Pre-diabetes

 

As of 2002, a new term has come into official use.  This term is pre-diabetes.  The word "pre-diabetes" may be new, but the condition to which it refers is most definitely not.  Pre-diabetes is another way of referring to what we used to call "impaired glucose tolerance" or "impaired fasting glucose."  People years ago that were labelled as having "borderline diabetes" (a term which we no longer use because there is, in fact, no such thing as "borderline" diabetes.  Just like one cannot be "borderline pregnant."  You either is or you ain't.)  likely often had "pre-diabetes" (and probably equally often had established diabetes).

 

So then, what is "pre-diabetes?"

(I love posing my own questions...that way I can make sure I prepare the answer in advance!)

I'll answer that by stating a few facts:

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Before diabetes develops (and this entire discussion relates to type 2, not type 1 diabetes by the way), people have often had years (!) of higher than normal blood sugar levels.  Not necessarily high enough to have made you feel unwell, and not necessarily high enough to make a diagnosis of diabetes, but nonetheless, high enough that they would reveal that you are at increased risk of a heart attack (for example).

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If you have higher than normal blood sugars the likelihood of that progressing to the point that you get diabetes is very large.  In fact, the odds are 5 to 10 percent each year.  So within a few years, the odds are very high indeed that you will have progressed from slightly high sugars to moderately high sugars to a stage of true diabetes.  A slippery slope, indeed!

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We now know that we can often PREVENT this deterioration IF we intervene early enough.  If you know that your sugar levels are higher than normal and IF you improve your lifestyle (more exercise, lose weight, etc.), you can dramatically reduce your odds of getting diabetes.  We have increasing evidence that taking medicines (particularly Actos and Avandia but also metformin and acarbose) can also reduce your risk.

So what to make of these three facts?

Simply this; if you have higher than normal sugar levels and if you want to avoid getting diabetes you may be able to avoid it (or at the very least, you may be able to delay its onset) so long as you make the appropriate changes in your life.

 

Why the new term?  Why pre-diabetes rather than "impaired glucose tolerance?"

Well, I'll give you my personal spin on this.  What sounds worse to you..."pre-diabetes" or "impaired glucose tolerance?"  What term sounds more meaningful (and less like medicalese)?  Which condition is more likely to get you to get off the couch and into your running shoes?  Choose one of the following answers:

  1. Pre-diabetes
  2. Pre-diabetes
  3. Pre-diabetes
  4. Pre-diabetes
  5. Enough already!  I get the point.

 

More information is available at the ADA web site.

 

 

 

© Ian Blumer, M.D.