What is Prediabetes or Borderline Diabetes?
Borderline diabetes, also called prediabetes, is a condition that develops before a person gets type 2 diabetes. It’s also known as impaired fasting glucose or glucose intolerance. It basically means your blood sugar levels are higher than normal, but they’re not quite high enough to be considered a sign of diabetes.
During the prediabetes phase, your pancreas still produces enough insulin in response to ingested carbohydrates. The insulin is less effective at removing the sugar from the bloodstream, though, so your blood sugar remains high. This condition is called insulin resistance.
If you have prediabetes, you should know you’re not alone. In 2015, it was estimated that 84.1 million Americans age 18 and older had the condition. That’s 1 in 3 Americans.
Having prediabetes doesn’t mean you’ll definitely develop diabetes. It’s a warning of what could lie ahead, however. People with prediabetes have a 5 to 15 times higher risk for type 2 diabetes than someone with normal blood sugar levels.
Those chances increase if you don’t make any healthy changes to your diet or activity habits.
Early warning signs
Someone with insulin resistance in its early stages can develop type 2 diabetes if it continues long enough. Only 10 percentTrusted Source of people with prediabetes even know they have it because many don’t display any symptoms.
“Prediabetes is not pre-problem,” says Jill Weisenberger, MS, RD, CDE, and author of “Diabetes Weight Loss Week by Week.”
Borderline diabetes risk factors
Any of these risk factors can increase your chances of developing prediabetes:
- being overweight or obese
- being inactive
- having high blood pressure
- having high cholesterol
- having a close family member with type 2 diabetes
- giving birth to a baby weighing more than 9 pounds
- Determining if you have borderline diabetes
Prediabetes is a silent condition, so getting a regular wellness checkup is important for early detection. If you think you might have borderline diabetes, discuss your concerns with your doctor.
If your doctor is concerned you may have prediabetes, they’ll most likely perform a hemoglobin A1c (HbA1c) test or oral glucose tolerance test (OGTT).
HbA1c is an indicator of your blood sugar patterns over the last two to three months, so it’s often a better overall picture than a single fasting blood sugar check. An HbA1c level between 5.7 and 6.4 indicates prediabetes.
Potential complications of borderline diabetes
High blood glucose levels, especially if they’re left untreated, can affect other systems in your body. This can leave you vulnerable to a variety of health risks and chronic health conditions. For example, uncontrolled diabetes can lead to:
- vision loss
- nerve damage
- kidney damage
- cardiovascular disease
The high insulin levels that come with insulin resistance can cause additional problems.
Prediabetes is reversible, but it is often easier to prevent than treat. Lifestyle factors are the primary causes of prediabetes, and making changes in some aspects of life can significantly reduce risk factors.
A balanced, nutritious diet that moderates sugar intake and regular exercise can help reverse borderline diabetes.
According to the American Diabetes Association, diet and nutrition changes should include the following:
- improving intake of unprocessed high-fiber carbohydrates
- increasing fruit and vegetable consumption
- reducing saturated fat and processed meat intake.
Click here to find out more about what to eat with prediabetes.
Exercise is also important. According to a report in Diabetes Care, exercise can help prevent or delay diabetes from developing.
Current guidelines for Americans recommend that adults should:
- have at least 150–300 minutes of moderate-intensity aerobic activity each week
- do muscle-strengthening exercises at least twice a week, such as lifting weights or doing push-ups
Examples of moderate exercise are fast dancing and brisk walking.
Regular exercise and a healthful diet not only help reduce the risk of developing diabetes but also protect the heart against future diseases.
Diabetes Prevention Program
The Diabetes Prevention Program (DPP) was a long-term study that aimed to identify practical steps for reducing diabetes risk and reversing prediabetes.
The people who took part in the DPP Lifestyle Change Program aimed to lose 7 percent of their body weight and maintain this loss through dietary changes and activity. After 3 years, the results of the program showed:
- a 58-percent drop in the risk of developing diabetes regardless of sex or ethnicity, compared with those who took a placebo
- a 71-percent drop in risk people of developing type 2 diabetes among people aged over 60 years
All the people in the program received motivational support on effective diet and exercise and attended “lifestyle change classes,” for the duration of the study.
Follow-ups took place regularly. After 15 years, people in the DPP Lifestyle Change Program continued to see a delay in the onset of diabetes compared to people who took a medication called metformin or a placebo.
Anyone who developed diabetes during the study received extra medical care. However, diet and exercise remained important in managing symptoms and reducing the risk of complications.
Monitoring borderline diabetes
In addition to lifestyle changes, doctors may recommend other steps for managing the risk of diabetes.
Medical management may include treating related conditions, such as obesity and heart disease.
Managing prediabetes also involves continued monitoring of the risk factors and regular testing of blood sugar levels.
A person can reverse borderline diabetes if they can make and maintain the necessary lifestyle changes.
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