Prediabetes Explained

In general, type 2 diabetes is not a condition that develops out of the blue. A diagnosis of diabetes is often made after many years of slight abnormalities in glucose levels. This period of blood sugar limbo between normal readings and full-blown diabetes has become known as prediabetes.

Health risks of prediabetes

The greatest risk to Canada’s 6 million prediabetics is that of developing type 2 diabetes in the future. Unmanaged diabetes ultimately leads to nerve and kidney damage, blindness, and death from cardiovascular disease.

However, recent studies have found that irreversible damage to blood vessels and nerves may happen long before diabetes is diagnosed. It now appears that prediabetics are also at risk for complications previously associated with much higher blood sugar levels. In addition, the risk of cardiovascular disease doubles in the prediabetic state, and studies suggest poorer prognoses for prediabetics with cancer.

Symptoms of prediabetes

As prediabetes is a condition that often has no symptoms, many sufferers don’t know that their glucose levels are putting them at risk. Blood testing is the only way to diagnose prediabetes.

Metabolic syndrome is the name given to a constellation of symptoms that include high fasting blood glucose (FBG), blood pressure, and triglycerides; low levels of good cholesterol (HDL); and abdominal obesity—and 50 percent of prediabetics with an abnormal oral glucose tolerance test meet the criteria for metabolic syndrome.

The diagnosis of other common conditions, such as coronary artery disease, polycystic ovarian syndrome, and gestational diabetes, may also indicate that a blood glucose assessment is required.

Having metabolic syndrome can double or even triple the risk of death from cardiovascular disease, and is seen as a prediabetic condition even if FBG is normal. For that reason, those with metabolic syndrome or other risk factors require regular blood sugar testing.

Other symptoms may include:

• changes in eye, nerve, and kidney function
• darkened skin around the neck and armpits
• skin tags
• recurrent infections
• slow wound healing

If you are concerned that you may have prediabetes, consult a health care practitioner.

What’s the good news?

While undiagnosed prediabetes poses real risks to our health, early detection and treatment will delay or even prevent the development of diabetes. Stopping the escalation of blood glucose levels is key to avoiding the complications of prediabetes. In many people, changes to diet and lifestyle can have profound benefits and are more effective than drug-based treatments.

Increasing dietary fibre, avoiding refined carbohydrates, and choosing foods with a lower glycemic index help to keep blood sugar levels in the healthy range. Losing as little as five to 10 percent of body weight reduces blood glucose and improves cholesterol levels, and exercising for 30 minutes most days supports weight loss while protecting the heart.

Both exercise and supplemental vitamin D have also been shown to improve insulin sensitivity.

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