Pre-Diabetes - Could You Have It?

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Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: William C. Shiel, Jr, MD, FACP, FACR

About 41 million Americans between the ages of 40 and 74 have "pre-diabetes." Prediabetes is a condition that, as the name implies, can be considered an early, potentially reversible, stage in the development of Type II diabetes. Pre-diabetes is sometimes called Impaired Glucose Tolerance or Impaired Fasting Glucose (IGT/IFG). In pre-diabetes, a person's blood sugar (glucose) levels are slightly higher than the normal range, but not high enough for a true diagnosis of diabetes. People with pre-diabetes have a significant risk of developing full-blown diabetes; in the Diabetes Prevention Program study, about 11% of people with pre-diabetes developed Type II diabetes each year during the three-year follow-up time of the study.

Doctors generally use one of two different blood tests to diagnose diabetes and pre-diabetes. One is called the fasting plasma glucose test (FPG), in which a person's blood glucose level is measured first thing in the morning before breakfast. The normal fasting blood glucose level is below 100 mg/dl. A person with pre-diabetes has a fasting blood glucose level between 100 and 125 mg/dl. If the blood glucose level rises to 126 mg/dl or above, a person is considered to have diabetes.

The second test used in the diagnosis of diabetes is the oral glucose tolerance test (OGTT). In this test, a person's blood glucose is measured in the morning after fasting overnight and again 2 hours after drinking a glucose-rich beverage. The normal value for blood glucose is below 140 mg/dl two hours after the drink. In pre-diabetes, the two-hour blood glucose is 140 to 199 mg/dl. If the two-hour blood glucose rises to 200 mg/dl or above, a person has diabetes.

Research has shown that some of the long-term effects of diabetes on the body, such as damage to the heart and blood vessels, can begin even when a person only has pre-diabetes. Having pre-diabetes increases your risk of developing cardiovascular disease by about 50% compared to people with normal blood sugar levels.

You won't necessarily know if you have pre-diabetes, since the condition usually causes no specific symptoms. If you are overweight or have other risk factors for the development of diabetes, your doctor can help you decide if screening for pre-diabetes is appropriate.

The good news for people with pre-diabetes is that they can prevent or delay the development of diabetes with lifestyle modifications. Modest weight loss through diet and moderate exercise (such as walking 30 minutes per day, five times a week) can slow the development of diabetes and can even return blood glucose levels to normal in some people with pre-diabetes. Overweight people who have pre-diabetes need not achieve their ideal body weight to improve their condition; studies show that a weight reduction of just five to ten per cent of body weight can improve blood glucose levels. Since you can take measures to reverse the condition, recognition of pre-diabetes is an important step in disease prevention.