While more than 20 million Americans have diabetes, it is estimated that a further 60 million have a condition known as pre-diabetes, which is also referred to as Impaired Glucose Tolerance (IGT) or Impaired Fasting Glucose (IFG). People with pre-diabetes have blood-glucose levels that are higher than normal, but are not quite high enough for them to be classified as a diabetic.
A normal blood glucose level for a fasting plasma glucose test is less than 100 mg per deciliter (<5.6 mmol/L). A person is considered to have diabetes if their fasting blood glucose level is above 125 mg per deciliter (>6.9 mmol/L). If your blood glucose level falls between this range you are considered a pre-diabetic.
Similarly a reading between 140 and 199 mg der deciliter 2 hours after drinking a glucose rich beverage (known as the oral glucose tolerance test or OGTT) is indicative of pre-diabetes.
The vast majority of people with pre-diabetes show no symptoms, however pre-diabetics do tend to be overweight, have higher than normal blood pressure, and high triglyceride and/or cholesterol levels.
It is estimated that around 50% of pre-diabetics will eventually go on to develop diabetes however the other half manage to stabilize or even reverse the condition so that they fall into the normal blood glucose range again.
Pre-diabetes is particularly prevalent in older and overweight individuals. A 2003 study put the prevalence of pre-diabetes in the USA at 22.6% amongst overweight adults aged 45-74.
Like diabetics, those with pre-diabetes are at higher than normal risk of cardiovascular disease (CVD). A 2005 study, published in the journal Diabetes Care looked at the fasting glucose levels of 36,386 Taiwanese adults aged between 40 and 69 and their subsequent risk of CVD.
The researchers found that compared to those with normal fasting glucose levels, those with fasting glucose levels between 110 mg/dL and 125 mg/dL had 50% higher risk of developing CVD. While this was in part due to the fact that those with impaired fasting glucose had elevated cholesterol levels and blood pressure, were more likely to smoke, and had higher BMI levels – all of which are all risk factors for CVD, even after adjusting for these factors, impaired fasting glucose was still associated with a 30% increased risk of CVD.
The study underscores the importance of keeping fasting blood sugar levels under 100 mg/dL, even if an individual still feels healthy and does not meet the diagnosis for full blown diabetes.
Pre-diabetics are recommended to make the same changes to their meal plans as a diabetic would. This includes reducing overall food intake, choosing foods with a low glycemic index (GI), reducing intake of sugary beverages, reducing total fat intake especially from high fat dairy products such as whole milk, ice cream, and butter, switching to wholegrain breads and cereals, and eating a diet high in fruit and vegetables. Lifestyle changes such as quitting smoking, increasing exercise levels, and reducing overall body weight are also recommended.
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