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What is Prediabetes and how do you know if you have it?

Dr. Abhishtita Mudunuri

4 Min Read

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According to the National Urban Diabetes Survey, the estimated prevalence of prediabetes in India is 14%. Now, the concern is that the global prevalence of diabetes in the world is projected to increase by 51% by 2045. Identifying and reversing prediabetes in young people can help reduce these numbers and ensure the overall health of people the world over.

Diabetes is often considered a chronic disease and Type 2 diabetes is closely related to our lifestyle choices. But, diabetes doesn’t develop overnight; a series of wrong health choices coupled with environmental and genetic factors predispose us to this condition. There has been a disproportionate increase in the incidence of Type 2 diabetes in children, adolescents, and young people in the last decade. This has been attributed a lot to our lifestyle. Identifying prediabetes early and introducing interventions to reverse it can protect us from developing diabetes and its related complications related to it.

What is Prediabetes?

Prediabetes, as the name suggests can be seen as a precursor to diabetes. It’s a state of Insulin resistance in our body which, if left neglected, can progress to Type 2 diabetes.

How does Prediabetes develop?

Prolonged years of excess carbohydrate intake along with physical inactivity, sleep deprivation, and even increased stress levels can work together to develop a state of insulin resistance in your body.

Insulin is a sugar-lowering hormone that is usually released through a cascade of reactions in response to food intake. When we follow an unhealthy lifestyle, especially a high carbohydrate diet, higher levels of insulin are released initially (Hyperinsulinemia) which over a period of time leads to a state of insulin resistance in our body.

Imagine a car fuel tank – the fuel is the carbohydrate for us. When the car tank is full, even if you try to fill in more fuel it will spill out; similarly, when all the excess carbohydrates are stored in our body in the form of triglycerides it will resist the action of insulin and take in more carbohydrates will only worsen the situation, wherein you progress further into a state of first insulin resistance then prediabetes and then diabetes.

Who is at risk of Prediabetes?

Risk factors for prediabetes are influenced by genetic and environmental factors

Strong family history of diabetes
Past history of Gestational diabetes
Overweight or obese individuals
People who have a sedentary lifestyle
Age
PCOS

These are a few risk factors that can predispose you to the early onset of prediabetes or diabetes. If you’re following a high carbohydrate diet with a sedentary lifestyle along with inadequate sleep and/or experience increased high-stress levels – these strongly influence the onset of prediabetes even if there is no genetic predisposition.

What are the common symptoms of Prediabetes?

Prediabetes usually manifests as:

Skin pigmentation is also known as acanthosis nigricans which is black velvety pigmentation around the nape of the neck and armpits
Difficulty losing weight
Abdominal adiposity or increased waist circumference will resist the action of insulin and taking in more carbohydrates will only worsen the situation.
Skin tags especially around the neck
Sugar cravings
Lack of energy
Feeling drowsy especially after a heavy carbohydrate meal
Chronic body pains or headache
Hormonal imbalance especially for women especially PCOS

If you are experiencing any of these symptoms you can talk to a doctor to check for prediabetes.

How do we diagnose Prediabetes?

Diagnosis is done via a blood test:

Hba1c
Fasting blood glucose
2 hours post-meal glucose is checked.

Prediabetes is when:

Hba1c is between 5.7-6.4
Fasting blood glucose between 100-125mg/dl (also called impaired fasting glucose)
2 hours post-meal glucose 140-200mg/dl (also called impaired glucose tolerance)

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What are the treatment options for Prediabetes?

The best approach is to focus on lifestyle changes.

Cutting down carbohydrates to less than 30% of the diet is one of the ways. Remember carbohydrates are not essential for diet; proteins and fats are essential.
Practice intermittent fasting which is based on time-restricted feeding and fasting for 14-16 hours. This will induce a starvation state which will help break down fats as a source of fuel in your body and will also address the root cause of prediabetes and help reverse the state of insulin resistance.
Physical activity is key to the reversal of insulin resistance on a muscle level. Aim for at least 10000 steps per day, moderate-intensity aerobic exercise for 45 minutes at least 3 times a week, and 20 minutes of yoga.
Meditation and calm music are also good to deal with stressful situations.
Sleep is important to maintain our circadian rhythm and sleep helps to repair and rejuvenate our body. When you sleep, memory formation happens, and also if you don’t get adequate sleep, cortisol levels may be elevated and appetite hormones balance may get skewed. Getting <6-7 hours of sleep can influence these mechanisms causing weight gain, cravings, elevated blood glucose, or sugar levels.

Some doctors may choose to prescribe metformin (antidiabetes tablet ) to control blood glucose levels if there are inadequate responses post lifestyle changes. So, following a carbohydrate-restricted diet, an active lifestyle, getting adequate sleep, and reducing stress levels will all help reverse a state of prediabetes and prevent progression to diabetes. Never ignore a symptom. Instead, get an online consultation with MFine’s expert doctors and keep your health in check.

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Written by

Dr. Abhishtita Mudunuri

Dr. Abhishtita Mudunuri is an Internal Medicine Physician Diabetologist with over 10 years of experience in treating lifestyle disorders like Diabetes, Hypertension, Dyslipidemia, etc. She has worked previously at Columbia Asia, Sunshine Hospitals, and Apollo Group of Hospitals. Currently, she is working as a Senior Manager and Diabetologist at MFine.

What is Prediabetes and how do you know if you have it?

What is Prediabetes?

How does Prediabetes develop?

Who is at risk of Prediabetes?

What are the common symptoms of Prediabetes?

How do we diagnose Prediabetes?

What are the treatment options for Prediabetes?

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