Diabetes: Pre-Diabetes
Introduction
Before people develop type 2 diabetes, they almost always have an
asymptomatic condition called "pre-diabetes." Also known as "impaired glucose
tolerance," pre-diabetes is a term that refers to the 41 million people in the
U.S. who have blood glucose levels that are higher than normal, but are not high
enough to be classified as diabetes.
More and more, doctors are recognizing the importance of diagnosing
pre-diabetes as treatment of the condition may prevent type 2 diabetes as well
as the complications associated with type 2 diabetes, such as heart and blood
vessel disease and eye and kidney disease. Doctors now know that the
complications associated with the condition occur before the diabetes diagnosis
is made.
Who's At Risk For Developing Type 2 Diabetes?
- People with a family history of type 2 diabetes
- Women who had gestational diabetes or have had a baby more than 9 pounds
- Women who have polycystic ovary syndrome (PCOS)
- • African Americans, Native Americans, Latinos, and Pacific Islanders,
minority groups that are disproportionately affected by diabetes
- People who are overweight or obese especially around the abdomen
- People with high cholesterol, high triglycerides, low good 'HDL' cholesterol and a high bad 'LDL' cholesterol and high blood pressure. This cluster of problems is known as the
metabolic syndrome or
insulin resistance.
- People who are inactive
- Older people. As people age they are less able to process glucose appropriately and therefore have a greater risk of developing type 2 diabetes.
Symptoms of pre-diabetes
Although most people with pre-diabetes have no symptoms at all, symptoms
of diabetes may include unusual thirst, a frequent desire to urinate, blurred
vision, or extreme fatigue.
A lab test may show some signs that suggest pre-diabetes may be present.
Who Should be Tested for Pre-Diabetes?
You should be tested if:
- You're over 45 years of age
- You have any risk factors for diabetes
- You're overweight with a BMI (body mass index) over 25
- You belong to a high risk ethnic group
- You were know to previously have an abnormal glucose tolerance test (see
below) or have an impaired fasting glucose level (see below)
- You have a history of gestational diabetes or delivering a baby that weight more than 9 lbs
- You have high triglycerides and low HDL cholesterol, central obesity and
hypertension (the metabolic insulin resistance syndrome)
If your weight is normal and you're over age 45, you should ask your doctor during a routine office visit if testing is appropriate.
How Is Pre-Diabetes Diagnosed?
Your doctor can perform two different blood tests - the fasting plasma
glucose (FPG) test and the oral glucose tolerance test (OGTT) -- to determine if
you have pre-diabetes.
During the FPG test your blood glucose level is measured after an 8 hour
fast. This test can determine if your body metabolizes glucose correctly. If
your blood glucose level is abnormal after the fasting plasma glucose (FPG)
test, you could have what's called "impaired fasting glucose," which suggests
pre-diabetes.
Understanding the FPG Test Results
| Condition |
FPG |
| Normal |
Less than 100 mg/dL (milligrams per deciliter) |
| Pre-diabetes |
100 mg/dL - 125 mg/dL |
| Diabetes |
Greater than 126 mg/dL on two or more tests |
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