Prediabetes means that your blood sugar level is higher than normal but not yet high enough to be classified as type 2 diabetes. Without intervention, prediabetes is likely to become type 2 diabetes in 10 years or less.
*1impaired fasting glucose level(ifg)
*2imaired glucose tolerance test.
WHO criteria: fasting plasma glucose level from 6.1 mmol/l (110 mg/dL) to 6.9 mmol/L (125 mg/dL)
]ADA criteria: fasting plasma glucose level from 5.6 mmol/L (100 mg/dL) to 6.9 mmol/L (125
*Family history (parent or sibling)
*Dyslipidemia (triglycerides > 200 or HDL < 35) or
*obesity (body mass index > 25)
*History of gestational diabetes or infant born with birth weight greater than 9 lb (4 kg)High risk ethnic
*[vague]Hypertension (systolic blood pressure>140 mmHg or diastolic blood pressure > 90 mmHg)
*Prior fasting blood glucose > 99Known *vascular disease
*Markers of insulin resistance (PCOS)&acanthosis Nigricans
*racial African-American, Native American, Latino, or Pacific Islander
*Don’t exercise
Are older; people over age 45 are most likely to get it.
Have a waist larger than 40 inches if you’re a man and 35 inches if you’re a woman.
Eat red and processed meat, or drink sugary beverages but skimp on fruit, veggies, nuts, whole grains, and olive oil
Have a sleep problem, like sleep apnea, or you work changing shifts or night shifts
Prediabetes typically has no distinct signs or symptoms. Patients should monitor for signs and symptoms of type 2 diabetes mellitus. These include the following:
*Constant hunger
*Unexplained weight loss
*Flu-like symptoms, including weakness and fatigue
*Blurred vision
*Slow healing of cuts or bruises
*Tingling or loss of feeling in hands or feet
*Recurring gum or skin infections
*Recurring vaginal or bladder infections
*A high BMI (Body Mass Index
DIAGNOSES OF PREDIABETIS ;-
is based on the presence of impaired fasting glucose, impaired glucose tolerance, and/o relevated HBA1c level
.1- Impaired glucose tolerance is defined as blood glucose levels of 140 to 199 mg/dL during a 75-gram oral glucose tolerance test (normal < 140 mg/dL), and
2= impaired fasting glucose is defined as blood glucose levels of 100 to 125 mg/dL
3-elevated HBA1c level between 5.7%and 6.4%
*conversion into T2DM
*CAD
*Diastolic heart failure
#PREVENTION :_
*lifestyle changes to loose weight & decrease obesity
*healthylow fat diet intake
*regulardaily excercise program about 30m/day 5 days/week
reduction of weight about 10-15% keeping BMI < 25%
*avoidance of sedentary habits
*abesteince of smooking
*adequate control of blood pressure
*proper treatment of hyperlipidaemia
*if all above meassure failed the adition of drugs like metformin/acrobas
#MANAGMENT ;-
A-LIFESTYLE MODIFICATION
The combination of diet and exercise is arguably the single most important factor that could halt the progression towards type 2 diabetes in patients with prediabetes
B-PHARMACOLOGICAL TREATMENT;-
currently there are four medications for treating the prediabetes subpopulation, including
metformin, pioglitazone, acarbose, and liraglutide.
In addition, the American Association of Clinical Endocrinologists (AACE) has also proposed three weight-loss therapies—including orlistat, lorcaserin, and phentermine/topiramate ER—to manage obesity with the goal of halting the progression of insulin resistance and type 2 diabetes
C-BARIATRIC SURGERY;-
If medical management fails to achieve glycemic control, advanced measures such as bariatric surgery can be used with the goal of reversing the prediabetis & helping the pts to loose weight.