The Journal of Clinical Endocrinology & Metabolism Vol. 92, No. 1 0
Copyright © 2007 by The Endocrine Society
Patient Information Page from The Hormone Foundation |
Prediabetes
Enrique Caballero, MD,
Abbas E. Kitabchi, PhD, MD,
Guillermo Umpierrez, MD and
Ariel Zisman, MD
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What is prediabetes?
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Glucose (or blood sugar) is produced by the body from the foods that you eat (and some by the liver). Insulin, a hormone produced by the pancreas, takes the glucose from the bloodstream and carries it to your cells where it is used for energy. This process controls the amount of sugar in your blood, keeping it from getting too low or too high.
Prediabetes is a condition in which your body becomes resistant to the effect of insulin and doesn’t take up glucose from the bloodstream as it normally would. This causes the levels of blood sugar to become higher than normal. Over time, having too much sugar in your blood puts you at risk for heart disease and stroke, and for developing type 2 diabetes.
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Who is at risk of developing prediabetes?
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According to the Centers for Disease Control and Prevention about 41 million American adults have prediabetes. Sadly, as the population has become more overweight and inactive, the number of children and young adults with prediabetes is also rising.
Risk factors that increase your chances of developing prediabetes include:
- Being overweight or obese
- Lack of exercise
- Family history of type 2 diabetes
- Age 45 years or older (but younger people, including children and adolescents are now at risk)
- Race (rates of diabetes are higher in African Americans, Latinos/Hispanics, and American Indians)
- Gestational diabetes (diabetes during pregnancy) or giving birth to a baby weighing more than 9 pounds
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How do you know if you have prediabetes?
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Prediabetes has no visible signs or obvious symptoms. Two blood tests are used to check the levels of glucose in your blood and diagnose this condition: - Fasting blood glucose test (FBG)-Blood is drawn after you fast (go without food) overnight or for at least 8 hours.
- Oral glucose tolerance test (OGT)-This test requires that you fast for at least 8 hours. Blood is drawn before you drink 8 ounces of a sugary solution and 2 hours after. (If your glucose sugar is between 140 to 199 mg/dL after 2 hours, you have impaired glucose tolerance, a prediabetes condition.)
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NORMAL
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FBG: 70 to 99 mg/dL
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OGT: Under 140 mg/dL
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PREDIABETES
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FBG: 100 to 125 mg/dL
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OGT: 140 and 199 mg/dL
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DIABETES
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FBG: 126 mg/dL and higher
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OGT: Higher than 200 mg/dL
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Why should prediabetes be taken seriously?
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Each year about 1 out of 10 patients (or 10%) with prediabetes develops type 2 diabetes.
If left untreated, diabetes can cause blindness, kidney failure, nerve damage, heart disease, stroke, and high blood pressure. Even when blood sugar levels are slightly high, as they are with prediabetes, your risk for cardiovascular disease increases.
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How do you prevent and treat prediabetes?
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Prevention of prediabetes (and type 2 diabetes) is possible even if diabetes runs in your family. In most people with prediabetes, progression to diabetes can be avoided with lifestyle changes that include: - Eating a balanced meal plan, low in fat and high in fruits, vegetables, and whole grains
- Getting regular physical activity (a half-hour five times a week)
- Maintaining a healthy weight (if you are overweight or obese, losing just 5% to 10% of your weight may help you dramatically lower your chances of developing type 2 diabetes )
While lifestyle changes are the first choice to treat prediabetes and prevent diabetes, medications may be an option to be used in combination with diet and exercise. If medication is considered, several drugs have been proven to lower the risk of progression to diabetes including metformin, rosiglitazone, pioglitazone, and acarbose. Because of the relationship between type 2 diabetes and obesity, medications that help with weight loss may also lower the risk of developing diabetes.
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What should you do with this information?
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If you are overweight and/or age 45 years or older, you should be checked for prediabetes at your next medical visit. If you have prediabetes, you should be checked for type 2 diabetes every 1 to 2 years after your diagnosis. Remember, prediabetes doesn’t have to turn into type 2 diabetes. Healthy lifestyle choices are critical for bringing blood sugar levels back to normal and for keeping them under control.
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Resources:
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- Find-an-Endocrinologist: www.hormone.org or call 1-800-HORMONE (800-467-6663)
- American Diabetes Association: www.diabetes.org
- National Diabetes Education Program (NIH); http://ndep.nih.gov
- National Diabetes Information Clearinghouse (NIH): http://diabetes.niddk.nih.gov/about/index.htm
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Footnotes
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For more information on how to find an endocrinologist, download free publications, translate this fact sheet into other languages, or make a contribution to The Hormone Foundation, visit www.hormone.org/bilingual or call 1-800-HORMONE. The Hormone Foundation, the public education affiliate of The Endocrine Society (www.endo-society.org), serves as a resource for the public by promoting the prevention, treatment, and cure of hormone-related conditions. This page may be reproduced non-commercially by health care professionals and health educators to share with patients and students. Translation by MEDI-FLAG Corp.
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What is prediabetes?
Who is at risk...
