Q: What is the difference between pre-diabetes and type 2 diabetes? Are they treated differently?
A: Pre-diabetes means your blood sugar levels are higher than normal, yet not high enough to be categorized as type 2 diabetes. It is also an early warning that preventive measures like weight loss and regular exercise need to be implemented or else diabetes and its potential complications (heart, circulatory, kidney and eye problems, a nerve disorder known as neuropathy, and others) may occur.
Abnormal build-up of glucose
Pre-diabetes and type 2 are similar in that both are known for an abnormal build-up of glucose in the bloodstream. However, different degrees of build-up are present for type 2. The following blood tests, alone or in combination, can be used as a diagnosis tool:
* A fasting plasma glucose (FPG) or fasting blood sugar test. This test measures glucose levels after an overnight fast of eight hours.
+ A result of 70–100 mg/dl is considered normal.
+ Levels above 100 and up to 125 mg/dl indicate impaired fasting glucose, or pre-diabetes.
+ If levels are 126 mg/dl and above on two separate testing dates, the diagnosis would be diabetes.
* An oral glucose tolerance test (OGTT). This test goes one step beyond an overnight or eight hour fast. In addition to checking fasting plasma glucose, a second blood test is tested two hours after drinking a specially formulated sugar solution.
+ If the two-hour result is less than 140 mg/dl it is considered normal.
+ For levels that range from 140 to 199 mg/dl, impaired glucose tolerance and pre-diabetes are indicated.
+ Any value of 200 mg/dl or above suggests the diagnosis of diabetes.
* Random blood sugar (RBS). For this test, a blood sample is taken at random and not related to the timing of the last meal or drink.
+ A result of 200 mg/dl or greater may suggest diabetes.
Type 2 diabetes is also known for its "insulin resistance." This impacts the body's ability to properly utilize the hormone insulin, making it difficult to move the circulating glucose out of the bloodstream and into the cells for our energy needs. As a result, glucose levels rise to abnormally high levels. And, if left unchecked and untreated, there is a high likelihood for this disease to eventually cause symptoms like frequent urination, blurred vision, unexplained fatigue, slow healing wounds, or increased thirst and hunger, and thus would be harmful to your health.
Risk factors
While anyone is at risk for pre-diabetes or type 2, there are factors that increase the likelihood for one of these conditions to occur. For some, an early warning sign may arrive in the form of a slightly elevated blood sugar level. For others, the onset of type 2 diabetes may occur along with its related health concerns. Either way, the risk factors are essentially the same and include the following:
* Older age—those age 45 and above (especially if overweight)
* Overweight—body mass index greater than 25 (especially if inactive)
* Metabolic syndrome—three of the following: waist larger than 40 inches for men or 35 inches for women; triglycerides greater than 150; HDL cholesterol lower than 40 in men or 50 in women; high blood pressure or fasting blood glucose greater than 110 mg/dl)
* Family history of type 2 diabetes
* Being a member of a higher risk population group including those of Native Alaskan, American Indian, Asian, African, Latino or Pacific Islander descent
* History of gestational diabetes (high blood sugar during pregnancy) or delivering a baby over nine pounds
* High blood pressure (greater than 130/85 mm/Hg)
* Alcohol use (moderate to heavy use)
* Cigarette use (smokers have a higher risk than non-smokers)
There are additional risk factors for people who are overweight and less than 45 years of age, including those with the following indicators:
* High-density lipoproteins (HDL) less than 35 mg/dl
* Triglycerides (a type of fat in our blood plasma) greater than 250 mg/dl
* First-degree relative (parents, brothers, sisters or children) with diabetes
* Medical conditions known to have insulin resistance including polycystic ovarian syndrome and acanthosis nigricans (dark and velvety-appearing markings on the neck, under the arms or in the groin) that is often associated in those with obesity
* Inactivity (less than 30 minutes of activities such as walking, riding a bicycle, etc.) at least five days per week
Treatments
You have the power to prevent or significantly delay pre-diabetes from progressing to type 2 diabetes by what you do (regular exercise for 30 minutes five times per week), by what you eat (balanced diet, low fat sources of protein, whole grains with higher fiber), and by choosing to strive for a healthier weight that is more in line with your height and activity level.
For type 2 diabetes, a treatment plan would consist of lifelong blood sugar monitoring in combination with healthy eating, regular exercise, and possibly, diabetes medication and insulin therapy.
For further information, speak with a registered dietitian and your family doctor. In addition, you'll find helpful information at the American Diabetes Association and the Centers for Disease Control and Prevention.
More Diabetes Advice From Dr. Rob:
* Tips to Tame Diabetes
* Type 2 Diabetes: You Can Beat It
* The Risk of Diabetes in Children
|
