Your Health A-Z

Are you at risk of diabetes?

Intermediate hyperglycaemia (impaired fasting glucose and impaired glucose tolerance) is a ‘pre-diagnosis’ of diabetes. The good news is you can prevent Type 2 diabetes if you make considered lifestyle changes.

When your blood glucose level (blood sugar level) is higher than normal but not high enough to be considered diabetic, doctors will say you either have impaired fasting glucose (blood glucose levels are elevated during periods of fasting or IFG) or impaired glucose tolerance (elevated blood glucose levels not yet at diabetic levels or IGT). In the past people have refered to this state of intermediate hyperglycaemia (in between normal blood glucose levels and diabetes) as ‘pre-diabetes’.

‘Either your insulin production isn’t adequate – or your body’s cells aren’t responding properly to it – and sugar can start building up in your bloodstream because your cells aren’t able to absorb sufficient glucose from your food,’ says Ilsabe Spoelstra, a dietician at Medicinic Bloemfontein.

Intermediate hyperglycaemia puts you at risk of developing diabetes and cardiovascular disease in future.

If you are over 35, overweight (especially if you carry those extra kilograms around your middle), are of Indian descent, have a family history of diabetes, have high cholesterol and / or high blood pressure, or developed gestational diabetes during pregnancy, you might also be at increased risk of intermediate hyperglycemia or becoming diabetic in future.

While developing Type 2 diabetes isn’t inevitable, you might not realise the disease is progressing because you might feel perfectly healthy, Spoelstra adds. However, if you are experiencing any of the following, you should consult your healthcare provider.

  • Extreme fatigue:  If sugar lingers in your bloodstream it’s not going into your cells where it’s used for energy.
  • Blurry vision: This is caused by sudden spikes and dips in your blood sugar levels.
  • Excessive thirst: This happens because your kidneys are trying to flush out the excess glucose in your body, making you urinate frequently and causing dehydration.
  • Wounds that don’t heal: When your glucose levels remains high, your circulation slows down and your body doesn’t get the right levels of white blood cells to fight infections.
  • Sudden weight gain: When your insulin levels are too high, you aren’t able to burn excess fat.

If you are pre-diabetic, eating healthily, exercising regularly, controlling your blood pressure  and cholesterol and maintaining a healthy weight are lifestyle choices you can make to prevent your condition from developing into full-blown diabetes,’ says Spoelstra.

‘Ensure you eat three balanced meals a day, especially if you’re not on medication for raised blood glucose levels. Include good-quality protein and veggies for every meal, including breakfast (e.g. an omelette with asparagus and tomatoes). Watch your carbohydrate and fruit intake and steer clear of pre-prepared meals.’

What should your blood sugar levels be?

Normal fasting blood glucose is about 5.6 mmol/litre. In IGT/IFG (intermediate hyperglycaemia), your fasting blood glucose is between 6.1-6.9 mmol/litre. Once your fasting blood glucose is 7mmol/litre, you likely have a diagnosis of diabetes. Depending on your symptoms and presentation, your doctor may request further glucose tests such as an HbA1c or an oral glucose tolerance test (OGTT) to make the diagnosis.

There are two ways to measure your blood sugar levels:

  1. DIY blood sugar checks via your glucose metre that tell you what your blood sugar level is at the time you test.
  2. The HbA1C test, or glycated haemoglobin, which is an indicator of your average blood sugar level over the past two to three months.

References:

http://www.diabetesplan.org/how-prediabetes-is-different-from-diabetes/

https://www.webmd.com/diabetes/tc/prediabetes-topic-overview#1

https://www.healthline.com/health/diabetes/borderline-diabetes-know-the-signs#diagnosis4

In the interest of our patients, in accordance with SA law and our commitment to expertise, Mediclinic cannot subscribe to the practice of online diagnosis. Please consult a medical professional for specific medical advice. If you have any major concerns, please see your doctor for an assessment. If you have any cause for concern, your GP will be able to direct you to the appropriate specialists.