By Nr Chinonso Cynthia Ukah. BNSc, RN, RM. Freelance Health Writer and DLHA Volunteer. Medically and editorially reviewed by the DLHA Team
You may have prediabetes and not know. Image credit: Freepik
"You can have prediabetes for years without knowing," says the Centers for Disease Control and Prevention. But the good news is that it you can take control and change the outcome. [1]
Because prediabetes often does not present with any obvious symptoms, about 80% of people go about their daily lives, while the condition may gradually progress to type 2 diabetes and cardiovascular diseases.
Read on to find out what prediabetes means, how it is diagnosed and what to do to avoid its progression to diabetes.
Prediabetes is a rise in blood sugar levels but usually not high enough to be called diabetes.
The World Health Organization defines it as a blood glucose of 110 - 125 mg/dL (or 6.1 - 6.9 mmol/L) after you haven't eaten or drank anything except water for 8-12 hours. [2]
Prediabetes can also be called impaired fasting glucose, impaired glucose tolerance, or borderline diabetes – a state that fluctuates between normal blood glucose levels and diabetes.
The truth is, you may not know for a long time, as you may feel perfectly fine with no symptoms.
Some people often experience signs similar to type 2 diabetes such as increased thirst, weight gain, increased urination, fatigue and so on, but this is very rare and is typically felt when the condition is at the brink of becoming type 2 diabetes. [2]
The skin of a person with prediabetes may look discolored especially in areas like the neck (acanthosis nigricans), armpits, and the groin area.
Yet, there are three blood testing methods your doctor may recommend to help you confirm prediabetes. [3] These tests identify and diagnose people with the condition:
A1C is a test that measures your average blood sugar over the past 2-3 months. A range of 5.7% to 6.4% on this test confirms prediabetes. It saves you the stress of fasting and lengthy laboratory visits.
This test measures your blood sugar after not eating for at least 8 hours. Even if you can check your blood sugar at home using a glucometer or continuous glucose monitor, an official diagnosis should come from a laboratory test. A value between 100-125 mg/dL (5.6-6.9 mmol/L) obtained from this test suggests prediabetes.
In this test, you'll be given a 75g glucose solution to drink, and your blood sugar will be measured 2 hours later. If the result shows anything between 140-199 mg/dL (7.8-11.0 mmol/L), you may have prediabetes.
Yes, people in Sub-Saharan Africa have prediabetes. The condition does not discriminate between populations in different regions of the world.
In a 2022 study carried out in rural parts of Namibia and urban parts of South Africa, researchers identified 187 and 701 prediabetic cases per 1000 persons, respectively. [4]
Among a cross-section of Liberians aged 25-64 years, prediabetes was present in 149 out of 1000 persons, with 14% being males and 15% being females. [4]
Another study carried out in the Democratic Republic of Congo, which used fasting blood glucose as a confirmatory test, reported that the prediabetes rate was as high as 91.4%. [4]
In Iganga municipality of Uganda, it was discovered that 38 out of 1000 people aged 13-60 years had pre-diabetes. [5]
Also, out of 1000 healthcare workers studied in a Nigerian hospital, 194 were shown to have prediabetes, demonstrating that healthcare workers aren't exempted from developing prediabetes. [4]
Diabetic research experts have estimated that by 2030, the number of people with prediabetes will reach 47.3 million individuals, given the high levels of underdiagnosis, uncoordinated care, and shortage of physicians in Sub-Saharan Africa. [5]
There are several risk factors for prediabetes some of which may raise your odds for the condition. These risk factors include:
It is possible to have one or more of these risk factors as a prediabetic and not progress to type 2 diabetes.
Yearly, only 5-10% of people who are diagnosed with prediabetes successfully progress to type 2 diabetes. [6]
Although, this progression from prediabetes to diabetes may vary among individuals. A Spanish study revealed that approximately 70% of individuals with prediabetes develop diabetes in their lifetime. [6]
Waiting for prediabetes to become diabetes before treating the issue can lead to complications including heart failure, cognitive impairments, and other health problems.
In Sub-Saharan Africa, making healthy lifestyle changes is vital since diagnosing diabetes early may be challenging some countries in the regions.
Lifestyle modifications are an excellent way to prevent prediabetes from progressing to type 2 diabetes and may help return blood glucose levels to normal.
Physical activity and weight management are the two main modifiable factors that can help prevent type 2 diabetes if you are diagnosed with prediabetes. [6]
The American Diabetes Association recommends at least 150 minutes of moderate-intensity physical activity per week.
Aerobic exercises like, taking a brisk walk, swimming, cycling, or running on most days of the week are very effective.
The Diabetes Prevention Program studies in the United States and Finland showed that a healthy diet and exercise can lower your risk of developing type 2 diabetes by about 58%. [6]
Tara Seymour, an advanced practice clinical dietitian and diabetes educator in John Hopkins University recommends the Mediterranean diet as a gold standard for preventing prediabetes from progressing to type 2 diabetes. She noted that prediabetes cannot progress if you;
These lifestyle changes have been shown to work better than taking only diabetic medicines. A study found that lifestyle changes reduced risk by 58% while the diabetes medicine metformin reduced it by 31%. [6]
Blood sugar can also return to normal without any lifestyle modifications, but this is less common. One study found a spontaneous reversion rate of about 19% among people with prediabetes who didn't make any lifestyle changes. [6]
Prediabetes is not a disease in itself but a risk factor for type 2 diabetes and cardiovascular diseases.
In Sub-Saharan Africa, where most countries are in the low to middle income bracket, complications of prediabetes are often due to a multitude of factors including, limited awareness of how to prevent the condition, limited healthcare and health promotion and education resources, poor nutrition, financial challenges, etc.
Research shows that people with prediabetes have a higher risk of:
The economic burden of managing these complications is also a challenge for families in Sub-Saharan Africa, where out-of-pocket healthcare expenses are often high.
Prediabetes serves as an early warning sign that your health might be at risk, but it's also an opportunity to take action. You don't need to wait for it to progress to type 2 diabetes. Regular screening, especially if you have the risk factors listed above, can help catch prediabetes early. Through consistent lifestyle modifications, you can reduce your risk of developing type 2 diabetes.
1. Centers for Disease Control and Prevention. The Surprising Truth About Prediabetes [Internet] Atlanta (GA). 2024 May 15. [Cited 2024 Nov 6]. Available from here.
2. Echouffo-Tcheugui JB, Selvin E. Pre-Diabetes and What It Means: The Epidemiological Evidence. Annu Rev Public Health. 2021 Dec 23;42:59-77. 2021 Apr 1;42:59-77. doi: 10.1146/annurev-publhealth-090419-102644. Available from here.
3. National Institute of Diabetes and Digestive and Kidney Diseases. Recommended Tests for Identifying Prediabetes [Internet]. Last reviewed 2015 October. [Cited 2024 Nov 6]. Available from here.
4. Walker RJ, Thorgerson AM, Yan A, Williams JS, Campbell JA, Dawson AZ, et al. Prevalence and correlates of pre-diabetes in Sub-Saharan Africa using Demographic and Health Survey Data: a cross-sectional study. BMJ Open. 2023;13(10). Available from here.
5. Aramo C, Oyom AP, Okello E, Acam V, Okiria JC, Mwambi B, Oyet C. Assessing the prevalence and risk factors of pre-diabetes among the community of Iganga municipality, Uganda: a cross sectional study. BMC Research Notes. 2019 Dec;12:553,1-5. Doi: 10.1186/s13104-019-4589-1. Available from here.
6. Bennasar-Veny M, Fresneda S, López-González A, Busquets-Cortés C, Aguiló A, Yañez AM. Lifestyle and Progression to Type 2 Diabetes in a Cohort of Workers with Prediabetes. Nutrients. 2020 May 25;12(5):1538. doi: 10.3390/nu12051538. Available from here.
7. Seymour T. Prediabetes diet. [Internet, n.d.]. John Hopkins Medicine (JHM): Health; [cited 2024 Nov 6]. Available from here.
Related:
Type 2 Diabetes: What Africans Need to Know?
Diabetes in pregnancy in Sub-Saharan Africa: An overview
Published: November 18, 2024
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