Before people develop type 2 diabetes, a lifelong disease marked by high levels of glucose (sugar) in the blood, they almost always have a condition known as “pre-diabetes.” This occurs when blood glucose levels are higher than normal but not high enough to be diagnosed as diabetes.
According to the American Diabetes Association, most of the estimated 16 million American adults who have pre-diabetes will develop type 2 diabetes within 10 years. Research also shows that long-term damage to the body can occur during pre-diabetes, especially to the heart and circulatory system.
“We now know that pre-diabetes – referred to in medicine as impaired fasting glucose or impaired glucose tolerance – is a precursor to type 2 diabetes, a very serious and widespread disease that can result in heart disease, stroke, nerve damage, kidney failure, blindness and limb amputation,” said Denise Joffe, M.D., a Cooper endocrinologist.
“It’s very important for people to recognize and address their pre-diabetes in order to prevent serious complications later on,” added Dr. Joffe.
In a major diabetes-prevention study completed by the National Institutes of Health in 2002, evidence was conclusive that people with pre-diabetes can prevent the development of type 2 diabetes by making modest changes in their diet and increasing their physical activity. They might even be able to return their blood glucose levels to normal, the study suggests.
But recognizing and seeking help for pre-diabetes can be tricky. People with pre-diabetes frequently have no symptoms at all, or they dismiss what symptoms they might have as a normal part of aging.
“Tiredness, darkened skin around the eyes, more frequent urination, increased abdominal fat, changes in vision…these are all possible pre-diabetes signs that many middle-age people simply attribute to the natural aging process,” said Dr. Joffe.
Regardless of symptoms, if you’re overweight and age 45 or above, the American Diabetes Association strongly recommends that you get screened for pre-diabetes during your next routine medical office visit.
Your doctor can utilize two different screening tests to determine whether you have pre-diabetes, the fasting plasma glucose test or the oral glucose tolerance test. Either test is effective in determining whether you have a normal metabolism, pre-diabetes or diabetes. If your blood glucose level is abnormal following the fasting plasma glucose test, you have impaired fasting glucose (IFG); if it’s abnormal following the oral glucose tolerance test, you have impaired glucose tolerance (IGT).
“Screenings for IFG or IGT should also be considered for overweight adults who are under age 45 and have other diabetes-risk factors,” Dr. Joffe said.
Risk factors for diabetes include high blood pressure, low HDL cholesterol and high triglycerides, a family history of diabetes, a history of gestational diabetes (development of the disease while pregnant), or belonging to an ethnic group at higher risk for developing diabetes: African American, American Indian, Asian American, Hispanic American/Latino and Pacific Islander.