Pre-diabetes: Are you at risk?

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The United Nations has declared 14 November, 2007 World Diabetes Day. “Yeah, that’s great, but I don’t have diabetes so I don’t need to pay attention to all the talk about it”, we hear you say. Well maybe, maybe not.

Diabetes Australia estimates that 2 million Australians have pre-diabetes. Left untreated, pre-diabetes can develop into Type 2 diabetes, which can have serious health consequences. Most people with pre-diabetes aren’t even aware they have it. Are you one of them? Read this article to find out.

What is pre-diabetes?

Pre-diabetes means your blood glucose levels are higher than normal, but not high enough for you to be classified as diabetic. A diagnosis of pre-diabetes is a warning sign that should be heeded, as it means you are likely to develop Type 2 diabetes in the future, unless you take preventative action now.

The condition occurs when your insulin (the hormone that helps convert sugars from food into energy) is not working properly and can’t move the glucose from the blood into the cells where it needs to be. This is known as insulin resistance.

Do you have pre-diabetes?

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How do you know if you have pre-diabetes? You can take a blood test, but the first thing to do is to check for risk factors. Take a look at the list below and see how many risk factors are true for you:

  • Do you have a family history of diabetes?
  • Are you overweight?
  • Do you have a low level of physical activity?
  • Do you have a high triglyceride level and low HDL cholesterol level and/or high total cholesterol?
  • Do you have high blood pressure?
  • Do you have Polycystic Ovarian Syndrome and are overweight?
  • Have you had gestational diabetes (diabetes in pregnancy) or given birth to a baby weighing more than 4.5 kg ?
  • What is your ethnic background? Aborigines and Torres Strait Islanders, Pacific Islanders, Asians and Indians are at higher risk of developing diabetes.

If you answered “yes” to two or more of these questions, you are at risk for pre-diabetes.

Why should you be concerned about pre-diabetes?

Left unmanaged, pre-diabetes can develop into Type 2 diabetes within five to ten years, and this is the biggest risk. The Australian Institute of Health and Welfare reports that nearly 950 000 Australians aged 25 or above had diabetes in 1999-2000.  The bad news is the trend is an upwards one, with predictions by Diabetes Australia that by year 2010, there will be 1.8 million cases of diabetes in Australia.

The best way to put the brakes on these dramatic figures is through the early diagnosis and treatment of those at risk for pre-diabetes. Studies in diabetes prevention have shown that if people are diagnosed and treated for pre-diabetes, their chances of developing Type 2 diabetes decrease dramatically. For some people with pre-diabetes, intervention can actually turn back the clock and return elevated blood glucose levels to the normal range. That’s why it’s so important to get checked out if you think you are at risk.

Testing and diagnosis

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If you suspect you may have pre-diabetes, speak with your doctor, who can order a blood test called a fasting plasma glucose test (FPG). As the name suggests, you will need to fast before this test.

The FPG test will show three possible diagnoses:

1.Diabetes unlikely – if you have a reading of less than 5.5 millimoles of glucose per litre of blood (mmol/l);

2.Pre-diabetes – between 5.5 mmol/l and 6.9 mmol/l;

3.Type 2 diabetes – 7mmol/l or more.

If your FPG test shows a reading of between 5.5 and 6.9mmol/l, your doctor will perform a further test, an Oral Glucose Tolerance Test (OGTT): You will be given a glucose-rich drink and two hours afterwards, the change in your glucose level will be measured.

If either of the glucose tests indicate you have diabetes, and you didn’t show symptoms of diabetes before the test, your doctor will perform a confirmation test on a separate day.

Should you take the test?

  • If you are more than 45 years old and:

-are obese, or

-have high blood pressure (hypertension), or

-have a family history of diabetes

it’s recommended you have your blood glucose level checked every three years.

  • If you are younger than 45, but have one or more risk factors for pre-diabetes, you should also have your blood glucose level tested.
  • If your FPG test showed you were within the range for pre-diabetes, but the follow-up (OGTT) test failed to confirm it, you should be retested after one year.
  • If you are diagnosed with pre-diabetes, you should have a FPG test every year.

Treatment

The good news about pre-diabetes is that it can be treated, and through treatment, the onset of Type 2 diabetes can be delayed or even prevented. 872 5

Whether you want to prevent getting pre-diabetes or reduce your chances of it progressing to Type 2 diabetes, the advice from Diabetes Australia is the same: You need to make changes to your lifestyle by doing regular physical activity and eating healthily.

Here are some tips for making these lifestyle changes:

  • Eat foods that are low in fat and high in fibre, such as fruits and vegetables, beans, wholegrain breads and cereals
  • Space your meals evenly throughout the day
  • Aim for at least 30 minutes of physical activity most days of the week
  • Remember to talk to your doctor before starting any new type of exercise to make sure it’s suitable for you
  • Reduce your weight by five to ten percent – even a small weight loss has been found to make a big difference to the impact of pre-diabetes
  • Maintain your weight loss
  • Include the whole family in lifestyle changes – look after the future health of your children by teaching them healthy behaviours

By taking action to manage your blood glucose when you have pre-diabetes, you can prevent Type 2 diabetes from ever developing – and that’s good news!

References :

This article was compiled in consultation with Calorie King experts and in reference to the following sources:

Diabetes Australia, ‘What is diabetes?’

diabeteswa, www.dontignorediabetes.com.au

Diabetes Australia, ‘National Evidence-Based Guidelines for the Management of Type 2 Diabetes Mellitus’ www.diabetesaustralia.com.au

Australian Institute of Health and Welfare, ‘Australia’s Health 2006’ www.aihw.gov.au

Calorie King
CalorieKing's mission is to provide the best information, tools and education to Australians to help them conquer their weight.

CalorieKing is the brainchild of Allan Borushek, registered dietitian, co-found here at food.com.au and author of "Allan Borushek's Pocket Calorie & Fat Counter", Australia's best-selling calorie counter for over 30 years.

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