Pre-Diabetes - Impaired Fasting Glucose, Impaired Glucose Tolerance
High Blood Glucose Levels But No Diagnosis of Diabetes

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Guide to Pre-Diabetes

Pre-diabetes is a condition in which blood glucose levels are higher than normal but are not yet high enough for a diagnosis of full-blown diabetes. At least 20.1 million people in America, aged 40-74, have pre-diabetes. Patients with pre-diabetes have an increased risk for developing type 2 diabetes, heart disease and stroke. Indeed, latest research data indicates that some long-term damage to the body - especially cardiovascular system - may have already occurred during the pre-diabetes stage.

Types of Pre-Diabetes

There are two forms of pre-diabetes, impaired fasting glucose and impaired glucose tolerance. To test for pre-diabetes, doctors use either the fasting plasma glucose test (FPG) or the oral glucose tolerance test (OGTT). Both require a person to fast overnight. In the fasting plasma glucose test, a person's blood glucose is measured first thing in the morning before eating. In the oral glucose tolerance test, a person's blood glucose is tested after fasting and again 2 hours after drinking a glucose-rich drink.

Impaired Fasting Glucose (IFG)

A person has impaired fasting glucose when fasting plasma glucose is 100 to 125 mg/dL. This level is higher than normal but less than the level indicating a diagnosis of diabetes.

Impaired Glucose Tolerance (IGT)

A diagnosis of impaired glucose tolerance means that blood glucose during the oral glucose tolerance test is higher than normal but not high enough for a diagnosis of diabetes. Impaired glucose tolerance is diagnosed when the glucose level is 140 to 199 mg/dL 2 hours after a person is given a drink containing 75 grams of glucose.

Diagnosis of Pre-Diabetes Can Delay Type 2 Diabetes

Knowing you have pre-diabetes allows you to take preventative action to reduce your risk of developing type 2 diabetes. Studies show that people with pre-diabetes can prevent or delay the onset of type 2 diabetes by up to 58 percent, by making changes to their lifestyle that include weight reduction and regular exercise. Diabetes experts recommend that people with pre-diabetes reduce their weight by 5-10 percent and take modest physical activity for 30 minutes each day. For some patients with pre-diabetes, such lifestyle changes can return elevated blood sugar levels to normal.

Prevalence of Pre-Diabetes in America

In a cross-section of American adults age 40 to 74, tested during the period 1988 to 1994, 20.1 million (21.1 percent) had pre-diabetes. Of those, 9.6 million (10.1 percent) had impaired fasting glucose and 14.2 million (14.9 percent) had impaired glucose tolerance.

Diabetes Prevention Study

The Diabetes Prevention Program was a major 3-year clinical trial, which investigated whether either diet and exercise or the oral diabetes drug metformin (Glucophage) could prevent or delay the onset of type 2 diabetes in people with impaired glucose tolerance (IGT). Patients from 27 clinical centers around the country were randomly split into different treatment groups. All participants were overweight and had IGT, which are well recognized risk factors for the development of type 2 diabetes. Furthermore, 45 percent of the participants were from minority groups (African American, Hispanic American/Latino, Asian American or Pacific Islander, or American Indian) known to have an increased risk of developing diabetes.

Group 1, called the lifestyle intervention group, received intensive training in diet, exercise, and behavior modification. By eating less fat and fewer calories and exercising for a total of 150 minutes a week, they aimed to lose 7 percent of their body weight and maintain that weight loss. Group 2 took 850 mg of metformin twice a day, while Group 3 received placebo pills instead of metformin. The metformin and placebo groups also received information on diet and exercise, but no intensive counseling efforts.

The results of the Diabetes Prevention Program showed that diet and exercise sharply reduced the risk of developing diabetes. Metformin also reduced risk, although less dramatically. The findings were published in the February 7, 2002, issue of the New England Journal of Medicine.

[cf. insulin resistance: the body's inability to respond to and use the insulin it produces. Insulin resistance may be linked to obesity, hypertension, and high levels of fat in the blood.]

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GI Value For Whole Grains provides general information about the glycemic index (GI), glycemic load (GL), low GI diets, GI values for all food groups, health problems of high blood glucose including metabolic disorders such as pre-diabetes, impaired glucose tolerance, insulin resistance, hyperinsulinism as well as type 1 and type 2 diabetes. But no information is intended as a substitute for medical advice. Copyright 2003-2021.