is sometime referred to as impaired fasting glucose or Metabolic Syndrome where central obesity is also present. With Pre Diabetes fasting blood glucose levels are higher than the normal range of up to 5.5mmol/L but less than the level where Type 2 Diabetes is diagnosed at 7.0mmol/L
If you have impaired fasting glucose (5.5mmol/L – 6.9mmol/L) your Doctor will most likely request an oral glucose tolerance test to confirm the diagnosis. This test measures your body’s ability to manage a set dose of glucose over the following two hour period. Pre Diabetes will be diagnosed if you have impaired fasting glucose (6.1 mmol/L-6.9mmol/L) or a 2 hours post prandial (post consumption) impaired glucose tolerance of 7.8mmol/L- 11mmol/L.
Individuals with pre Diabetes are at high risk of developing Type 2 Diabetes and have an increased risk of cardiovascular disease which includes heart attack and stroke.
Modifiable risk factors that may be associated with Pre Diabetes include:
- Body mass index (BMI) in the overweight (25-29.9kgm2) or obese (≥ 30kgm2) category
- Sedentary lifestyle
- High blood pressure (140/90) or greater
- Abnormal levels of specific fats or fat like substances in the blood – namely low high density lipoprotein or HDL (often referred to as good cholesterol because it transports excess cholesterol to the liver for removal)
- High levels of triglycerides
You’re also more likely to be diagnosed with pre Diabetes if you are:
- Older than 45 years
- Have Type 2 Diabetes in your family
- If you developed gestational Diabetes during your pregnancy
How many of these boxes do you tick?
If you are at risk, it’s time to change your lifestyle. Eliminating obesity can significantly reduce your risk of developing Type 2 Diabetes and normalise associated cardiovascular risk factors. So making lifestyle changes such as creating new habits around healthier eating, increasing exercise, weight loss and keeping off excess weight are the first line of treatment when it comes to reversing Pre Diabetes and preventing Type 2 Diabetes.
Recent high quality research out of the United Kingdom has shown that maintained weight loss of around 15% of body weight is an effective way to achieve Diabetes remission in people who have been diagnosed with Type 2 Diabetes for up to 4 years. Results showed that the removal of fat from the liver and the pancreas normalised function of these organs so sensitivity to insulin was restored and blood glucose levels normalised.
Type 2 Diabetes is a lifestyle related chronic disease. This is why lifestyle changes are so effective in preventing its onset. Sure, you might have drawn a short straw in that you may have a family history of Type 2 Diabetes but environmental factors like diet and exercise can go a long way to reducing a genetic susceptibility. Remember that what we are is a product of our genes interacting with the environment and we can control our environment. Diagnosis with Pre Diabetes can be unexpected and unwelcome. Seeing it as a wakeup call to make lifestyle changes to achieve a healthy weight will reduce your risk of developing Type 2 Diabetes. In addition to much higher risks of heart attack and stroke, Type 2 Diabetes also leads to progressive complications of eye, kidney, nerve and circulatory disease.