What numbers mean prediabetes?
The diagnosis is made based on laboratory parameters, and not on how you feel. Fasting venous plasma glucose from 6.1 to 6.9 mmol/l is interpreted as impaired fasting glycemia. A glucose level after two hours during an exercise test between 7.8 and 11.0 mmol/L indicates impaired glucose tolerance. Glycated hemoglobin reflects average sugar over the past three months, and its intermediate values also indicate prediabetes. One test does not make a diagnosis: the result must be confirmed by a repeat test, because stress, infection and taking certain medications temporarily increase sugar.
- Fasting glucose 6.1–6.9 mmol/l (venous plasma)
- Glucose 2 hours after exercise 7.8–11.0 mmol/l
- Intermediate values of glycated hemoglobin
- The diagnosis is confirmed by repeated analysis
- Blood is donated on an empty stomach, after 8–14 hours without food
Why is this developing?
The basis is insulin resistance: muscles, liver and fatty tissue respond less well to insulin, and the pancreas has to secrete more of it. A key role is played by visceral fat around internal organs, which secretes substances that support inflammation and reduce insulin sensitivity. Therefore, waist size is more informative than weight. Additional contributors include a sedentary lifestyle, lack of sleep, a diet high in sugar and ultra-processed foods, and heredity. In women, risk factors include a history of gestational diabetes and polycystic ovary syndrome.
- Excess weight, especially belly fat
- Sedentary lifestyle
- Heredity: type 2 diabetes in close relatives
- Age after 45 years
- History of gestational diabetes or large fetus
- Polycystic ovary syndrome
- Arterial hypertension and lipid metabolism disorders
- Chronic lack of sleep and nocturnal lifestyle
Who and when to check
Since there are no symptoms, the only way to detect prediabetes is through screening. It is recommended that everyone over the age of 45 check their blood sugar at least once every three years, and if they are overweight and have other risk factors, earlier and more often. Separately, it is worth examining for arterial hypertension, high cholesterol, polycystic ovary syndrome, and for women after pregnancy with gestational diabetes. Dark, velvety areas of skin on the neck, armpits and groin often accompany insulin resistance and are a reason to get tested.
- Everyone over 45 years old - at least once every 3 years
- If you are overweight and have a risk factor - earlier
- For hypertension and high cholesterol
- After gestational diabetes - regularly
- For PCOS and signs of insulin resistance
- For darkening of the skin in folds
Why is prediabetes dangerous?
The main danger is the high probability of transition to type 2 diabetes in the coming years. But vascular damage begins even before a formal diagnosis: prediabetes is associated with an increased risk of heart attack and stroke, and often goes hand in hand with hypertension, lipid disorders and fatty liver disease. Damage to the small nerves of the feet is sometimes detected already at this stage. That is why prediabetes is not a harmless number in the analysis, but a signal to reconsider your lifestyle and evaluate your cardiovascular risks as a whole.
- Transition to type 2 diabetes mellitus
- Increased risk of heart attack and stroke
- Arterial hypertension
- Non-alcoholic fatty liver disease
- Lipid disorders
- Early changes in the nerves of the feet
What to do: nutrition, movement, weight
Lifestyle changes at this stage work as well as medications, and this is a proven fact. Reducing body weight by 5-7 percent from the original already significantly reduces the risk of diabetes. The optimal amount of exercise is at least 150 minutes of moderate activity per week, for example brisk walking for 30 minutes five times, plus strength exercises twice a week. The main thing in nutrition is to eliminate sugary drinks and juices, reduce refined carbohydrates and ultra-processed foods, add vegetables, legumes, whole grains, fish and nuts. Your doctor may prescribe medications if lifestyle changes are not enough. Control of analyzes - usually once a year.
- Weight reduction of 5–7 percent
- At least 150 minutes of moderate activity per week
- Strength exercises 2 times a week
- Avoiding sugary drinks and packaged juices
- More vegetables, legumes, whole grains
- Adequate sleep 7–8 hours
- Quitting smoking
- Drug therapy according to the doctor's decision
- Monitor glucose and HbA1c at least once a year
