The progression to diabetes happens in stages. For example, before you get diabetes, chances are your blood glucose levels are above normal but below the threshold for diabetes. This is called prediabetes.

Not many people have heard of it but ‘prediabetes’ has become a standard term in today’s medical industry. The concept of prediabetes emerged in the late 1970s originating from the National Diabetes Data Group. This resulted in a better understanding of the natural progression of diabetes. ‘Prediabetes’ was then adopted by the American Diabetes Association and World Health Organization and has become a standard term in diabetes awareness.

Prediabetes is considered a disease and should be taken seriously. Basically, if you have prediabetes and do not take an active role to prevent it from further developing, you increase your chances of getting full diabetes.

Prediabetes is reversible but not diabetes. So quick action is certainly needed for those who have been diagnosed with prediabetes, before it is too late.

Prediabetes increases the risk of progression to Type 2 Diabetes. There is strong evidence that 70 to 90 per cent of prediabetes patients without intervention will eventually develop Type 2 Diabetes. In addition, patients with prediabetes have higher risk of cardiovascular diseases too, among other health issues.

Prediabates predominantly happens to those who are obese. The good news is, with prediabetes, there is still hope. Prediabetes can definitely be reversed with some commitment and effort. Through intensive behavioural lifestyle intervention such as those involving diet and physical activities, weight loss can be achieved. Other ways to reverse it is by way of a pharmacological agent, namely metformin, especially for high-risk patients. Bariatric surgery is also another option but there is limited evidence that it reduces progression of diabetes. Once prediabetes is reversed and there is improvement in the patient’s health as glucose levels settle down, it is very important to maintain one’s health so prediabetes does not recur.

There are steps to take to avoid getting prediabetes again which is by maintaining diet and continuing physical activities regularly.  Ensure diet remains low calorie, low fat and high fiber. Make sure that you get no less than 150 minutes a week of moderate intensity exercises such as brisk walking. Equally important is to regularly monitor your blood glucose level/HbA1c.

Based on the numbers from International Diabetes Federation (IDF), the prediabetic age group comprise of 48.1 per cent people below the age of 50 and 28.3 per cent in the age group between 20 and 39 years. These are the ones who are likely to be face a long-term high risk of developing adverse health outcomes.

The prevalence of prediabetes is similar for both male and female. There is ample evidence that lifestyle-related changes as a result of rapid urbanisation are influencing the surge of prediabetes and Type 2 Diabetes, particularly in weight gain and sedentary lifestyle.

Diabetes is not a selective disease. Hence, we don’t want to keep pushing our luck by living an unhealthy lifestyle, especially because prediabetes symptoms can be very subtle and misleading. One should not make the mistake of thinking that diabetes would not affect them in their lifetime. Every individual is at risk depending on that individual’s lifestyle habits.

Prediabetes is like a ticking timebomb, as it is an early indication for future diabetes progression. One could easily progress into full diabetic stage as prediabetes does not usually have any signs or symptoms and mostly detected through screenings only.

Another reason to arrest diabetes when it is at a prediabetic stage, is because having diabetes can become a financial burden to patients and their families. It will result in an increase in your household or monthly expenditure. This is due to the cost of antidiabetic agents, diabetic supplies such as glucometer, glucose strips and needles for insulin users, follow-ups and other secondary complications arising from it. On average, people with diabetes have medical expenditures that are approximately 2.3 times higher compared to expenditure in the absence of diabetes.

Importance of early diabetes control

Diabetes is a chronic disease which cannot be cured but can be controlled through lifestyle modification, medications and regular follow-ups. The aim of treatment is to get the glucose to target at the point of diagnosis in order to prevent complication later in life. This means early glycemic control is important in order to prevent diabetes complications.

If ever you feel hopeless about your weight, eating habits, and sedentary lifestyle, do not give up. Carry on with your efforts but bear in mind to not expect immediate results. It will take time to see improvements to your health.

It is also never too late to take steps to improve your physical health condition as every little effort taken will have a positive impact towards keeping diabetes from progressing further. Diabetes is a global problem and there is a lot of information available to help keep it in control. Let’s make ourselves aware about prediabetes and ensure it doesn’t progress to full diabetes.

By Dr Radhamani Rajakumar
Consultant Internal Medicine Physician & Endocrinologist
Columbia Asia Hospital – Bukit Rimau

This content is provided by Columbia Asia Sdn Bhd