You need not wait to be a diabetic to treating diabetes. With campaigns on the run up to World Diabetes Day on November 14 advocating prevention of diabetes, focus is clearly on the pre-diabetes stage. The pre-diabetes stage is the ‘cat on the wall' stage as V.Ravindranath, consultant diabetologist, Tiruchi Diabetes Speciality Centre puts it, with blood glucose levels falling between the normal and diabetic range. Those in the pre-diabetic stage are potential diabetics as diabetes does not emerge overnight. Physicians and various specialists reiterate the significance of intervention at this crucial phase not only to prevent or delay onset of diabetes but to avoid other complications in the long run. Various studies have proved that cardiovascular complications including heart disease has already set in at the time of detection of diabetes in many patients opine cardiologists. Hence intervening at this stage means that complications are stalled.
“Pre-diabetic stage precedes diabetes by five to ten years. While macro vascular complications like cardiac disease, stroke and peripheral vascular disease set in ten years before diagnosis of diabetes, micro vascular conditions like diabetic retinopathy (eye disease), diabetic nephropathy(kidney) and neuropathy (nerves) set in before five years,” says Dr.Ravindranath. When someone is diagnosed with diabetes, it is advisable to check for these complications immediately, he adds.
Though family history and genetic predisposition plays an important role in developing type II diabetes, there are those who develop diabetic due to non-genetic factors like obesity, high stress levels, faulty diet and sedentary lifestyle. What worries doctors is the early onset of diabetes. Though age remains a risk factor, incidence of diabetes in patients below the age of 60 has been increasing.
The pre-diabetes stage cannot be brushed off just because blood glucose levels do not fall in the diabetic range. The blood sugar levels are kept from reaching the diabetic level as beta cells that produce insulin work overtime to keep it normal. But compounded by obesity and sedentary lifestyle, they may soon lose their effectiveness in keeping blood sugar levels under check.
The normal range is less than 100 mg/dl and 140 mg/dl for fasting blood sugar and post prandial respectively as opposed to diabetic range that is more than 126 and 200. Pre-diabetic stage is the range when fasting blood sugar is between 100- 125 and post prandial between 140- 199. Borderline diabetes includes Impaired glucose tolerance (IGT) where post prandial glucose level is in the pre-diabetic range and fasting sugar level is normal and Impaired fasting glucose (IFG) where it is vice-versa. When both parameters are in the pre-diabetic range, it is a case of combined IGT.
Oral glucose tolerance tests can classify the person as normal, pre-diabetic or diabetic. Anyone above 30 should take the test once in two years while it is advisable for those above 40 to make it an annual affair. Those in the pre-diabetic category should monitor their blood glucose levels by repeating the test once in three or six months. Though there are arguments supporting medication and pharmacotherapy at the pre-diabetic stage, lifestyle modification involving calorie-based diet, regular exercise like brisk walking, quitting smoking, moderating alcohol consumption and keeping tabs on hypertension can ensure these individuals revert to normal blood sugar levels or at the least, delay onset of diabetes, in genetically predisposed individuals.
