Prediabetes/Early diabetes: A Second Chance to Prevent Diabetes?

Diabetes is a global health burden that affects hundreds of millions¹ with Malaysia having one of the highest prevalence of diabetics². Whilst diabetes is widely diagnosed, there is a lesser known condition called prediabetes/early diabetes, which precedes diabetes.

Prediabetes/early diabetes is defined as a state whereby glucose levels do not meet the criteria for diabetes but are too high to be considered normal³. Prediabetes/early diabetes could manifest as impaired fasting glucose (IFG), impaired glucose tolerance (IGT) or both⁴, up to 13 years prior to the diagnosis of diabetes⁵.

Impaired fasting glucose (IFG):

• Hepatic insulin resistance and normal muscle insulin sensitivity⁶
• Chronic elevation of fasting plasma glucose occurs in the absence of a deterioration in postprandial glucose control⁴

Impaired glucose tolerance (IGT):

• Normal to slightly reduced hepatic insulin sensitivity and moderate to severe muscle insulin resistance⁶
• Postprandial glucose control is impaired but fasting glucose is normal⁴

In Malaysia, every 1 in 6 adults is diagnosed with IGT while the number of adult IGT patients is expected to increase from 3.3 million in 2017 to 5.0 million in 2045¹. Approximately 70% of prediabetics /early diabetics would eventually develop diabetes⁶, with 11% progressing to type 2 diabetes within a year⁷.  Aside from type 2 diabetes, prediabetics/early diabetics have a higher risk of developing several complications such as cardiovascular disease, stroke, neuropathy (nerve damage), nephropathy (kidney disease) and retinopathy (progressive loss of vision)⁸.

As there are no obvious signs and symptoms, it is unsurprising that 9 out of 10 people with prediabetes/early diabetes are completely unaware of their condition⁹. Hence, FPG, OGTT and Hba1c tests are recommended for patients aged about 35 years and/or high risk individuals that include²: 

• Overweight or obese individuals
• Family history of diabetes
• History of gestational diabetes
• High blood pressure
• Dyslipidemia (eg. high cholesterol, high triglycerides) 

If you have some of these risk factors, get your blood glucose tested today and see a doctor for medical advice. This could be your wake-up call to make the necessary changes before your condition progresses to diabetes.