The term pre-diabetes was introduced by the American Diabetes Association (ADA) in 2002 as a way to more clearly describe a state that is between normal blood sugar and type 2 diabetes. In the past, your doctor may have diagnosed you with “borderline diabetes.” Before 2002, your doctor might have told you (euphemistically), “Your blood sugar is a little high” or “You have a touch of sugar.” These words provide little meaning to the person hearing them, and they don’t show the urgent need to do something about the situation. Pre-diabetes is defined by specific boundaries, namely the results of blood glucose tests (described in the next section).
When you have pre-diabetes, your blood sugar level is higher than normal, but it’s not yet high enough to be classified as type 2 diabetes. Pre-diabetes means that you are on your way to developing diabetes if there are no interventions on your part. And this is very important to understand—progressing to type 2 diabetes is not inevitable. There is a great deal that you can do to reverse pre-diabetes and bring your blood sugar level back to a normal range. A diagnosis of type 2 diabetes, on the other hand, is permanent. While there is much that can be done to control diabetes, it is important to realize that type 2 diabetes does not go away.
If you have received a diagnosis of prediabetes, there is some good news. You have received a wake-up call and been given an opportunity to improve your health, lose weight, and make healthy lifestyle changes. If you take action now, you can prevent, or at the very least halt, the progression to a serious, more permanent disease.
Diagnosing Prediabetes
If you are trying to determine whether you have pre-diabetes or are monitoring your condition after you have been diagnosed, you will need to have some information about your health. This information includes lab tests, blood pressure, and other measurements such as weight and waist circumference. Your prior health history provides additional clues in the determination of pre-diabetes or diabetes. Three types of blood tests are used to diagnose pre-diabetes and diabetes:
Fasting Blood Glucose Tests
A fasting blood glucose test provides a clue about the possibility of pre-diabetes. In this simple blood test you draw a sample of blood first thing in the morning after an overnight fast. A fasting blood glucose of 100–125 mg/DL on more than one occasion is an indicator for pre-diabetes, whereas a fasting blood glucose 126 mg/dl or above indicates diabetes.
Two-Hour Oral Glucose Tolerance Test
Some doctors prefer using a glucose challenge rather than a fasting test. In this case, you are given a glucose drink that provides 75 grams of glucose. Blood is drawn two hours after taking the drink, and then the blood glucose is measured. With this test, a blood glucose result of 140–199 mg/DLtwo hours after taking 75 grams of glucose (on more than one occasion) indicates pre-diabetes. Two-hour readings that are above 200 mg/DL on more than one occasion indicate diabetes.
Hemoglobin A1c
When a fasting glucose test or two hour glucose challenge is done, the reading provides a result for that moment in time. Because your glucose can vary a great deal throughout the day, these tests do not provide information about what your blood sugar is at other times of the day or longer term. That is why a test called the hemoglobin A1c (HbA1c) is done, particularly when your doctor finds pre-diabetes or diabetes.
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