Prediabetes - what you don't know may kill you

It is possible to have diabetes and not know it. In South Africa, more than half the adult population has prediabetes or diabetes, caused mainly by being overweight or obese.

Type 2 diabetes usually develops gradually over many years, and the initial symptoms may be almost unnoticeable. Many people discover that they have type 2 diabetes when a routine laboratory test shows high blood glucose levels.

What is prediabetes?

Prediabetes is diagnosed when your blood sugar levels are above the specified range but not high enough to be classified as having type 2 diabetes. Blood glucose levels of less than 5.5mmol/l are considered normal by the World Health Organization (WHO). People with diabetes have a blood sugar level of 7mmol/l or higher. The prediabetic range is between these two cut-off points: 5.5 to 7mmol/l.

You are being diagnosed with prediabetes (often referred to as insulin resistance or impaired glucose tolerance) when your body needs some help to prevent diabetes. Prediabetes means your risk of developing diabetes is 10 to 20 times greater than those with normal blood sugars. But there is good news. If you have prediabetes, you can turn it around by improving your blood sugar levels by changing your diet and lifestyle. This significantly lowers the risk of developing type 2 diabetes, but only if you know you have it!

What are the warning signs of prediabetes?

Diabetes can be challenging to manage and, if left untreated, can lead to complications. Fortunately, you can identify risk factors for diabetes early on. Here is a checklist of potential warning signs that might indicate that you have prediabetes or type 2 diabetes and need to see your doctor right away:

• Increased thirst, dry mouth, and frequent urination: When your kidneys are not working as well as they should be, they battle to get rid of excess fluids. As a result, you may feel thirsty more often and need to urinate more frequently.
  
• Feelings of fatigue, weakness, and weight loss: If your body doesn't receive enough nutrients because of insulin resistance, you may experience fatigue, weakness, and weight loss. This is because your organs (such as your heart and liver) work harder to clean the blood of excess glucose.
  
• Skin issues like wounds or sores that won't heal and darkened skin: If your blood sugar is too high, it may damage your nerves, making you more susceptible to infections and other skin issues. Other signs of prediabetes are skin tags and patches of dark velvety skin on certain parts of the body. Affected areas can include the neck, armpits and groin.
  
• Blurred vision: High blood pressure changes the shape of eye cells temporarily.
  
• Tingling or numbness in hands and feet: High blood sugar causes nerve damage leading to tingling feet.

How is it diagnosed?

If you experience any of the early signs of diabetes, visit your doctor to test your blood sugar levels and your tolerance to glucose. An early diagnosis can stop these temporary symptoms from becoming permanent. Your doctor might do a finger prick test first to get a general idea, followed by a haemoglobin A1C (HbA1c) test. A HbA1C test is a blood test that shows what your average blood sugar (glucose) level was over the past two to three months.

If you have prediabetes, your doctor will recommend you make lifestyle changes, such as eating healthier and exercising more. They may also prescribe medications to lower your blood sugar levels.

The National Department of Health recommends every adult over 45 years old gets an annual diabetes screening.

Prevention

Healthy lifestyle choices can help you prevent prediabetes and its progression to type 2 diabetes – even if diabetes runs in your family. These include:

• Eating healthy foods
  
• Getting active
  
• Losing excess weight
  
• Controlling your blood pressure and cholesterol
  
• Not smoking