World Health Organisation figures show that diabetes was the seventh leading cause of death in the year 2016, about 1.6 million deaths were directly due to diabetes. It has been observed that diabetes is one of the main causes of blindness, kidney failure, heart attacks, stroke and lower limb amputation (1). 

Because of the epidemic proportion diabetes prevalence has reached it has become crucial to find ways to prevent diabetes. One such measure is detecting prediabetic status and making sure that it does not advance to diabetes.  

What is prediabetes?

Prediabetes is an intermediate condition of hyperglycaemia in which the glycaemic parameters are above normal but below the levels of a diabetic person. These people are at higher risk of developing diabetes (2). 

The diagnostic criteria to declare a person prediabetic is not uniform among the various professional international organizations throughout the world.

 The American Diabetes Association defines prediabetes as a fasting glucose of 100 to <126 mg/dL (impaired fasting glucose), a 2-h plasma glucose of 140 to <200 mg/dL after a 75-g oral glucose tolerance test (impaired glucose tolerance), or HbA1c 5.7% to <6.5% (1).

How to prevent prediabetes from becoming type 2 diabetes? 

According to several studies lifestyle interventions can result in relative risk reduction of 40%-70% in adults with prediabetes from becoming diabetics (2).

Regular health check ups

The American Diabetes Association recommends that checking for diabetes should start at the age of 45 years for all adults who are overweight and have any other risk factors such as

• Physical inactivity
• Hypertension
• History of cardiovascular disease
• Abnormal lipid profile 
• Family history of diabetes
• Women with polycystic ovarian disorder
• Gestational diabetes 
• Certain ethnic groups (3).

Early detection of prediabetic condition helps in prevention of type 2 diabetes.

Achieving ideal weight (4, 5)

Try and stick to ideal weight by consuming the recommended number of calories and also follow regular exercise routine recommended. Many of the people affected by type 2 diabetes are overweight or obese and weight reduction is the first objective of their dietary management.

Excessive weight may cause insulin resistance which is one of the causes of T2D. Especially central or abdominal obesity is linked to insulin resistance (6).

Dietary modifications

The diet for prediabetic should be planned so that they lose any excessive weight and achieve ideal weight. Diabetics have higher risk of getting cardiovascular diseases (CVDs) hence the diet should help them maintain normal blood pressure and blood cholesterol levels (4, 5). Hypertension and high cholesterol levels are risk factors of CVDs.

• Avoid excess calories
• Reduce saturated fat to 10 % of total energy or less.
• Consuming low glycaemic index foods is of utmost importance. Take expert help.
• Keep salt intake low to keep blood pressure in control.
• Avoid excess alcohol.

Increasing physical activity

A prediabetic person should make sure that an exercise routine is worked into their daily lives. This will help them maintain their weight and manage their blood glucose levels. Increasing physical activity may significantly reduce the risk of developing type 2 diabetes in individuals who are at high risk (7).

Final word

Life style modifications such as healthy diet, achieving ideal weight, increased physical activity and regular health check ups can help in preventing prediabetes from becoming type 2 diabetes.

References

1. Abraham, T. M. and Fox, C. S. (2013) Implications of Rising Prediabetes Prevalence, Diabetes Care. Vol. 36 (8). 

https://care.diabetesjournals.org/content/36/8/2139

1. Bansal, N. (2015) Prediabetes diagnosis and treatment: A review, World journal of diabetes. Vol. 6 (2). 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4360422/

1. Tuso P. (2014) Prediabetes and lifestyle modification: time to prevent a preventable disease, The Permanente journal. Vol. 18 (3). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4116271/

1. Wildman, R. (2009) The Nutritionist-Food, Nutrition and Optimal Health. Routledge, Taylor and Francis Group. Second Edition. New York and London.

1. Truswell, A. S. (2003) ABC of Nutrition. BMJ Publishing Group, BMA House Tavistock Square. Fourth Edition. London WC1H 9JR

1. National Institute of Diabetes and Digestive and Kidney Diseases (2016). Symptoms & Causes of Diabetes.

https://www.niddk.nih.gov/health-information/diabetes/overview/symptoms-causes#type

1. Laaksonen, D.E., Lindström, J., Lakka, T.A., Eriksson, J.G., Niskanen, L., Wikström, K., Aunola, S., Keinänen-Kiukaanniemi, S., Laakso, M., Valle, T.T., Ilanne-Parikka, P., Louheranta, A., Hämäläinen, H., Rastas, M., Salminen, V., Cepaitis, Z., Hakumäki, M., Kaikkonen, H., Härkönen, P.K., Sundvall, J.E., Tuomilehto, J. and Uusitupa, M. (2005) Physical activity in the prevention of type 2 diabetes: the Finnish diabetes prevention study, Diabetes. Vol. 54 (1).

https://diabetes.diabetesjournals.org/content/54/1/158.short