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Prediabetes: what’s it all about?

Tuesday 15 July 2014

During the last few weeks, prediabetes has been talked about a lot in the media. But there is still some uncertainty around what it actually means.

Here Simon O’Neill, Director of Healthcare and Professional Liaison, explains just why it’s important that we identify people who have a high chance of getting Type 2 diabetes and do all we can to help them avoid it if they can.

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Simon O'Neill

“We know that doctors use a range of terms such as prediabetes, borderline diabetes, Impaired Fasting Glucose (IFG), Impaired Glucose Tolerance (IGT) and Impaired Glucose Regulation (IGR). And these might sometimes sound confusing. Your first question might be ‘does this mean I have Type 2 diabetes?’, ‘does this mean I’ll definitely get Type 2 diabetes?’ or even ‘does this mean I’m in the clear?’

“The answer to all of these is no. You don’t have Type 2 diabetes at the moment, but you do need to act now if you want to try and avoid it.

“Simply put, these terms can all be used to explain that your blood glucose levels are higher than normal, but not high enough for you to be diagnosed with Type 2 diabetes. They are largely based on an individual measurement of your blood glucose levels, regardless of any other factors. Having high blood glucose levels can increase your risk of developing Type 2 diabetes and other health complications, although this is not inevitable.

“Prediabetes isn’t actually a clinical term which is recognised by the World Health Organization. In fact, the American Diabetes Association has set the level for prediabetes at a blood glucose measurement of HbA1C 5.7% (39mmol/mol) but it is the only organisation which uses this criteria. In the UK there is no defined criteria for prediabetes or borderline diabetes.

“So why do some clinicians still use it? Well we know that sometimes it can be useful when explaining your individual risk of developing Type 2 diabetes. It emphasises how serious it is to have high blood glucose levels. Between 5% and 10% of people with prediabetes go on to develop Type 2 diabetes each year.

“It can also be helpful when looking into the risk of Type 2 diabetes within a population. So, knowing thatup to 18 million people in the UKpotentially fall into this category highlights the need for public health interventions in order to avoid a dramatic increase in Type 2 diabetes.

“At Diabetes UK, we use another way of measuring someone’s risk of going on to develop Type 2 diabetes. Ourrisk scorewas developed in partnership with the University of Leicester and it determines the likelihood of getting Type 2 diabetes based on seven differentrisk factors, including family history, age and BMI. It doesn't look at blood glucose levels.

"If you haven’t already found out your risk, why don’t you head over to ouronline risk score which only takes a few minutes to complete, or see whether we have a Healthy Lifestyle Roadshow coming to your area where you can be risk assessed.

“Whether you’re found to be at risk using our online tool, or whether your doctor has told you that you have prediabetes or any of the other similar terms I’ve mentioned, this means you have a higher chance of developing Type 2 diabetes, which is a lifelong condition. Knowing this is the first step to being able to do something about it.

“Around 80% of cases of Type 2 diabetes could be delayed or prevented through making lifestyle changes. Eating a healthy balanced diet, low in salt, sugar and fat and rich in fruit and vegetables, as well as being physically active is the best way of reducing your risk. Even if you’re not overweight, maintaining a healthy weight through eating well and being active is an important part of managing blood glucose levels and avoiding other health complications.

“Of course, it’s not just down to you. Healthcare professionals should support all people who have a higher risk of Type 2 diabetes, whichever way this has been identified.”

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