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Diabetes

November 09, 2017

What you need to know about prediabetes

If diabetes is runaway blood sugar, prediabetes is blood sugar that’s halfway out the door. Here’s what you can do to rein it in.

It’s no secret that type 2 diabetes is a growing health risk, both across Canada and worldwide. But prediabetes — a condition that occurs when your blood sugar levels are higher than normal, but not high enough for a diabetes diagnosis — gets considerably less attention.

That’s unfortunate, because Diabetes Canada estimates that prediabetes affects at least 6 million Canadians, many of whom don’t know they have it. And while prediabetes won’t typically cause noticeable symptoms, it does cause tissue damage that puts you at risk of diabetes-related complications later on.  

So it’s time to sound the alarm on this silent threat. Read on to learn more about what’s really happening during prediabetes, the risks prediabetes can pose to your health and — most important — how to prevent and reverse it.

Prediabetes is about insulin resistance and a loss of blood-sugar control

Your body already has a system in place to keep your blood sugar (properly called blood glucose) within a healthy range. When your blood sugar rises — say, for example, after a carb-heavy meal — your pancreas releases a hormone called insulin, which tells your cells to use that glucose for energy. 

If you’re carrying excess weight and eating more than you need to, though, your metabolism ends up working less efficiently. 

“In prediabetes, many of the metabolic systems of the body are overloaded,” says Dr. David Jenkins, the director of the Clinical Nutrition and Risk Factor Modification Centre at St. Michael’s Hospital in Toronto. You end up taking glucose less readily into your muscles and other organs that need it after a meal — a condition called insulin resistance — and your pancreas releases more and more insulin to compensate.  

When you’ve been “fasting” for several hours — for example, overnight — your liver puts out more glucose to fuel your body, and your pancreas in turn has to secrete more insulin. “This goes on until the pancreas can’t keep up as well,” Jenkins says. “So it ‘gives up the ghost’ and you start to see your blood-glucose level rising.” 

What are the risks of prediabetes?

The greatest risk associated with prediabetes is that your blood sugar levels will continue to rise and eventually meet the diagnostic criteria for type 2 diabetes. If that happens, you might feel fatigued, experience unexplained weight gain and notice you’re passing a larger-than-normal amount of urine — and feeling excessively thirsty as a result. 

But there are other adverse effects, too. Because prediabetes mimics what’s going on in your body during type 2 diabetes, but on a smaller scale, many of the side-effects associated with diabetes can also occur if you have prediabetes. Over time, a prediabetic state can damage your blood vessels, which raises your risk of developing cardiovascular disease or damaging your kidneys and eyesight, says Jenkins. 

But fear not: Lifestyle changes can prevent (and reverse!) prediabetes.

Fortunately, you don’t need lots of “health hacks” or pricey supplements to manage your risk of developing prediabetes. Jenkins says that the basics of a healthy lifestyle are the best defence against the disease. Here’s what to do:

  • Maintain a healthy body weight. Being overweight is the largest risk factor for prediabetes and type 2 diabetes. Research conducted at Leicester General Hospital in the United Kingdom found that even a small, sustained loss of just a few pounds is enough to lower your risk and may even reverse prediabetes.
  • Stay fit and active. Regular physical activity helps you maintain a healthy weight and builds muscle, which means you’ll have more muscle tissue to use up your blood glucose.
  • Eat fresh and healthy foods. Load up on veggies! Basing your diet around plants and eating less meat may lower your risk, says Jenkins. And managing your calorie intake prevents weight gain that would increase your prediabetes risk.
  • Sleep well. Sleep is essential for your overall health, and there’s some evidence that it might manage your prediabetes risk, too.  

Take the CANRISK test

If you’re concerned about prediabetes, try the Canadian Diabetes Risk Questionnaire to get a sense of your personal risk, and speak to your doctor about your concerns. By catching prediabetes early, you can act fast to lower or eliminate the chance of developing type 2 diabetes — and put yourself on track to stay healthy for life.  

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