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Mark fromDubai says that he
never even thought of diabetes or
pre-diabetes until one day when
he had to visit his GP for a throat
infection. He explains, “In routine,
the doctor asked me of my family
history. When I mentioned that
my mother had type 2 diabetes,
he suggested I get checked. I had
no issues and thought it was
routine. But the results came
back and shockingly showed that
I was in the very early stages of
diabetes. That was just one month
back; I have been so stressed
because of this and nervous…
What if I develop full blown
diabetes like my mother?”
Pre-diabetes or borderline diabetes, Dr.
Jallo clarifies that diabetes is diabetes
and there are certain accepted criteria
for diagnosing it. “The term pre-
diabetes is the correct and accepted
terms which means that your blood
sugar level is higher than normal range
which is 70 – 100 mg/dl however it’s
not yet high enough to be classified
as type 2 diabetes which is above 126
mg/dl,” he says. “However alarmingly,
without intervention, pre-diabetes is
likely to become type 2 diabetes in 10
years or less.” And even more so, he
explains that if you have pre-diabetes,
the long-term damage of diabetes -
especially to your heart and circulatory
system may have already begun.
Lack of Symptoms
Before developing type 2 diabetes, an
individual will almost always have pre-
diabetes beforehand. But unfortunately,
pre-diabetes is a condition without
symptoms, which essentially means
that many people can have it without
even knowing it. Luckily, pre-diabetes
can be diagnosed and treatment can
prevent many health problems and
complications. Pre-diabetes, tells Dr.
Jallo, is usually discovered accidentally
during a periodic checkup or during
investigations conducted for other
medical consultation. “Usually there
are no overt symptoms,” he tells,
however darkened areas of the skin, a
condition called acanthosis nigricans,
is one of the few signs suggesting you
are at risk for diabetes. “Common areas
that may be affected include the neck,
armpits, elbows, knees and knuckles,”
explains Dr. Jallo.
However the good news is that
during the past few years, with
increasing awareness and the public
screenings camps held regularly, early
diagnosis of pre-diabetes has become
facilitated. “Another positive side to
being diagnosed with pre-diabetes
is that it can be an opportunity for
you to improve your health, because
progression from pre-diabetes to
type 2 diabetes is NOT inevitable,” he
says, as incorporating healthy lifestyle
changes - such as consuming whole,
healthy foods, and also including
physical activity in your daily routine
as well as maintaining a healthy
weight; all which Dr. Jallo explains
may actually help to bring your blood
sugar level back to normal.
Factors At Large
Being Overweight
Unfortunately with more and more
people literally glued to their desks all
day long and increasingly consuming
unhealthy foods has led to excess
weight gain. And according to Dr.
Jallo, the same factors that increase
the risk of developing type 2 diabetes
also increase the risk of developing
pre-diabetes. These include extra
weight. “Being overweight is a
primary risk factor for pre-diabetes
as the more fatty tissue you have - the
more resistant your cells become to
insulin,” he explains.
Sedentary Lifestyle
Not finding the time to exercise
or just flat out too tired to partake
in regular exercise? Whatever the
excuse, partaking in routine exercise
is becoming a huge problem. Dr. Jallo
explains, “Another factor is inactivity
as the less active you are, the greater
your risk of pre-diabetes.” Physical
activity helps you control your weight,
uses up glucose as energy and he
adds, makes your cells more sensitive
to insulin.
While age is associated with
lower energy levels and the risk of
degenerative disease, there is also
a risk of diabetes. “Another factor
is advancing age as the risk of pre-
diabetes increases as you get older,
especially after age 45,” he points out.
“This may possibly be due to the fact
that as people get older, they often
tend to exercise less, lose muscle mass
and gain weight as they age.”
Family History and Race
If your mother, father or sibling has
type 2 diabetes, then Dr. Jallo tells that
the risk of pre-diabetes increases. “Race
is another factor, although it’s unclear
why (remove comma) people of certain
races – including African-Americans,
Hispanics, Native American Indians,
Asian-Americans and Pacific Islanders
- are more likely to develop pre-
diabetes,” he explains.
Also gestational diabetes is another
factor as Dr. Jallo explains that if you
developed gestational diabetes when
you were pregnant, your risk of later
developing diabetes increases. “If you
gave birth to a baby who weighed more
than 9 pounds (4.1 kilograms), you’re
also at increased risk of diabetes,” he
Polycystic Ovarian
Another possible trigger, tells Dr.
Jallo, is Polycystic Ovarian Syndrome.
“Women having this common
condition, which is characterized by
irregular menstrual periods, excess
hair growth and obesity - increases the
risk of diabetes,” he says.
Sleep plays a monumental role in
rejuvenating the mind and body but
did you know it also plays a role in the
possible development of pre-diabetes?
Dr. Jallo explains, “Another important
factor is sleep as several recent studies
have linked a lack of sleep or too much
sleep to an increased risk of insulin
resistance.” He adds that research
suggests that regularly sleeping fewer
than six hours or more than nine
hours a night might increase your
risk of pre-diabetes or type 2 diabetes.
“Even individuals with high blood
pressure, low levels of HDL, or the
‘good’ cholesterol as well as high levels
of triglycerides - a type of fat in your
blood-- are more likely to have pre-
diabetes,” he says.
Diagnostic tests for Pre-diabetes
The only way to know for certain that
you have pre-diabetes is by either
undergoing a fasting plasma glucose
test (FGP) or an oral glucose tolerance
test (OGTT). These tests can ascertain
whether or not you have pre-diabetes
by identifying the presence of either
impaired fasting glucose (IFT) or
impaired glucose tolerance (IGT), both
of which signify pre-diabetes.
July/Aug 2014