Dr. Annaswamy Raji
Prediabetes is a condition where the blood glucoses are higher than the normal range, but not high enough to be considered having diabetes.
People with prediabetes are considered to be at high risk for the future risk of diabetes. Sometimes they are called as impaired fasting blood sugar or impaired glucose tolerance, depending on the test that are used to diagnose prediabetes.
More recently, the American Diabetes Association has approved HbA1c, a simple blood test (which reflects a three-month average blood sugar) to be used to diagnose prediabetes. HBA1C between 5.7 and 6.4 percent is used to identify individuals with prediabetes
People usually have no symptoms and can have the condition for several years without noticing anything. Prediabetes is a risk factor for future diabetes and heart disease. The condition usually is associated with obesity, high cholesterol, high blood pressure and increased waistline.
Anyone over the age of 45, overweight or obese should be screened for prediabetes and diabetes. The others who are at risk for prediabetes are:
Being physically inactive.
Having a parent or sibling with diabetes.
Having a family background that is African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, or Pacific Islander.
Having high blood pressure — 140/90 or above — or being treated for high blood pressure.
¬ยท Having an HDL, or "good," cholesterol level below 35 mg/dL or a triglyceride level above 250 mg/dL.
Having polycystic ovary syndrome, also called PCOS.
Having a history of heart disease.
Patients diagnosed with prediabetes should be referred to an ongoing support program for weight loss of 5 to 10 percent of body weight. Patients should be encouraged to increase physical activity of at least 150 minutes a week of moderate activity like walking.
Ongoing lifestyle counseling and treatment of other associated conditions like high blood pressure, high cholesterol and monitoring patients for the development for diabetes are considered as a part of ongoing treatment.
Medication may be also considered by a physician for high-risk patients who are at very high risk for developing diabetes and have other metabolic conditions like high blood pressure or low good cholesterol, who are obese and are younger than 60 years old.
Annaswamy Raji is assistant professor/Harvard Medical School, and director of the Diabetes and Metabolism Center at Parkland Hospital.
