In a society with problems of obesity and less and less active and with jobs and hobbies that accentuate sedentary lifestyle, conditions such as prediabetes are more and more frequent.
Moreover, diabetes is reaching epidemic magnitudes in many countries. But, first of all, it is important to know what the increasingly heard prediabetes consists of and what its implications may be for the health of citizens.
A person is determined to have prediabetes when a blood glucose level is higher than normal but is not yet high enough to be considered type 2 diabetes. However, if action is not taken and some lifestyle changes, adults and children with prediabetes are more likely to develop type 2 diabetes.
In an interview with Infosalus, Dr. Javier Escalada, director of the Department of Endocrinology and Nutrition at the University Clinic of Navarra, with a preferential dedication to the study and treatment of diabetes mellitus, differentiates between two situations within prediabetes: L. to altered fasting blood glucose (fasting glucose values above 100 mg/dl).
Glucose intolerance (presenting values between 140 and 199 mg/dl two hours after an oral glucose load).
People Don’t Know They Have Prediabetes
Thus, this expert emphasizes that the prevalence of prediabetes (and diabetes) continues to “clearly and continuously rise.” In his opinion, the problem is that “a very high percentage” of people do not know that they have prediabetes.
“If in the case of diabetes there are 30-50% of people with diabetes who do not know they have it, in prediabetes, it is even worse. It has been estimated that 9 out of 10 people with prediabetes do not know they have it. Hence the importance of its active search for its early identification in order to be able to act soon and prevent its progression. The treatment of other associated cardiovascular risk factors is also very important,” he adds.
Why Is It Dangerous?
In fact, this specialist warns that prediabetes is a situation that can lead to diabetes: “It has been established that 5 to 10% of people with prediabetes develop diabetes after a year, but it is also possible to return to normal. A person with prediabetes has a higher cardiovascular risk than a person without prediabetes, due to a higher rate of hypertension, abnormal blood fats, and kidney damage. According to Dr. Escalada, its exact cause is currently unknown, although the importance of genetics, family history, lack of regular physical activity, overweight, and obesity is known.
“Along with the elevation of glucose, insulin resistance usually appears, which is characterized by high levels of insulin in the blood. These levels are indicating an ineffective action of insulin (the hormone responsible for metabolizing glucose), so the pancreas has to produce much more insulin than normal as it cannot completely normalize glucose”, details the specialist from Clínica Universidad de Navarra.
Thus, this specialist in Endocrinology states that the risk factors for prediabetes are the same as the risk factors for diabetes, that is, a sedentary lifestyle, obesity and especially abdominal obesity, as well as high blood pressure, dyslipidemia, Functional ovarian hyperandrogenism (polycystic ovary syndrome) or age over 45 years.
Regarding its symptoms, Dr. Escalada states that it is an asymptomatic condition. “The classic symptoms of diabetes (excessive urination, excessive thirst, weight loss without loss of appetite) do not appear in prediabetes because glucose levels are not high enough to produce symptoms. Therefore, it is a diagnosis that is achieved by actively seeking its existence,” he adds.
The diagnosis of prediabetes is based on its active search in those people with a higher risk of development: people over 45 years of age, people with obesity, hypertensive, with changes in blood fats, with a family history of diabetes, among others.
Remember here that there is a test, called ‘FINDRISC’, which allows you to ‘choose’ those people at highest risk according to a score based on age, body mass index, abdominal circumference, physical activity, fiber intake, high blood pressure, hyperglycemia, and family background.
“In these people at higher risk, a blood draw is done to measure fasting glucose. Also in some situations, it is also recommended to perform an oral glucose overload, which consists of drinking a sugary liquid with 75 grams of glucose to measure it before and the two hours of ingestion”, he maintains.
When it comes to preventing this disease, the director of the Department of Endocrinology and Nutrition of the University Clinic of Navarra points out that there are different studies that have shown that a change in lifestyle, with a nutritional intervention that starts a healthy diet and with increased physical activity, they decrease the likelihood of progression to diabetes and can help get back on track.
In addition to these basic interventions, in some patients with certain characteristics (obesity with a BMI greater than 35 kg/m2, under 60 years of age, women with a history of gestational diabetes) pharmacological treatment can be considered, fundamentally with metformin, a drug that is also used in diabetes, adds Dr. Escalada.