Prediabetes (or "borderline diabetes") is a state where your fasting blood glucose level is consistently between 100 mg/dl and 125 mg/dl. If your fasting blood glucose level reaches 126 mg/dl or higher, then, your doctor will diagnose you with full-blown Type 2 diabetes. 

Author's Perspective: Being an engineer, we really love numbers, maybe to a fault, especially when it comes to understanding blood test numbers. :-)

For example, a person with a fasting blood glucose of 125 is considered prediabetic; but, a person with a fasting blood glucose that is just 1 point higher is considered diabetic!

Also, from a biochemical and biological perspective (at the cellular level), prediabetes looks very much like full-blown diabetes! 

Both prediabetes and Type 2 diabetes exhibit insulin resistance, inflammation, oxidative stress, protein glycation, weight gain, fatigue, high blood pressure, high cholesterol, etc.

So, if you've been diagnosed with prediabetes or you're "borderline diabetic", then, you're right on the precipice of becoming a full-blown diabetic.

And if you have any risk factors like obesity, high blood pressure, high cholesterol, chronic fatigue, etc. then, you may be a lot closer to being diabetic than not being diabetic.

And, if you take a look at the worldwide medical data, more than 77% of people with prediabetes eventually develop full-blown diabetes within 5 years!

Note: The statistics are very similar for women with gestational diabetes. More than 67% of pregnant women with gestational diabetes eventually develop Type 2 diabetes within 3 years after giving birth -- especially if they fail to get rid of the baby weight.

And, if I take it a step further, and look at the following diagram and the pathophysiology of how full-blown diabetes develops, prediabetes is actually the 4th stage of how Type 2 diabetes develops!

  1. Insulin Resistance/Hyperglycemia
  2. Impaired Glucose Tolerance
  3. Chronic Inflammation/Oxidation
  4. Prediabetes
  5. Diabetes
  6. Complications

Although many of these stages overlap and may occur concurrently, the stages are still distinct enough for you to identify, track, and correct by making changes to your diet and lifestyle.

In fact, the same steps that a diabetic would use are the same steps that a prediabetic should use to successfully fight and reverse this disease.

Unfortunately, most prediabetics ignore the signs. That's why, according to several recent studies, more than 76% of people with prediabetes develop full-blown diabetes.

Prediabetes and Type 2 Diabetes Development

Author's Sidebar: When people are told by their doctors that they have prediabetes, they don't really expect to develop full-blown diabetes.

However, once their doctor diagnoses them with full-blown Type 2 diabetes, most people are shocked and surprised by the diagnosis -- just as I was when my doctors told me in the hospital.

This is because there are no obvious signs or symptoms that really tell you that you're becoming a full-blown diabetic. Yes, there are risk factors, but, there are risk factors for every disease!

On the other hand, we also know that Type 2 diabetes doesn't just happen all at once! So, where is the disconnect?

I believe that people and doctors look strictly at the one number (fasting blood glucose) and either don't consider the other risk factors or don't believe that they're significant enough to be concerned about.

As a result, the disease continues to develop silently at the cellular level, until one day, your fasting blood sugar hits the critical point.

By that time, your body has probably been in a "diabetic state" for months and maybe even years.

So, depending on your point of view, prediabetes is either one of the initial stages of Type 2 diabetes or it's a warning sign that you may develop full-blown diabetes.

But, no matter which point of view you have, the key here is to take action to stop prediabetes from becoming full-blown diabetes. It's a lot easier to get rid of prediabetes than full-blown diabetes.

Prediabetes is the state in which some but not all of the diagnostic criteria for diabetes are met. It is often described as the “gray area” between normal blood sugar and diabetic levels.

In general, you are pre-diabetic if your blood glucose level is between 101 mg/dl and 125 mg/dl. If your fasting blood glucose is 126 mg/dl or higher, then, you are diagnosed as diabetic.

While in this range, patients are at risk for not only developing Type 2 diabetes, but also for cardiovascular complications.

Prediabetes is also referred to as borderline diabetes, impaired glucose tolerance (IGT), or impaired fasting glucose (IFG).

Impaired fasting glucose (IFG) occurs when your blood glucose is 100 – 125 mg/dL after an overnight fast; but, is not high enough to be classified as diabetes mellitus.

Impaired glucose tolerance (IGT) is diagnosed if your blood glucose is 140-199 mg/dL two hours after drinking sugar water. 

IFG is considered a pre-diabetic state, associated with insulin resistance and increased risk of cardiovascular pathology, although of lesser risk than impaired glucose tolerance (IGT).

IFG sometimes progresses to Type 2 diabetes mellitus. There is a 50% risk over 10 years of progressing to full-blown diabetes. A recent study cited the average time for progression as less than three years.

Two blood tests are commonly used to determine if you have diabetes or prediabetes:

  • Fasting plasma glucose test (FPG)
  • Oral glucose tolerance test (OGTT)

These tests measure how quickly your body can "clear" glucose from your blood.

Fasting plasma glucose test (FPG)

The fasting plasma glucose test can be done after an overnight fast or after an eight-hour fast during the day. It is a relatively easy, inexpensive test. After the fast, a simple blood test measures glucose levels before you eat again. The test results indicate whether your blood glucose level is normal or whether you have pre-diabetes or diabetes:

  • Normal: less than 100 mg/dl
  • Prediabetes: 101-125 mg/dl 
  • Diabetes: greater than 125 mg/dl

Oral glucose tolerance test (OGTT)

The OGTT usually requires that you have the fasting glucose test first. Then you take a dose of high-sugar (glucose) solution to challenge your body to clear the glucose from your blood. After two hours, another blood glucose test is done. The final test results indicate whether you have a normal level of blood glucose or have pre-diabetes or diabetes:

  • Normal: less than 140 mg/dl 
  • Prediabetes: 140-199 mg/dl 
  • Diabetes: greater than 199 mg/dl

If you look closely at the diagram (above), you will see that "prediabetes" is actually one of the stages that eventually progresses to Type 2 diabetes!

Consequently, although prediabetes may not seem like a serious problem, if you ignore prediabetes, it will eventually lead to full-blown diabetes.

And, then, if you ignore the diabetes, then, full-blown diabetes will eventually lead to one or more major diabetic complications such as retinopathy, nephropathy, neuropathy, or heart disease.

If you have been diagnosed with prediabetes, you can prevent the onset of full-blown diabetes as long as you heed the warning and take action to change your eating habits and lifestyle.

Eat More Healthy Foods: Begin eating more whole foods and plant-based foods such as vegetables, fruits, beans, legumes, and plant oils such as extra virgin olive oil.

Avoid Eating: Avoid or at least cut back on eating the processed foods, fast foods, excess animal meat and living a sedentary lifestyle. Use the Death to Diabetes program to get you started on the right track.

Avoid Eating: Avoid eating cereal and other grains for breakfast -- instead eat a vegetable, plant-based breakfast.

Exercise: Start exercising on a consistent basis. Take a walk 4 to 5 times a week for 25 to 30 minutes.

Avoid Drugs: Avoid taking any diabetic medication! Diabetic medications such as metformin (Glucophage) may lower your blood sugar, but these drugs don't do anything to prevent the onset of Type 2 diabetes! So, don't start taking a diabetic pill thinking that the pill is going to stop the diabetes from developing in your body. It won't.

Knowledge: Educate yourself about diabetes, nutrition, and drugs if you're serious about preventing the onset of diabetes.

Get Diabetes Book: Get a book like Death to Diabetes, to get you started on acquiring this important knowledge. It will empower you on so many levels -- physically, emotionally, intellectually, spiritually, and eventually financially.

Note: Even though the DTD book was written for type 2 diabetics, people with prediabetes can still use the book.

For more information about prediabetes, refer to the Death to Diabetes Blog.

References

  1. ^ Prediabetes at Dorland's Medical Dictionary
  2. ^ Power of Prevention, American College of Endocrinology. Vol. 1, issue 1, January 2009. http://www.powerofprevention.com/POP_magazine_Jan2009_final.pdf/
  3. ^ a b c Jellinger, Paul S. "What You Need to Know about Prediabetes." Power of Prevention, American College of Endocrinology. Vol. 1, issue 2, May 2009. http://www.powerofprevention.com/
  4. ^ http://www.diabetes.co.uk/pre-diabetes.html
  5. ^ Nichols GA, Hillier TA, Brown JB (2007). "Progression From Newly Acquired Impaired Fasting Glusose to Type 2 Diabetes". Diabetes Care 30: 228–233. doi:10.2337/dc06-1392. PMID 17259486. http://care.diabetesjournals.org/cgi/content/full/30/2/228. 
  6. ^ Mayo Clinic Diabetes: "Prediabetes". [1]. Accessed Jan. 27, 2009.
  7. ^ "The Prevention or Delay of Type 2 Diabetes," ADA, Diabetes Care, 25: 742-749, 2002.
  8. ^ WebMD: Prediabetes. Accessed Jan. 27, 2009.
  9. ^ Dyson, Pamela, Sue Beatty and David Matthews. "A Low Carbohydrate Diet Is More Effective for Reducing Weight, % Body Fat and HbA1c Than Healthy Eating in Both Diabetic and Non-Diabetic Subjects." abstract.
  10. ^ Lilly M; Godwin M. "Treating prediabetes with metformin: systematic review and meta-analysis." Canadian Family Physician. 2009 Apr; Vol. 55 (4), pp. 363-9
  11. ^ "American College of Endocrinology Consensus Statement on the diagnosis and management of pre-diabetes in the continuum of hyperglycemia—When do the risks of diabetes begin?" (PDF). American College of Endocrinology Task Force on Pre-Diabetes. http://www.aace.com/meetings/consensus/hyperglycemia/hyperglycemia.pdf. Retrieved 2008-07-24. 
  12. ^ Nathan et al. "Impaired fasting glucose and impaired glucose tolerance: implications for care," Diabetes Care. 2007 Mar;30(3):753-9.

 

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