Prediabetes

Dr Chinnadorai Rajeswaran, consultant diabetologist explains all about investigations, treatment and complications of prediabetes. Please email him if you need more information.

Prediabetes has been discussed lot in the recent years. Prediabetes has been associated with a higher risk for cardiovascular disease (CVD) in some studies.

What is prediabetes?

People with prediabetes have higher than normal blood glucose but not high enough to be labelled as diabetes. Certain groups of people have a higher risk of developing prediabetes, which is similar to type 2 diabetes. You should be tested for prediabetes , if you fall into any of the below groups:

1. Overweight or obese
2. More than 40 years of age
3. Have close relative with type 2 diabetes
4. Hypertensive
5. High triglycerides and low HDL
6. South Asian or Afro-caribbean origin
7. History of gestational diabetes

How is prediabetes diagnosed?

A blood test to check either fasting plasma glucose or HbA1C is used to diagnose prediabetes. If

• Fasting plasma glucose is between 5.5 mmol/L to 6.9 mmol/L

OR

• HbA1c is between 42 to 47 mmol/mol (6.0 to 6.4%)

It is always a good practice to repeat the test to confirm.  If however you have symptoms of diabetes (excessive urination, thirst or weight loss) and have a HbA1c of below 42 mmol/mol (6.0%), another blood test called oral glucose tolerance test should be done.

As you know a HbA1C of 48mmol/mol or more is diagnostic of diabetes

Can prediabetes be reversed?

Yes, Prediabetes can be reversed. Once reversed blood test, in particular HbA1C is less than 42mmol/mol. NHS Diabetes prevention programme  revealed that prediabetes can be reversed with appropriate life style management and weight loss. However, any intervention is useful only if the outcomes are sustained.

It is therefore important to adapt life style changes which is inbuilt into your life. Rapid weight loss programme may not help in the long run.

What are the treatment options?

In addition to healthy life style changes and weight loss, metformin could be considered in some situations. Please discuss with your doctor.

What happens if it is not treated?

If prediabetes is not treated or reversed, there is a high chance of developing type 2 diabetes.

 

Dr Chinnadorai Rajeswaran is a consultant Physician specialising in Endocrinology, Diabetes and Obesity. As a private endocrinologist he  has private endocrine, diabetes and weight loss clinics in Harley Street, London, Chennai (India), Claremont Hospital, Sheffield, Nuffield Hospital, Leeds and Simplyweight, Bradford.

He has face to face consultations with people from Barnsley, Rotherham, Chesterfield, Doncaster, Wakefield, Huddersfield, Bradford, Harrogate, Leeds, Sheffield, London and Chennai (India). He also offers video consultations.