Taking control of prediabetes

What is prediabetes?

Prediabetes - also called non-diabetic hyperglycaemia - is where your blood sugar levels are higher than normal, but not yet high enough to be diagnosed as diabetes.

However, it's still a serious concern. If you have prediabetes you have a increased chance of developing type 2 diabetes - where your blood sugar levels become too high. This happens when your body either doesn't make enough insulin or can't effectively use the insulin it does make.

Michelle Routhenstein, Cardiology Dietitian at EntirelyNourished.com, New York, USA warns that a prediabetes diagnosis not only raises your chance of developing type 2 diabetes but also your likelihood of experiencing heart disease and stroke.

Does prediabetes have any symptoms?

Routhenstein explains that prediabetes often has no clear symptoms, making it difficult to detect. If you do have symptoms, they are subtle and may include:

• Increased thirst.

• Peeing more frequently.

• Feeling tired all the time.

• Blurred vision.

• Cuts and wounds healing more slowly than usual.

• Genital itching or yeast infections.

These symptoms are typically linked with type 2 diabetes - not prediabetes. Often, by the time these symptoms appear, diabetes may already be present.

According to Diabetes UK, around 1.2 million of us are living with undiagnosed type 2 diabetes.

How is prediabetes diagnosed?

Dr Akhil Shenoy, Endocrinologist, Aeroflow Diabetes, Texas, USA says the only way to diagnose prediabetes is by having routine blood tests done by your healthcare provider.

Dr Saleh Adi, paediatrics endocrinologist and Dawn Menning, registered dietitian, Nutu App, explain there are three main ways to measure your blood sugar (glucose) levels:

1. Fasting blood sugar (FBS): Checks blood sugar after not eating for 8-10 hours.

2. Prandial blood sugar (PBG): Measures blood sugar 1-2 hours after eating.

3. Haemoglobin A1c (HbA1c): Reflects average blood sugar levels over 2-3 months.

An HbA1c level that is higher than normal - between 42 mmol/mol (6%) and 47 mmol/mol (6.4%) - indicates prediabetes.

What are the potential causes of prediabetes?

A prediabetes diagnosis means you have an increased chance of developing type 2 diabetes, with several factors contributing to this.

Adi and Menning explain your chances are higher if you:

• Are overweight or obese.

• Are over 40 if you're white - over 25 if you're African-Caribbean, Black African, or South Asian.

• Have a family history of type 2 diabetes - especially a parent or sibling.

• Have high blood pressure.

• Developed gestational diabetes during pregnancy.

• Are physically inactive.

• Eat an unhealthy diet.

Shenoy adds that smoking, poor sleep, a diet high in red or processed meats, low in vegetables and high in sugar can contribute to the development of type 2 diabetes.

How to help prevent type 2 diabetes

If left unmanaged, prediabetes can lead to type 2 diabetes. This could lead to serious complications such as heart disease, nerve damage, kidney impairment, eye problems and stroke.

Routhenstein says: "Lifestyle changes such as losing weight, increasing physical activity, getting the right amount of sleep, and adopting a healthy diet can significantly prevent or slow this happening."

Maintain a healthy weight

Being overweight can increase your chance of developing type 2 diabetes. Adi and Menning advise that working gradually towards losing 5-7% of your body weight can significantly lower this chance.

Weight loss is a personal journey, with no one-size-fits-all approach. However, Routhenstein suggests working with a registered dietitian to help create a tailored plan that aligns with your food preferences, lifestyle, and cultural norms.

Eat a balanced diet

Diets such as the Mediterranean diet can help decrease your chance of developing diabetes, as they are rich in these types of foods.

Shenoy recommends you incorporate a plant-heavy diet rich in fruits and vegetables, lean proteins, whole grains and non-saturated fats.

Try to limit your intake of sugary drinks and treats, red and processed meats, refined carbs - such as white bread - and fried foods.

Move more

Increase your physical activity to 150 minutes a week. Diabetes UK suggests making minor adjustments to boost your activity levels. Even little changes can help.

• Stand up for phone calls.

• Take the stairs, not the lift.

• Try some chair-based exercises.

• Go for a lunchtime walk.

Stop smoking

Smoking increases your chance of having type 2 diabetes. People with diabetes already face a higher likelihood of heart disease, stroke, and circulation problems. Smoking doubles this, making you even more susceptible to these serious conditions.

A prediabetes diagnosis is a warning, not a certainty. It means your chance of developing type 2 diabetes is very high. However, you can reverse this by making healthy lifestyle changes. Focussing on diet, weight, and overall health now can help prevent diabetes and improve your wellbeing in the long run.

The NHS offers courses if you have prediabetes - such as the Diabetes Prevention Programme - to help you manage your weight, eat healthier, and exercise to reduce your chance of developing type 2 diabetes. This can be accessed through a referral from your doctor.