Prediabetes is a phase in person’s life during which his blood sugars are not high enough to label him as a diabetic, but at the same time, not low enough to label him as normal, non-diabetic. These people are at high risk of developing diabetes in the future.Diabetes is diagnosed if fasting plasma glucose of 126 mg or more and/or post 75 gm oral glucose challenge plasma glucose of 200 mg% or more, and or random [anytime] plasma glucose of 200 mg or more if associated with classical symptoms of diabetes such as excessive urination and thirst, weight loss, etc. In addition, HbA1c of 6.5% or above is diagnostic of diabetes. While HbA1c between 5.7-6.5% is diagnostic of prediabetes. Anyone of above mentioned four criteria is sufficient for the diagnosis of diabetes. In those whose sugars are in the above-mentioned range but devoid of any symptoms of diabetes, repeat the tests and confirm the diagnosis of diabetes if repeat values qualify for the same. In a non-diabetic person, fasting plasma glucose is less than 100 mg and post 75 gm glucose challenge value is less than 140 mg
Prediabetes Is Diagnosed In The Following Situations
• Fasting plasma glucose is between 100-125 mg, i.e. not high enough for the diagnosis of diabetes, but not low enough to qualify in the normal range; and two hours post glucose challenge plasma is in the normal range,140 mg.This subtype of prediabetes is called Impaired fasting glucose.
• HbA1c of 5.7 and above but less than 6.5 as per American Diabetes Association or HbA1c of 6.0 or above but less than 6.5% as per WHO criteria
• There are about 77.2 million prediabetic people in our country. They are all potential diabetics, every year 18 of prediabetics get converted into diabetics. The journey of an Indian from prediabetic to diabetic is almost four times faster than the western world.
• However, the good news is that with proper lifestyle changes [food planning and exercise], the onset of diabetes can be delayed or prevented in many of them. Some are even able to go a step further and reverse their status from prediabetic status to totally normal status. At a prediabetic stage, the affected people are totally symptom-free and outwardly very healthy and thus, the diagnosis of prediabetes can be made only if they submit themselves to periodic blood sugar tests after crossing the age of 30 years. Even in advanced countries like the USA, 9 out of 10 prediabetics are not aware of their prediabetic status and thus are not on any lifestyle measures to revert back to normal status.
• Another very important implication of prediabetic is a higher risk of getting coronary heart disease and high blood pressure. Thus, if one wants to avoid heart disease, one should reverse his prediabetes status as early as possible.
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