Prediabetes is a diagnosis increasingly showing up on patients' medical charts, so we asked three physicians - Kevin Hoppock and Elaine Harrington of the Wichita Clinic and Ron Hunninghake of the Center for the Improvement of Human Functioning International - to explain what it is.
Q: Prediabetes seems to be a new term. Why haven't we heard of it until recently, and what does having it mean?
A: It used to be known as insulin resistance. It sometimes is called glucose intolerance or impaired glucose tolerance or borderline diabetes. Prediabetes is a more accurate term for someone who doesn't have diabetes but does have problems metabolizing sugars properly.
Glucose - a sugar - is the body's main source of energy. It's absorbed into your bloodstream when you eat or when your liver releases it. Insulin unlocks receptors that allow cells to pull it out of your bloodstream. If the process doesn't work right, excess glucose builds up in your blood. When you have blood sugar levels above 125, you have diabetes. Between 100 and 125 is prediabetes. Below 100 is normal.
Q: Who's at risk?
A: Being overweight is one of the biggest risk factors, so the majority of Americans are at risk. The Mayo Clinic estimates that 54 million Americans may have prediabetes.
Harrington, a pediatrician, says the majority of her patients who have prediabetes are 12 to 15 years old, but she has younger patients with it. She thinks that's due to kids' unhealthy eating habits, being overweight and not getting enough physical activity.
For adults, waist circumference is an indicator: A woman whose waist is 35 inches or more is at risk. For men, it's 40 inches, Hunninghake says. Feeling tired after eating also is a sign.
Q: What are the symptoms?
A: Beyond blood sugar levels, there usually are none. That's the problem: Your heart, nerves, eyes and kidneys are being damaged, but you don't know there's anything wrong.
Q: Should I be tested for it?
A: Ask your doctor. Initial testing is by a fasting blood glucose test. Those are often done as part of routine blood testing. Additional testing may be done if levels are high.
The American Diabetes Association says everyone should be tested at age 45, if they haven't been already.
Q: How is prediabetes treated?
A: The cure is reduction of weight, by avoiding simple sugars and getting back to normal weight.