We’ve all heard about type 2 diabetes and are aware that it is dramatically on the rise, but it is just the tip of the iceberg. Lurking below the surface is a much larger group – those with pre-diabetes. These are people whose blood sugars are high but not yet in the diabetic range. If you are over the age of 30 there is a one in three chance you have it and, because there are no symptoms, you probably won’t know unless you are tested.
Pre-diabetes isn’t taken seriously enough. The actor Tom Hanks was told his blood sugars were creeping up, yet he only decided to do something about it when he developed full blown diabetes.
Finding out and then taking positive action matters because having persistently high blood sugar levels, even if they are not yet in the diabetic range, will damage blood vessels and leave you at greater risk of stroke, heart disease and dementia.
The good news is that by making simple diet, exercise and lifestyle changes you can fully reverse the process and return your blood-sugar levels to normal.
You can start by cutting back on foods full of sugar and refined carbs, such as biscuits and cakes, but you should also reduce starchy foods such as white bread, potatoes and white rice, along with restricting calories to get weight back to normal.
As a GP I find it incredibly satisfying helping people to take control of their health rather than having to rely on medication. In my practice we have been offering advice to patients with pre-diabetes, and a recent survey I carried out found that of 134 patients with pre-diabetes who had been offered such advice over the past two years, an impressive 57 per cent were no longer in the danger zone.
So could you be at risk of pre-diabetes? You are at greater risk than the average person if…
● you are overweight or obese;
● you store your fat around your middle, even if your weight is normal (if you are male and your waist, measured over your tummy button, is 40 inches, or 35 inches for females);
● you are sedentary for much of the time;
● you have a close family history of type 2 diabetes;
● your background is Asian, Middle Eastern or African Caribbean;
● you are a woman with polycystic ovary syndrome or have had large babies.
● you have high blood pressure or a poor cholesterol profile.
If you are aged between 40 and 74 you will be invited to your GP surgery for the NHS Health Check, but if you are concerned, see your GP or nurse for advice and they will usually fit you in earlier. If your HbA1c (average blood sugar) is between 42 and 47mmol/mol or your fasting blood sugar is 5.5-6.9mmol/l then you have pre-diabetes.