Saturday, Dec 03, 2022

Pre-diabetes: What is it and how do you know if you have it?

An expert said that diabetes "doesn't develop overnight; a series of wrong health choices coupled with environmental and genetic factors predisposes us to this condition."

Pixabay-sugar-diabetes-1200Keep your health in check. (Source: Pexels)

“According to the National Urban Diabetes survey, the estimated prevalence of prediabetes in India is 14 per cent. But, the global prevalence of diabetes is projected to increase by 51 per cent by 2045. As such, identifying and reversing pre-diabetes in young people can help reduce these numbers and ensure overall health of people world over,” said Dr Abhishtita Mudunuri, Senior Manager and Diabetologist, MFine.

Diabetes is a chronic disease which is related to ones lifestyle choices. But, the expert said that diabetes “doesn’t develop overnight; a series of wrong health choices coupled with environmental and genetic factors predisposes us to this condition.”

“There has been a disproportionate increase in incidence of Type 2 diabetes in children, adolescents and young people in the last decade. This has been attributed a lot to our lifestyle. Identifying prediabetes early and introducing interventions to reverse it can protect us from developing diabetes and its related complications related to it,” she told

What is prediabetes?

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Prediabetes, as the name suggests, can be seen as a precursor to diabetes. It’s a state of insulin resistance in our body which, if left neglected, can progress to Type 2 diabetes.

How does this develop?

“Prolonged years of excess carbohydrate intake along with physical inactivity, sleep deprivation and even increased stress levels can work together to develop a state of insulin resistance in your body,” the expert explained.

Insulin is a sugar lowering hormone which is usually released through a cascade of reactions in response to food intake. When we follow an unhealthy lifestyle, especially a high carbohydrate diet, higher levels of insulin are released initially (Hyperinsulinemia) which over a period of time leads to a state of insulin resistance in our body .

“When all the excess carbohydrates are stored in our body in the form of triglycerides it will resist the action of insulin and taking in more carbohydrates will only worsen the situation, wherein you progress further into a state of first insulin resistance then prediabetes and then diabetes,” she explained.

Who is at risk?


Risk factors for prediabetes are influenced by genetic and environmental factors
Strong family history of diabetes
Past history of gestational diabetes
Overweight or obese individuals
People who have a sedentary lifestyle

“These are a few risk factors that can predispose you to early onset of prediabetes or diabetes. If you’re following a high carbohydrate diet with a sedentary lifestyle along with inadequate sleep and/or experience increased high stress levels – these strongly influence onset of prediabetes even if there is no genetic predisposition,” she said.


Prediabetes usually manifests as: :

1) Skin pigmentation, also known as acanthosis nigricans, which is black velvety pigmentation around the nape of the neck and armpits

2) Difficulty losing weight

3) Abdominal adiposity, increased weight circumference

4) Skin tags especially around the neck

5) Sugar cravings

6) Lack of energy

7) Feeling drowsy especially after a heavy carbohydrate meal

8) Chronic body pains or headache

9) Hormonal imbalance especially for women especially PCOS


If you are experiencing any of these symptoms you can talk to a doctor to check for prediabetes .

diabetes, living with diabetes, diabetes and blood pressure, high blood pressure and diabetes, diabetics, how to manage high blood pressure in diabetics, world diabetes day, indian express news Diabetes causes damage to the small blood vessels in the body and stiffens their walls leading to high blood pressure. (Photo: Getty/Thinkstock)

How do we diagnose prediabetes?

Diagnosis is done via a blood test:
– Hba1c
– Fasting blood glucose
– 2 hours post meal glucose is checked.

Prediabetes is when

– Hba1c is between 5.7-6.4

– Fasting blood glucose between 100-125mg/dl (also called impaired fasting glucose )

– 2 hours post meal glucose 140-200mg/dl (also called impaired glucose tolerance)

Treatment options


The best approach is to focus on lifestyle changes, suggested Dr Mudunuri.

– Cutting down carbohydrates to less than 30% of the diet is one of the ways. Remember carbohydrates are not essential for diet; proteins and fats are essential .


– Practice intermittent fasting which is based on time-restricted feeding and fasting for 14-16 hours. This will induce a starvation state which will help break down fats as a source of fuel in your body and will also address the root cause of prediabetes and help reverse the state of insulin resistance.

– Physical activity is key to reversal of insulin resistance on a muscle level. Aim for at least 10000 steps, moderate intensity aerobic exercise for 45 minutes at least 3 times a week , and 20 minutes of yoga .


– Meditation and calm music are also good to deal with stressful situations.

– Sleep is important to maintain our circadian rhythm and sleep helps to repair and rejuvenate our body. When you sleep, memory formation happens and also if you don’t get adequate sleep, cortisol levels may be elevated and appetite hormones balance may get skewed. Getting <6-7 hours of sleep can influence these mechanisms causing weight gain, cravings, elevated blood glucose or sugar levels.

“Some doctors may choose to prescribe metformin (antidiabetes tablet  to control blood glucose levels if there is inadequate response post lifestyle changes. So following a carbohydrate restricted diet, active lifestyle, getting adequate sleep and reducing stress levels will all help reverse a state of prediabetes and prevent progression to diabetes,” she said.

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First published on: 28-11-2021 at 12:30:08 pm
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