Pre-diabetes has serious implications

CORPUS CHRISTI - The word pre-diabetes was created about 10 years ago. It was intended to replace two old medical terms used to describe the early stages of diabetes: impaired glucose tolerance and impaired fasting glucose.

A simpler phrase was developed to prompt greater public awareness and understanding of the risk for developing Type 2 diabetes so appropriate preventive action could be taken sooner. Weight loss and increasing daily physical activity are cornerstones of Type 2 diabetes prevention. But pre-diabetes itself masks a condition that is more serious than most people, and even some doctors, think.

Using a stoplight analogy, some people may equate pre-diabetes to a yellow light signal. In one sense this is a good analogy, since it suggests there is time to make changes and hopefully prevent the development of Type 2 diabetes. However, other may think that not having the formal diagnosis of diabetes means that their health has been spared in some way.

There are very specific and measurable criteria for what constitutes pre-diabetes. It should not be based only on a medical history and physical examination. The diagnosis of pre-diabetes is based on certain laboratory studies ordered by the doctor.

Pre-diabetes actually is a serious condition that demands immediate action. A diagnosed prediabetic carries a 5 to 10 percent risk of developing Type 2 diabetes within five years. Research has proved that pre-diabetes already has serious implications everyone should know about.

If you have pre-diabetes, you already are well on the road to developing diabetes. One in three Americans are prediabetic. Consider diabetes as sitting along a spectrum. Normal blood sugar control sits at the left end and diabetes is on the right. The space in between these two extremes is where pre-diabetes lies.

Keeping this in mind, the typical prediabetic permanently has lost more than half his or her ability to make the hormone insulin, which is needed to maintain normal blood sugar levels. Just for comparison, the typical person with Type 2 diabetes has lost around 80 percent of his or her insulin capacity by the time he or she is diagnosed.

Diabetes complications are a concern to anyone with diabetes. The typical patient with Type 1 diabetes usually is complication free for several years after diagnosis. The thinking is that the clock for complications begins ticking at the time of diagnosis in people with the type 1 form of diabetes. But in type 2 pre-diabetics, the clock already has been running for a while.

Many doctors still don't know that the person with type 2 pre-diabetes already carries a risk for developing long term diabetes complications well before the formal label of diabetes is applied. For example, one in 10 pre-diabetics already have evidence of background diabetic eye disease, known as retinopathy as well as peripheral neuropathy. Heart disease and stroke risk are higher in pre-diabetics, as is evidence of early diabetic kidney disease.

Other conditions in pre-diabetics include: high blood pressure, gout, abnormal cholesterol levels and obstructive sleep apnea.

The prediabetic already is well on the way to developing full blown Type 2 diabetes and its early complications unless some action is taken. The choice confronting anyone diagnosed with pre-diabetes is deciding when and exactly how to act. Without doubt, sooner always is better.