Prediabetes: Causes, Symptoms, Risk Factors, Diagnosis, Treatment and Complications

Prediabetes is indicated by a blood sugar level that is greater than normal. Type 2 diabetes cannot yet be ruled out due to its low level. If they do not modify their lifestyle, adults, and children with prediabetes are highly vulnerable to type 2 diabetes.

If you have prediabetes, the long-term impacts of diabetes may already be manifesting, especially in the kidneys, heart, and blood vessels. However, there is positive news. The progression of prediabetes to type 2 diabetes is not guaranteed.

Eating a balanced diet, exercising frequently, and keeping a healthy weight can all help your blood sugar return to normal. The same dietary changes that help adults prevent type 2 diabetes may also help children get back to their regular lives.

Causes Of Prediabetes

The exact cause of prediabetes is unknown. However, it appears that family history and heredity play a big role. Those who have prediabetes are unable to metabolize glucose, or sugar properly.

Most of the glucose in your body comes from your diet. When you digest, sugar is released into your bloodstream. Insulin permits sugar to enter your cells, lowering blood sugar levels.

The gland that makes insulin is called the pancreas, and it is located behind the stomach. Your pancreas produces insulin in your bloodstream when you eat. The pancreas reduces the amount of insulin secreted into the blood when your blood sugar drops.

This method is not as effective in people with prediabetes. Consequently, glucose accumulates in your bloodstream rather than providing energy for your cells. This is possible because:

• It's possible that your pancreas produces insufficient amounts of insulin.
• Your cells stop responding to insulin and stop taking in as much sugar.

Also Read: Diabetes: Types, Symptoms, Causes, Diagnosis and Treatment

Symptoms Of Prediabetes

Prediabetes typically has no warning signs or symptoms.

One sign of prediabetes may be darker skin on particular body parts. It may affect the neck, armpits, and groin.

Common markers that signify the shift from prediabetes to type 2 diabetes consist of:

• An increase in thirst
• More frequent urination 
• Hungry
• Tired
• Blurry eyesight
• Tingling or numbness in the hands or feet recurrent infections
• Slow-healing wounds
• Unintentional weight loss

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Risk Factors Of Prediabetes 

Prediabetes is more likely to develop due to the same variables that raise the risk of type 2 diabetes. Among these components are:

• Obese: The main risk factor for prediabetes is being overweight. Your cells become more resistant to insulin the more fatty tissue you have, particularly inside and between the muscles and skin around your abdomen.
• Waist circumference: A large waist size may be a sign of insulin resistance. Insulin resistance is more common in men with waists larger than 40 inches and women with waists larger than 35 inches.
• Diet: A higher risk of prediabetes has been associated with the consumption of red and processed meat as well as sugar-filled beverages.
• Lack of activity: As your level of exercise decreases, your chance of developing prediabetes increases.
• Age: Diabetes can strike at any age, but prediabetes rises after the age of 35.
• History within the household: You are more likely to acquire prediabetes if you have a parent or sibling who has type 2 diabetes.
• Race or ethnicity: Prediabetes is more common in some populations than others, including Black, Hispanic, American Indian, and Asian American individuals.
• Diabetes throughout pregnancy: If gestational diabetes was present during your pregnancy, there is a higher chance that both you and your unborn child will develop prediabetes.
• Polycystic ovarian syndrome: Predispositions to prediabetes are higher in women with this common condition, which is characterised by irregular menstrual cycles, thick hair growth, and obesity.
• Sleep: Insulin resistance is a greater risk for those with obstructive sleep apnea who frequently have sleep disturbances. It is more common for overweight or obese persons to acquire obstructive sleep apnea.
• Smoking: Smoking may exacerbate insulin resistance in those with prediabetes and increase their risk of type 2 diabetes. Smoking also increases the chance of having diabetes-related complications.

Additional conditions connected to an increased risk of  developing prediabetes include:

• High BP
• Blood triglyceride levels, a type of fat, were raised when there was insufficient high-density lipoprotein (HDL), the "good" cholesterol.
• Metabolic syndrome

Diabetes, heart disease, and stroke risk factors are increased by certain obesity-related conditions that are associated with insulin resistance. Three or more of these conditions taken together are referred to as metabolic syndrome:

• High BP
• Decreased HDL cholesterol
• Higher triglycerides
• Higher than normal blood sugar levels
• Large measurement of the waist

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Diagnosis Of Prediabetes

According to the American Diabetes Association (ADA), most people should begin receiving testing for diabetes at the age of 35. The American Diabetes Association advises having a diabetes screening before the age of 35 if you are overweight and have additional risk factors for type 2 diabetes or prediabetes.

If you have gestational diabetes, your doctor will likely check your blood sugar levels at least once every three years.

There are several blood tests available for prediabetes.

Glycated haemoglobin (A1C) testing

This test displays your average blood sugar level over the last two to three months.

In general:

• It is typically less than 5.7%.
• Precisely 5.7% to 6.4% of the population has it.
• Diabetic if the combined results of two separate tests come out at least 6.5%.
• For example, if you have an unusual kind of haemoglobin or are pregnant, the results of the A1C test might not be accurate.

Test of blood sugar performed after following fasting

A blood sample is collected after you have fasted for at least eight hours or without food for the entire night.

For blood sugar measurements, millimoles of sugar per litre (mmol/L) or milligrammes of sugar per deciliter (mg/dL) are used. Broadly speaking:

Less than 100 mg/dL (5.6 mmol/L) is regarded as normal; between 100 and 125 mg/dL (5.6 to 6.9 mmol/L) as prediabetes; and when two separate tests reveal 126 mg/dL (7.0 mmol/L) and higher, diabetes is diagnosed.

Test for oral glucose tolerance

Except in cases of pregnancy, this test is not used as often as the others. You will be required to fast for the entire night before to having a sugary beverage at the primary care physician's office or the lab testing facility. You will be taking regular blood sugar readings over the next two hours.

Broadly speaking:

• Under 140 mg/dL (7.8 mmol/L) is considered normal.
• Prediabetes is defined as 7.8 to 11.0 mmol/L, or 140 to 199 mg/dL.
• Two hours later, diabetes is indicated by 200 mg/dL (11.1 mmol/L) or higher.
• Generally, if you have prediabetes, your doctor will check your blood sugar at least once a year.

Assessing children for prediabetes

The likelihood that type 2 diabetes will become more common in children and teenagers is as a result of an increase in childhood obesity.

It is recommended by the American Diabetes Association (ADA) that children who are obese or overweight and have one or more additional risk factors for type 2 diabetes, such as:

• Type 2 diabetes in the family history being a member of a racial or ethnic group where low birth weight pregnancies are more common gestational diabetes blood sugar values are similar in adults and children and correspond to normal, prediabetes, and diabetes.
• Children with prediabetes should have a diabetes screening every year, or more frequently if their weight changes or if they begin to show signs of the condition, such as increased thirst, increased urination, lethargy, or blurred vision.

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Treatment Of Prediabetes

Maintaining a healthy lifestyle will help you get your blood sugar back to normal, or at the absolute least, keep it from rising to the levels linked to type 2 diabetes.

Try the following to prevent prediabetes from progressing to type 2 diabetes:

• Eat healthy meals: Reduced incidence of prediabetes is associated with a diet high in fruits, vegetables, nuts, whole grains, and olive oil. Choose foods that are low in calories and fat and high in fibre. Eat a variety of meals to help you meet your goals without compromising on taste or nutrients.
• Increase your level of activity: Exercise helps the body better utilise insulin, burns sugar for energy, and supports weight control. Aim for at least 150 minutes per week of moderate to strenuous aerobic exercise, or a combination of the two.
• Cut back on any extra weight you may be carrying: If you are overweight, losing just 5% to 7% of your body weight, or 14 pounds (6.4 kg) if you weigh 200 pounds (91 kg), will significantly reduce your risk of getting type 2 diabetes. To maintain a healthy weight, make long-term changes to your diet and exercise regimen.
• Quit smoking: Quitting smoking can improve the way insulin works, which can increase blood sugar levels.
• Take your medications as directed: Your doctor could recommend metformin if you have a high risk of developing diabetes. Medication administration is an additional option for treating excessive cholesterol and blood pressure.

Therapy for childhood prediabetes

Young people with prediabetes should follow the same dietary and lifestyle guidelines as adults with type 2 diabetes, including:

• Gaining physical fitness
• consuming fewer processed carbohydrates and fats and more fiber
• Reducing the quantity of food served
• consuming fewer meals outside and engaging in regular exercise for at least an hour
• Medication for children with prediabetes is usually not recommended until lifestyle changes are no longer able to lower blood sugar levels. Metformin is usually recommended when medication is needed.

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Prevention Of Prediabetes

Even if your family has diabetes, you can stop prediabetes and the disease's progression to type 2 diabetes by maintaining a healthy lifestyle. They include:

• Eating a diet high in nutrients
• Taking Part in an Activity
• Cutting down on excess body weight
• Keeping your blood pressure and cholesterol under control giving up smoking

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Complications Of Prediabetes

Prediabetes has been associated with long-term complications, including damage to your kidneys, blood vessels, and heart, even if you haven't developed type 2 diabetes. Furthermore, prediabetes is linked to undetected (silent) heart attacks.

In the event that prediabetes develops, type 2 diabetes may cause:

• High BP
• Higher cholesterol
• Heart problems 
• Stroke
• Nerve damage 
• Renal disease
• Eye damage  including blindness
• Amputations
• Fatty liver disease

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