pre-diabetes

Pre-diabetes, as the name suggests, is the precursor to type 2 diabetes . A person with pre-diabetes has blood glucose levels that are higher than normal, but not high enough to be considered true diabetes. It is a phase in which it is possible to reverse the tendency to develop diabetes and restore normal blood sugar levels. We sometimes speak of glucose intolerance to characterize pre-diabetes.
Reversal is important to treat the patient properly to avoid complications such as kidney or eye problems.

Measuring blood glucose levels should be done regularly if you suffer from diabetes or pre-diabetes, and this can easily be done at a health center (health centre, hospital, etc).

Criticism of the concept of pre-diabetes
In an article published on December 17, 2016 in the New York Times, the famous North American newspaper, some criticisms have been issued about this new “disease”. In fact, pre-diabetes began to be publicized in the United States only after 2005. Before, very few people knew the term. One problem with the concept of prediabetes is that under some definitions (see also below) as many as 80% of Americans over the age of 60 suffer from prediabetes. Some health experts in the United States are wondering if pre-diabetes is not a very general concept, if it is nothing more than a “marketing invention” or a “medicalization” (meaning that at one time it was considered normal and with time becomes a disease) of the present society.

Pre-diabetes in the United States
The term pre-diabetes is widely used in the United States, because in this country there are a large number of diabetics and pre-diabetics. The CDC (Centers for Disease Control and Prevention) estimates that 1 in every 3 American adults, that is, 79 million people, suffer from pre-diabetes, according to data from 2010.
Another institution, the American Diabetes Association, evaluates by 86 million the number of Americans in a state of pre-diabetes.
The vast majority of pre-diabetes Americans are unaware that they suffer from this metabolic problem.
In 2015, a study conducted by the National Institute of Diabetes showed that 38% of Americans suffer from pre-diabetes or diabetes.

The CDC estimates that without a change in lifestyle (diet and exercise, primarily) 15-30% of people with pre-diabetes will develop type 2 diabetes within 5 years. The speed of progression from pre-diabetes to diabetes is greater among the elderly.

Lifestyle Change
A key point in people with pre-diabetes is to make a lifestyle change. Research has shown that even modest weight loss and regular exercise can prevent or delay the onset of type 2 diabetes in about 58% of pre-diabetics. When we talk about a modest weight loss it is a decrease of 5 to 7% of body weight. A person who weighs 80 kg can already reduce blood glucose by losing 4 kg. Doing at least 2h30min of exercise a week is also important.

World
Worldwide, there were an estimated 463 million adults with diabetes in 2019, or 9.3% of the world’s adult population, according to the Internal Diabetes Federation ‘s Atlas of Diabetes (more information: link available Nov. 2019 ) based in Brussels, Belgium. In 2017 there were 38 million more adults who had diabetes than in 2019. This report was released on November 14, 2019, World Diabetes Day. This 2019 report indicates that more than half (50.1%) or 231 million adults are undiagnosed, meaning they are unaware they have the disease. Type 2 diabetes accounts for about 90% of all people with diabetes.

Effective method of prevention, the National Diabetes Prevention Program

In the United States, the CDC created a very innovative program called the National Diabetes Prevention Program. This program is based on encouraging people with pre-diabetes to change their lifestyle. Different institutions across the United States offer this program.

Each pre-diabetes patient can follow a few sessions with the health coach (like a trainer) for about 1 year. This way, pre-diabetics learn to eat more healthily, including practice and regular exercise. It will be particularly important to eat less fatty, sugary foods and stop smoking.

The scientists who developed this program showed that reducing one kilogram of body weight decreases the risk of type 2 diabetes by 16%.

This tendency to act more and more in prevention is likely to be generalized to combat the rising costs of health systems. It is better to be safe than sorry.

Other tips to prevent prediabetes

In addition to exercising regularly and changing your diet, here are some helpful tips for lowering your blood sugar and reversing this diabetic trend:

– Try to sleep more than 6 hours a night, ideally an average of 7 hours a night. Too little sleep can impair metabolism, and in particular that of glucose. Short nights of sleep increase insulin resistance, a cause of type 2 diabetes.

– Try to relax, according to your beliefs, you could pray, do yoga, relaxation techniques, etc. Stress is a risk factor for prediabetes. Stress increases the level of cortisol which disrupts the body’s use of insulin. Sleep well, if possible more than 6 hours a night, it’s a way to reduce stress.

– Consume foods based on  dietary fiber regularly . It is a good solution for controlling blood glucose. Beans and pods, as well as fruits, contain high amounts of fiber. The Mediterranean diet , rich in fruits, vegetables and olive oil, is an excellent diet to prevent the onset of diabetes. It will be necessary to avoid eating very sweet foods, as well as meat.

– Quit smoking , as tobacco apparently increases insulin resistance. The consequence for smokers is an increased risk of suffering from diabetes. It is estimated that smokers have between 30 and 40% more risk of suffering from diabetes compared to non-smokers.

– Low and very low carbohydrate diets (ketogenic diet) are the only dietary therapies that have consistently shown beneficial results for adults with diabetes (or pre-diabetes ). These are the 2019 findings from the American Diabetes Association 1.

treatment alternative

Alternatives may be recommended for some people with pre-diabetes in order to prevent the appearance of type 2 diabetes. Drug therapy may be indicated in individuals with several risk factors or who do not change their eating habits and lifestyle (sedentary lifestyle). ). Doctors often prescribe metformin or acarbose.

Metformin delays the onset of type 2 diabetes by an average of 15 years, as demonstrated by an extensive US government study.

Comparison between metformin and obesity surgery:
People with newly diagnosed Type 2 diabetes or pre-diabetes who had a gastric band, a type of bariatric surgery to aid weight loss, showed similar diabetes stabilization in those who received metformin ( a widely used oral antidiabetic) alone. Also, people who had bariatric surgery lost more weight than those who took metformin alone. This study, which included 88 participants, was published October 3, 2018 in the scientific journal Diabetes Care (DOI: 10.2337/dc18-1662).

The risk groups

Some groups are more likely to suffer from diabetes and type 2 pre-diabetes such as:

– People over 40 years of age

– People who are overweight or obese ( BMI equal to or greater than 25 ). Among Asians, the American Diabetes Association estimates that there is a risk starting at a BMI of 23 or more.

– Cases of diabetes in the family (genetic component).

– African or Afro-American ethnicities, Hispanics (Latinos), Native Americans, Asia and Pacific Islanders. Caucasians are slightly less likely than individuals from other ethnic groups around the world.

– Women who have had gestational diabetes .

– The tendency to sedentary person (less than 3 times a week exercise).

– People suffering from hypertension or high cholesterol .

Diagnosis of pre-diabetes, when can pre-diabetes be considered?

If a person suffers from diabetes or pre-diabetes, the healthcare professional can use several methods. The three tests are all based on the blood test.

– Fasting blood glucose . This test measures the level of blood glucose (blood sugar) when a person is fasting. The person should not be eating for 8 hours before the exam. If the patient has a blood glucose level between 100 and 125 mg/dL (5.6 mM to 6.9 mM), it is called pre-diabetes or glucose intolerance according to the ADA (American Diabetes Association) . The WHO calls pre-diabetes values ​​between 110 and 125 mg/dL (6.1 mM to 6.9 mM).

– The glucose tolerance test. This test measures the blood glucose level when the patient is fasting (no food for the last 8 hours), but it should be done 2 hours after the person has been drinking a standardized sweet liquid provided by a doctor. In this case, glucose varies between 140 and 199 mg/dl (7.8-11.0 mM) in cases of pre-diabetes.

– The A1C hemoglobin test. This test measures the amount of glucose found in erythrocytes (red blood cells). One of its advantages is the fact that it is not necessary to fast to perform it, which is why this test is increasingly used. An A1C value between 5.7 and 6.4% indicates prediabetes. Below 5.7% the value is normal and above 6.4% it is diabetes (eg type 2).

Anyone who is pre-diabetes should consider a program to change their lifestyle and retest 6 to 12 months after the first pre-diabetes test.

Starting at age 45, every person should test their blood sugar every 3 years and every year for people at high risk of diabetes or pre-diabetes.

Jeanne Kenney
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I’m a stylist trainer, a content creator, and an entrepreneur passion. Virgo sign and Pisces ascendant, I move easily between my dreams, the crazy world I want, and my feet on the ground to carry out my projects.

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