Pre-Diabetes – Part 2 - Health Plus Digest

The second test is an oral glucose tolerance test (GTT). This test requires a bit more cooperation from the patient since they must drink a high sugar drink that is between 8 and 16 ounces after having fasted for 12 hours. If the physician wants the oral GTT they will draw a fasting glucose prior to starting the test. Once the individual drinks the fluid a lab technician will draw blood and request urine every 30 to 60 minutes. This test measures the body’s response to a high load of glucose and how well the pancreas can respond with insulin as well as how quickly the body can move the glucose into the cells. (5)

Doctors will evaluate the numbers that are reported back from these two tests and make a determination that an individual has pre-diabetes if their glucose in their blood is between 140 and 200 after a GTT or between 100 and 126 after a fasting glucose test. These numbers have been revised downward over the years as researchers are better able to determine the impact they have on long-term health.

Today, treatment for pre-diabetes includes dietary changes, lifestyle changes and exercise. All of these things will help the body to more fully utilize the insulin that the body is producing and possibly delay further treatment for diabetes with oral hypoglycemic agents or insulin injections.

Blood sugar values that range over 126 for fasting or 140 for oral glucose challenge represents Diabetes that must be treated and monitored more closely. In a study by the American Diabetes Association, researchers found that approximately 11% of patients with pre-diabetes go on to develop Diabetes in one year. (6)

Usually pre-diabetes doesn’t have symptoms. It is the high blood glucose levels that cause the classic symptoms of Diabetes and in individuals who have pre-diabetes their blood glucose isn’t high enough to cause symptoms such as excessive thirst, multiple trips to the bathroom, unexplained weight loss, blurred vision and extreme hunger.

In new research published July 2009, researchers found that the increased risk to heart disease and stroke found in individuals who smoked was most likely caused because nicotine builds an insulin resistance in the body. This resistance causes pre-diabetes which leads to a greater risk of cardiovascular disease. Their results suggested that by working to decrease the insulin resistance found in smokers they could effectively decrease the increased risk to cardiovascular disease in the same population. (7)

References:

(1) Diabetes UK: What is Diabetes?

http://www.diabetes.org.uk/Guide-to-diabetes/Introduction-to-diabetes/What_is_diabetes/

(2) American Diabetes Association: Diabetes Statistics

http://www.diabetes.org/diabetes-basics/diabetes-statistics/

(3) Kids Health: Long-Term Complications of Diabetes

http://kidshealth.org/teen/diabetes_center/basics/complications.html

(4) The New England Journal of Medicine: Normal Fasting Plasma Glucose Levels and Type 2 Diabetes in Young Men

http://www.nejm.org/doi/full/10.1056/NEJMoa050080

(5) MedlinePlus: Glucose Tolerance Test

http://www.nlm.nih.gov/medlineplus/ency/article/003466.htm

(6) American Diabetes Association: Prediabetes FAQ