What You'll Learn Here:
Though national health authorities have ignored this chronic illness, in 2007 the U.S. Department of Health and Human Services estimated that fifty-seven million Americans – aged twenty and older – were pre-diabetic.1
Also referred to as borderline diabetes, impaired fasting glucose (IFG), and impaired glucose tolerance (IGT), pre-diabetes is associated with insulin resistance. The condition occurs when blood glucose levels are higher than normal, but not high enough to warrant a diabetes diagnosis. Pre-diabetes raises the risk of developing type 2 diabetes, heart disease, and stroke.
Many people have pre-diabetes prior to developing type 2 diabetes. Unless they decrease their body weight by five to seven percent, within ten years the majority of people with pre-diabetes develop type 2 diabetes.2
Research indicates that many serious long-term complications associated with diabetes – heart disease, circulatory problems, and nerve damage among them – may actually begin during pre-diabetes, and have already caused long-term damage before the sufferer is even aware there’s a problem. So if you’re at risk for pre-diabetes, it is important to know whether or not you have it.
As a rule, there are no overt symptoms associated with pre-diabetes. However, when there are signs, they include the classic symptoms of type 2 diabetes:
- Blurred vision
- Constant hunger
- Erectile dysfunction
- Frequent bladder infections or dysfunction
- Frequent gum or skin infections
- Frequent vaginal infections
- Frequent urination
- Increased fatigue
- Increased thirst
- Loss of feeling in hands or feet
- Slow healing of cuts and wounds
- Symptoms of flu including weakness and fatigue
- Tingling in hands or feet
- Unexpected weight gain
- Unexplained weight loss
You can have pre-diabetes for many years without being aware of it. People with a severe form of insulin resistance may have dark patches of skin (acanthosis nigricans) on the back of the neck, or on the armpits, elbows, knees, and/or knuckles; others have a dark ring around the neck.
Pre-diabetes Risk Factors3
In addition to being overweight, obese, or being age 45 or older, risk factors for pre-diabetes (and diabetes) include the following:
- Being diagnosed with gestational diabetes
- Giving birth to a baby weighing more than nine pounds
- Physical inactivity
- An African American, Alaskan Native, Native American, Asian American, Hispanic/Latino, or Pacific Islander background
- A history of cardiovascular disease
- A parent or sibling with diabetes
- An HDL (high-density lipoprotein), or good, cholesterol level below 35 mg/dL or a triglyceride level above 250 mg/dL
- High blood pressure – 140/90 or above – or being treated for high blood pressure
- Impaired fasting glucose (IFG)
- Impaired glucose tolerance (IGT)
- Other conditions associated with insulin resistance, such as severe obesity or acanthosis nigricans
- Polycystic ovary syndrome (PCOS)
Glycated hemoglobin (A1C) blood test
The A1C test is often used to screen for pre-diabetes. Glycated (or glycosylated) hemoglobin refers to hemoglobin that has bound with glucose. Measuring the percentage of blood sugar bound to hemoglobin illustrates average blood sugar level for the past two or three months. Those with high blood sugar levels have more hemoglobin with sugar attached to it. Two different tests showing an A1C level of 6.5 percent or higher is an indication of diabetes.
Fasting plasma glucose test (FPG)
Most reliable when performed after an overnight fast, the FPG test measures blood sugar levels in a person who hasn’t eaten for eight hours or more. A blood glucose level between 100 mg/dL and 125 mg/dL indicates impaired fasting glucose (IFG). The FPG will not detect some forms of diabetes or pre-diabetes, such as gestational diabetes.
Oral glucose tolerance test (OGTT)
Similar to, but more sensitive than the FPG test for diagnosing pre-diabetes and all other forms of diabetes, the OGTT is not as convenient to administer. Fasting for a minimum of eight hours prior to testing is necessary. Immediately before drinking a liquid comprised of glucose dissolved in water, and two hours afterwards, plasma glucose levels are measured. When blood sugar levels are between 140 and 199 mg/dL two hours after consuming the liquid, impaired glucose tolerance (IGT) is indicated.
Clinical trials indicate that some treatments can help prevent certain high-risk individuals from developing diabetes as well as delay or even prevent onset of the disease. As yet, there are no drugs that have been approved by the U.S. Food and Drug Administration to treat insulin resistance or pre-diabetes, or to prevent type 2 diabetes.
The American Diabetes Association, however, recommends that metformin be considered for diabetes prevention in high-risk individuals who have both forms of pre-diabetes (IGT and IFG), a body mass index (BMI) of at least 35, and are younger than sixty years of age.4 In trials, metformin reduced the risk of developing diabetes by thirty-one percent.5
Pre-diabetes and insulin resistance can be reversed. A modest amount of weight loss and physical activity (just thirty minutes of walking, five days a week) have been shown to be more effective than medication in helping to prevent some individuals from developing diabetes as well as delay or even prevent disease. Decreasing body weight by just five to seven percent can prevent or delay onset of diabetes by nearly sixty percent.6
Physical activity and maintaining a healthy body weight help people respond better to insulin, making it possible to avoid developing type 2 diabetes.
For those with pre-diabetes and diabetes, there’s the added nutritional complication of being on weight loss diets that may be substantially deficient in the recommended daily vitamin and mineral requirements.
Many vitamins and minerals are closely tied with the proper functioning of insulin and glucose metabolism. Unfortunately, ninety-seven percent of the diabetics in one study were deficient in three to seven nutrients of the twenty-two evaluated.7
So if you have pre-diabetes, a multi-vitamin supplementation can fill in the nutritional gaps that commonly accompany the condition. Look for a multi-vitamin that contains,
- Folic acid
- Vitamin A/Beta-carotene
- Vitamin B6
- Vitamin C
- Vitamin D
- Vitamin E