Understanding Prediabetes: A wake-up call to Better Health

By Dr Paulo Beco, Optimal Healthcare Ltd, Cayman Islands

What is prediabetes?

Prediabetes is a health condition where the blood sugar (called glucose by doctors) are higher than normal but not high enough to be diagnosed as type 2 diabetes. It is already a warning sign that the body cannot manage the sugar levels efficiently. If there is no intervention, many people with prediabetes will evolve into type 2 diabetes within 5-10 years.

The American Diabetes Association (ADA) recommends screening to start at the age of 35 and even sooner if you’re overweight or obese. The World Health Organization (WHO) believes million of people worldwide are living with prediabetes, often without realizing it. The positive side is that prediabetes is reversible through lifestyle changes and early management.

The Cayman Steps 2023 National Health Survey found around 10% of the population to have been found with raised blood sugar at least once in their life but more important, about 25% has never been tested.

Causes and risk factors.

The hormone in our bodies that is responsible for moving the sugar from the bloodstream to the cells is called insulin. If the cells become resistant to the insulin doing their job, the sugar builds in the blood and prediabetes develops.

A few circumstances, called risk factors, will make this process more likely to occur:

Being overweight or obese
Lack of physical activity
Unhealthy eating habits, meaning foods high in sugar and refined carbs
Family history of type 2 diabetes
History of gestational diabetes in women
Ethnic group, as we know there is a higher risk in African-Caribbean, Black African or South Asian

Symptoms of Prediabetes

For most people there are no symptoms, and certainly not obvious ones, which is why it can go unnoticed for years. However, some people might notice a few of the diabetes like symptoms. This will include increased thirst, frequent urination, fatigue, blurred vision, slow healing wounds or loosing weight without trying but you shouldn’t weight for any of it to act. As a doctor, it’s much more rewarding to prevent a disease then to treat it well.

How is it diagnosed?

We can easily diagnose diabetes buy a simple blood test of your sugar level. This should preferably be done fasting. Most doctors will choose to do another test called HbA1C, that also measures your sugar level but shows its average over the last 2-3 months.

Preventing and Managing Prediabetes

So, prediabetes can be prevented and even reversed by focusing on lifestyle changes:

Adopt a balanced and healthy diet
- You should focus on smaller portions with plenty of whole grains, lean protein, fruits and vegetables. Sugary foods, processed snacks, and refined carbs should be significantly reduced or even removed from the diet.
Exercise regularly
- Aim for at least 150 minutes per week of moderate activity
Maintain a healthy weight
- Reducing your body weight in 5-7% can significantly reduce your risk of diabetes
Quit smoking
- Smoking increases insulin resistance and the risk of diabetes type 2
Manage stress and sleep
- Blood sugar level is affected by stress and poor sleep

When to see your doctor

If you have noticed any of these symptoms or risk factors, you should speak with your doctor to have a blood sugar test, but why wait? I would recommend everyone over the age of 35 to have an annual screening test for diabetes, even if you feel your risk might be low.

I will soon release a follow up article focusing on prevention and managing and how in a simple way you can make changes in your everyday life to reduce your risk of prediabetes.