Prediabetes or Borderline Diabetes

Causes and risk factors of prediabetes

The following factors indicate or contribute to a higher risk of prediabetes and type 2 diabetes:

• Being overweight or obese
• Having a close family member with type 2 diabetes
• Being of South Asian, African Caribbean or Middle Eastern descent
• Having high blood pressure levels
• Having high cholesterol levels (non-HDL cholesterol)

A strong contributing cause of prediabetes is believed to be the accumulation of fat around internal organs such as the pancreas and liver. This type of fat is known as visceral fat.

Signs of prediabetes

As people with prediabetes have only slightly higher than normal blood sugar levels, the symptoms of prediabetes are likely to be subtle and may only be noticeable at certain times, such as following a meal.

Symptoms you may notice include:

• Tiredness after meals –particularly meals with a high amount of carbohydrate
• Hunger through the day or following meals
• Difficulty thinking or brain fog
• Acanthosis nigricans – dark areas of skin commonly found around the neck, armpits, elbows and knuckles

Treating prediabetes

Treatment for prediabetes will center around lifestyle changes, in the same way as treatment for type 2 diabetes does.

Lifestyle changes include:

• Losing weight – if you are overweight
• Having a healthy, balanced and usually low calorie diet
• Taking regular exercise

If you have high blood pressure or cholesterol levels, your doctor may prescribe blood pressure or cholesterol lowering medications.

In some cases, your doctor may prescribe a medication called metformin which has a modest effect in lowering blood glucose levels.

Progression to type 2 diabetes

Pre-diabetes is a critical stage in the development of diabetes. Developing insulin resistance this ‘pre-diabetic’ will, in most cases, lead to the onset of type 2 diabetes.

Whilst research is looking into whether type 2 diabetes can be effectively reversed, current understanding is that it is a permanent long term health condition.

By maintaining a good diet, taking exercise and losing significant weight (where relevant), it is possible to significantly delay, by a number of years, and possibly prevent type 2 diabetes from occurring.