Prediabetes (Impaired Glucose Tolerance)

Pre-diabetes (previously called Impaired Glucose Tolerance IGT) was first named in 2003 and is designed to foster attention and action in people who receive this diagnosis. It is defined as having a blood glucose level that is higher than normal, but not high enough to be classified as diabetes. The cutoff for pre-diabetes is a fasting blood sugar of 100 mg/dl. Fasting levels between 100 and 126 mg/dl are diagnosed as pre-diabetes and a fasting level of 126 mg/dl and up is diabetes. The other determiner of pre-diabetes is a blood sugar level two hours after eating carbs of 140 to 199 mg/dl. A blood sugar under 140 mg/dl is considered normal and one 200mg/dl and over is considered diabetes.

Early diagnosis is important. In the early years of pre-diabetes or diabetes, the beta cells are progressively damaged by high blood sugars.Usually by the time diabetes is diagnosed, half of the beta cells are nonfunctional. This can not be reversed so that the beta cells can go back to insulin production. When an early diagnosis of pre-diabetes is made, almost 100 percent of beta cells are functional. If lifestyle changes are made and some diabetes medications are used right away, many beta cells will stay healthy and make blood sugar control easier

Criteria for Diagnosing Prediabetes and Diabetes
Fasting BG BG 2 Hours After High Carbs
Normal 70-99 mg/dl < 140 mg/dl
Prediabetes 100-125 mg/dl 140-199 mg/dl
Diabetes ≥ 126 mg/dl ≥ 200 mg/dl

An estimated 20 million people have pre-diabetes in the U.S. and this number is growing rapidly. 50 percent of the people who have pre-diabetes are likely to develop Type 2 diabetes, however diet, exercise and glucose monitoring can greatly reduce the onset of diabetes altogether.

People who have a higher risk of developing pre-diabetes or Type 2 diabetes are:

  • those overweight, especially in the abdominal area.
  • those with a family history of diabetes
  • women who have had gestational diabetes
  • people with steroid induced hyperglycemia
  • or those having hypertension or an abnormal lipid profile

Below are risks associated with Type 2 diabetes:

  • Increased risk of heart attack and stroke
  • Coronary artery disease, hypertension, dyslipidemia
  • Impotence, blindness, amputations and kidney failure

Type 2 diabetes is complex. It is typically caused by one or more factors: obesity and lack of exercise (lifestyle factors), insulin resistance and decreased production of insulin by the beta cells (genetic factors). In many people it takes all of these factors to produce diabetes. But some people who have some of these factors do not get diabetes. For example you could be overweight and sedentary and not get diabetes.

Action should be taken when a diagnosis of pre-diabetes is made to delay or avoid progression to full blown Type 2 diabetes.Pre-diabetes should be treated aggressively with glucose monitoring, blood pressure monitoring, fasting lipid profiles, weight control and nutritional education to prevent the development of diabetes.

Some steps to take when diagnosed with pre-diabetes to help yourself avoid diabetes:

  • get a blood sugar meter and test. Measure your fasting blood sugar and your blood sugar two hours after eating carbohydrate to see if you are within normal range. See which foods spike your blood sugar and avoid them.
  • eat less and move more. Lose weight if you can, but if not, become physically fit to improve your blood sugars and lengthen your life.
  • eat carbs lower on the glycemic index. Eat more fiber. Avoid processed carbs.
  • move more by playing with a dog or a kid, dancing, window shopping, walking, anything that is fun.
  • eat fresh foods, especially a salad a day.
  • read food labels. Notice dietary fiber, portion size, trans fats.
  • don’t diet; eat healthy, wholesome foods you like in reasonable portions. Eat more fruits and vegetables.