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Pre-diabetes is a condition in which blood glucose levels are higher than normal, although not high enough to be called diabetes. Pre-diabetes has no warning signs or symptoms.
People with pre-diabetes are at increased risk of developing type 2 diabetes and cardiovascular (heart and circulation) disease. It is estimated that about two million Australians have pre-diabetes.
Without treatment, one in three people with pre-diabetes will go on to develop type 2 diabetes. The good news is that it is possible to prevent type 2 diabetes by making lifestyle changes.
Higher than normal glucose levels
If you are diagnosed with pre-diabetes, you will have either:
- Impaired fasting glucose (IFG) – this condition is diagnosed when the fasting blood glucose level is higher than normal, but still below the level for diabetes
- and/or
- Impaired glucose tolerance (IGT) – this condition is diagnosed when the blood glucose level taken after two hours as part of an oral glucose tolerance test (OGTT) is higher than normal, but still below the level for diabetes. The fasting level may be in the normal range.
Pre-diabetes can lead to type 2 diabetes
Type 2 diabetes is a condition in which the body can’t use insulin properly or doesn’t make enough insulin, or both. Type 2 diabetes is a serious and chronic medical condition that can lead to long-term damage of both nerve and blood vessels. Areas that can be affected include the kidneys, heart, eyes and feet. It is important that type 2 diabetes is well managed by the person and their doctor to reduce the risk of diabetes complications.
Symptoms
Pre-diabetes has no signs or symptoms, so it is important to be aware of the risk factors and have your blood glucose levels tested by your doctor if you are at risk.
Risk factors
The risk factors for developing pre-diabetes are the same as those for developing type 2 diabetes. They include:
- A family history of type 2 diabetes
- Having pre-diabetes or IFG/IGT
- Being aged 55 years or over
- Being aged 45 years or over, if you have high blood pressure or overweight
- Carrying excess weight around the abdomen
- Having clinical cardiovascular disease (heart attack, angina, stroke or peripheral vascular disease)
- Little or no physical activity
- Being aged over 35 years, if you are of Aboriginal or Torres Strait Islander background
- Being aged over 35 years, if you are of Chinese, Pacific Islander or Indian subcontinent background
- Women with polycystic ovarian syndrome (PCOS) who are overweight
- Women with a history of gestational diabetes.
Diagnosis
If you have identified yourself as being at risk, you should notify your doctor. They will organise for you to have a pathology test to check your fasting blood glucose level. If the result from this test is not definite, a further test known as an oral glucose tolerance test (OGTT) will be arranged.
The results from these tests can be used to show if your blood glucose level is in the normal, pre-diabetes or diabetes range. It is important that both pre-diabetes and diabetes are diagnosed early to provide you with the best possible outcome for your health.
Management of pre-diabetes
The main aim of pre-diabetes management is to prevent the development of type 2 diabetes. This can be done by making changes to your lifestyle. These changes will also improve your general health and wellbeing.
Important lifestyle changes include:
- Lose 5–7 per cent of your body weight. This helps the body to become more sensitive to insulin and use glucose more effectively.
- Become more physically active. Do at least 30 minutes of moderate intensity physical activity on at least five days of the week. This helps to manage weight and reduce blood glucose levels. It may also improve your blood pressure and cholesterol.
- Make healthy food choices. Reduce the amount of fat in your diet, especially foods containing saturated fats.
- Eat more fruit, vegetables and high fibre foods. Reducing your fat intake and increasing your fibre intake will help you to manage your weight and reduce your risk of heart disease.
- If you smoke, stop now.
- Have your blood pressure and cholesterol checked and managed by your doctor.
Speak to your doctor for help and guidance about making lifestyle changes.
Follow-up
There is no benefit in testing your own blood glucose level when you have pre-diabetes. Once you are diagnosed, your doctor will organise for you to have a repeat oral glucose tolerance test (OGTT) in 12 months, unless you develop symptoms earlier.
Where to get help
Things to remember
- Pre-diabetes has no signs or symptoms and can lead to type 2 diabetes if left untreated.
- Risk factors for developing type 2 diabetes include pre-diabetes, family history of type 2 diabetes, overweight or obesity, ethnic background and age.
- If you have pre-diabetes, lifestyle changes such as weight loss, healthy eating and regular physical activity can reduce your risk of developing type 2 diabetes.
You might also be interested in:
Diabetes.
Diabetes - diagnostic tests.
Diabetes and healthy eating.
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