Prediabetes

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Prediabetes
Synonyms	Borderline diabetes, Impaired glucose tolerance, Impaired fasting glucose
Pronounce	N/A
Specialty	N/A
Symptoms	Often none; may include increased thirst, frequent urination, fatigue
Complications	Type 2 diabetes, cardiovascular disease
Onset	Gradual
Duration	Long-term
Types	N/A
Causes	Insulin resistance, obesity, genetics
Risks	Obesity, sedentary lifestyle, family history of diabetes, gestational diabetes
Diagnosis	Fasting plasma glucose, oral glucose tolerance test, HbA1c
Differential diagnosis	Type 2 diabetes, metabolic syndrome
Prevention	Healthy diet, regular exercise, weight loss
Treatment	Lifestyle changes, metformin
Medication	N/A
Prognosis	N/A
Frequency	Common; affects millions worldwide
Deaths	N/A

Prediabetes is a medical condition characterized by blood glucose levels that are higher than normal but not yet high enough to be classified as type 2 diabetes. It is considered an intermediate stage in the development of diabetes and is a significant risk factor for the progression to type 2 diabetes, as well as for cardiovascular diseases.

Pathophysiology

Prediabetes occurs when the body begins to have trouble using the hormone insulin effectively, a condition known as insulin resistance. Insulin is produced by the pancreas and is essential for the regulation of blood glucose levels. In prediabetes, the pancreas may initially produce more insulin to overcome insulin resistance, but over time, it may not be able to keep up, leading to elevated blood glucose levels.

The HOMA-IR (Homeostatic Model Assessment of Insulin Resistance) is a method used to quantify insulin resistance.

Diagnosis

Prediabetes is diagnosed using one of the following blood tests:

• Fasting Plasma Glucose (FPG) Test: A fasting blood sugar level of 100 to 125 mg/dL (5.6 to 6.9 mmol/L) indicates prediabetes.
• Oral Glucose Tolerance Test (OGTT): A blood sugar level of 140 to 199 mg/dL (7.8 to 11.0 mmol/L) two hours after drinking a glucose-containing beverage indicates prediabetes.
• Hemoglobin A1c Test: An A1c level of 5.7% to 6.4% indicates prediabetes.

Risk Factors

Several factors increase the risk of developing prediabetes, including:

• Being overweight or obese
• Having a sedentary lifestyle
• Being over the age of 45
• Having a family history of diabetes
• Having high blood pressure or abnormal cholesterol levels
• Having a history of gestational diabetes

Management

The primary goal in managing prediabetes is to prevent the progression to type 2 diabetes. This can often be achieved through lifestyle modifications, such as:

• Dietary Changes: Adopting a healthy diet that is low in refined sugars and high in fiber.
• Physical Activity: Engaging in regular physical activity, such as brisk walking, for at least 150 minutes per week.
• Weight Loss: Losing 5-10% of body weight can significantly reduce the risk of developing type 2 diabetes.

In some cases, medication such as metformin may be prescribed to help manage blood glucose levels.

Complications

If left untreated, prediabetes can progress to type 2 diabetes, which is associated with numerous complications, including heart disease, kidney damage, and nerve damage. Early intervention is crucial to prevent these outcomes.

Also see

• Type 2 diabetes
• Insulin resistance
• Metabolic syndrome
• Gestational diabetes