Understanding Prediabetes: Signs, Habits, and Approaches to Prevent Diabetes

Prediabetes can be the phase in which we stop the progression to diabetes.

Prediabetes is the period before the onset of diabetes. If we manage to observe certain signs, we can stop the appearance of this disease. Dr. Iuliana Filip, diabetes, nutrition and metabolic disease primary physician answered several questions and clarified several aspects related to diabetes.

What’s happening doctor: What are the first signs that could make us think that we are one step closer to the diagnosis of diabetes?

Dr. Iuliana Filip: As a rule, we are talking about weight gain in a person who has a family history of diabetes, cardiovascular diseases, dyslipidemia, age over 45 years, history of diabetes during pregnancy, the association of some endocrine diseases. Children with excess weight and risk factors such as gestational diabetes in the mother, diabetes in the family history, endocrine diseases are conditions that can cause blood sugar levels to rise above the upper limit of normal values, which means prediabetes.

CSÎ.D.: Where do we stop any habits (what are those) that would make us prone to such health problems?

Dr. IF: Unbalanced diet, consumption of highly processed products, refined sugars, irregular meals, excessive alcohol consumption, disturbed sleep are determining factors of health problems. The sooner we stop these habits, the more health we get.

C.S.Î.D.: What are the main approaches in case of prediabetes, to stay at this “level”?

Dr. IF: Weight loss and moderate exercise are the defining elements that help remove the risk of diabetes. Monitoring blood pressure, lipid profile, uric acid, hepatic steatosis in those patients with prediabetes also contributes to stopping the evolution towards diabetes.

C.S.Î.D.: Although we are in 2023, there are still Romanians (47% of the respondents of a recent study) who believe that diabetes is related to excessive sugar consumption. How do we better explain this disease in a way that everyone can understand, so that later we can really prevent it?

Dr. IF: By definition, diabetes is a syndrome centered on a chronic increase in blood sugar and can be associated with changes in lipid, protein, hydro-electrolytic, and energy metabolism. In other words, a condition that causes the inability of the insulin produced by the pancreas to continuously adapt to the overload of the body causes diabetes.

CSÎ.D.: How can we find out if we have diabetes or not? How often should blood glucose be monitored and what are the normal values ​​that everyone should know?

Dr. IF: Through any of the tests:

Fasting blood glucose ≥126 mg/dl, 2-hour blood glucose (during TTGO) ≥200 mg/dl, random blood glucose ≥200 mg/dl, HbA1c ≥6.5%, the diagnosis of diabetes is made.

Glucose monitoring in those with confirmed diabetes has an individualized frequency correlated with the type of diabetes and comorbidities.

CSÎ.D.: How dangerous is uncontrolled diabetes? How can it affect the body?

Dr. IF: Uncontrolled diabetes can cause micro- and macrovascular complications.

Affecting the vision (diabetic retinopathy), kidney (diabetic nephropathy), peripheral nerves (diabetic neuropathy) along with those on the vascular wall (hypertension, heart failure, atherosclerotic disease) manifests itself in those with poor metabolic control.

CSÎ.D.: How is the life of a patient with diabetes today? Apart from blood sugar, what other values ​​should be carefully monitored?

Dr. IF: The materials disseminated through all communication channels, the integration of technology in blood glucose monitoring, insulin administration, advice for proper nutrition are an important support for the patient with diabetes.

Control of blood glucose, lipid profile, blood pressure, glycated hemoglobin, the percentage of correct values ​​in the range of optimal glycemic control, kidney, liver, eye screening, sensitivity tests are used in the constant monitoring of the diabetic patient.

CSÎ.D.: Are there foods that diabetics must give up forever to improve their health after diagnosis?

Dr. IF: The only forbidden food is sugar and sugary products. Thus, it is important to read the nutrition label of the purchased product so that it does not contain sugar or hidden sugars.

C.S.Î.D.: A study published in the European Journal of Preventive Cardiology showed that the vast majority of patients with type 2 diabetes (93%) have a high or very high risk of suffering an acute myocardial infarction or stroke. What are the most common complications in diabetic patients?

Dr. IF: The most common complications are those in the cardiovascular sphere. Glycemic control leads to a sustained reduction in diabetes complications.

Each 1% reduction in HBA1C is associated with a 21% reduction in any diabetes-related complications, a 14% reduction in myocardial infarction, and a 37% reduction in microvascular complications.