A new study suggests around a third of adults in England now has prediabetes.
Find out what it is and see ways to lower your risk of developing full-blown diabetes.
What is prediabetes?
If you have prediabetes, or 'borderline diabetes', it means you have blood sugar levels that are higher than normal but not considered high enough to be classed a
s type 2 diabetes. However, having prediabetes means a person is at a greater risk of going on to develop type 2 diabetes.
In the UK there's no formal criteria for defining prediabetes. In the US, however, the American Diabetes Association says a person is considered to have it if they
have a blood glucose (blood sugar) measurement of HbA1C 5.7% (39mmol/mol). Having prediabetes doesn't mean it's inevitable that you will develop full-blown diabetes.
Although your risk is higher, you can take proactive, preventative steps to lower high blood glucose levels and avoid the condition progressing to type 2 diabetes.
What are the symptoms of prediabetes?
Prediabetes doesn't usually have any symptoms. The condition can develop gradually over time with few warning signs. By the time you are diagnosed with type
2 diabetes you may already have developed some of the possible symptoms such as:
- Blurred vision
- Increased thirst.
Who is at risk of prediabetes and type 2 diabetes?
According to statistics, there's been a marked increase in cases of prediabetes in recent years - from 11% to 35% in England alone. That suggests 1 in 3 people
may have prediabetes.
You may be at higher risk if you:
- Are over 40
- Are overweight or obese
- Are inactive
- Have a BMI ( body mass index) that's 25 or more
- Have high blood pressure
- Have a south Asian ethic background
- Have high cholesterol
- Have heart disease
- Have had a high blood sugar diagnosis previously
- Had gestational diabetes during pregnancy
- Have polycystic ovary syndrome (PCOS).
There are online tools that can help assess your risk of prediabetes, including one provided by Diabetes UK.
How is prediabetes diagnosed?
Tests for prediabetes may measure your blood sugar levels:
- First thing in the morning, after fasting overnight
- Before and after eating.
- Urine test
- A sample of your urine is analysed for the presence of sugar.
- Fasting plasma glucose test
- Blood is usually tested in the morning before you have eaten. This provides the body enough time to fast for at least 8-10 hours before the test is carried out.
- Normal results are below 6.1 mmol/L.
- Tests that indicate prediabetes fall between 6.1 mmol/L to 6.9 mmol/L.
- Tests that indicate for full-blown diabetes are 7.0 mmol/l and above.
HbA1c blood test
This test is done at least once a year and often in addition to blood glucose monitoring at home. The test checks your blood sugar over the previous 2 - 3 months
to see how well it is being controlled. A sample of blood is taken and sent to a lab for analysis. Normal results are usually below 42 mmol/mol (6.0%).
Positive results for prediabetes fall between 42 and 47 (6.0 to 6.4%). Bear in mind that results can be affected by other health conditions like anaemia,
that affect your haemoglobin. Other factors that can affect results include:
- High cholesterol levels
- Supplements like vitamin C and E
- Liver disease
- Kidney disease
- High temperature, altitude or humidity.
- Oral glucose tolerance test (OGTT)
Blood is tested first thing in the morning before you eat and tested again two hours after having a special glucose drink. A normal result 2 hours after the drink is
less than 7.8mmol/L. If your levels are higher than that after 2 hours, between 7.9 - 11 mmol/L, you probably have prediabetes.
How is prediabetes treated?
According to Diabetes UK, about 80% of cases of type 2 diabetes can be delayed or prevented by tackling the problem when you are diagnosed with prediabetes.
Your doctor may recommend diabetes medication, such as metformin. However, research suggests that simple lifestyle changes may be even more effective
Preventative measures may involve:
- Weight control
Eating a low fat, low sugar diet can help regulate blood sugar levels and avoid weight gain. Extra fat makes it harder for your body to convert food into energy
without blood sugar spikes. Losing just 5 -10% of body weight can improve your blood sugar levels. A healthy diet can also help manage high cholesterol and
high blood pressure levels. Your doctor may refer you to a dietitian for help with:
- Reducing sugar and fat in your diet
- Reducing portion sizes
- Including the recommended 5-a-day of fruit and vegetables
- Adding lean protein and fibre to your diet.
Making physical activity a part of your daily routine can help you keep weight under control, as well as maintain healthy blood sugar levels. NHS guidelines
recommend getting at least 150 minutes of moderate exercise a week that gets your heart pumping. This can include:
- Aerobic exercise that gets your heart pumping, like brisk walking, cycling or swimming
- Strength training which builds muscle, controls blood sugar levels and burns calories, even at rest.
Research shows that people who smoke are more susceptible to type 2 diabetes. It's not clear why, but it's thought nicotine and other substances in cigarettes may
contribute to insulin resistance. Insulin helps the body to process glucose, so smoking can disrupt that process. Another theory is that smoking may stimulate stress
hormones that can increase glucose levels. If you have been diagnosed with prediabetes, quit smoking. Ask your GP, pharmacist, or NHS stop smoking service for help.
Research shows people are up to 4 times more likely to quit smoking successfully by using local NHS Stop Smoking Services and stop smoking treatments.