Do You Have Pre-di­a­betes?

Find out if you do and how you can pre­vent this silent killer.

Simply Her (Singapore) - - Panasonic Special - BY AZLINDA SAID

What Is Pre-di­a­betes?

This is when your blood su­gar level is higher than nor­mal, but not high enough to in­di­cate di­a­betes. “Be­ing pre-di­a­betic means that your body is show­ing signs of not han­dling the su­gar load very well. It’s the grey zone be­fore you de­velop full-fledged di­a­betes,” says Dr Derek Koh, head of the Life­style Cen­tre at Thom­son Med­i­cal.

Nor­mally, our bod­ies break down car­bo­hy­drates from the food we eat and con­vert it into glu­cose, a type of su­gar used by the body as a main source of en­ergy. That’s why our blood su­gar lev­els usu­ally rise af­ter a meal. The pan­creas pro­duces in­sulin to help the glu­cose en­ter our cells and be burnt as en­ergy. Ex­cess su­gar is stored as fat in fat cells, liver cells and mus­cles.

An oral glu­cose tol­er­ance test can con­firm pre-di­a­betes. Pa­tients fast for eight hours be­fore down­ing 100mg of sug­ared wa­ter. Two hours later, they’ll take a blood su­gar test.

“Nor­mally, your blood su­gar level will go up af­ter tak­ing that drink, but it will go down to 140 and be­low within two hours. If your body can’t bring it down to 140 and be­low, you have pre-di­a­betes. If your blood su­gar level shoots up to 200 and above, you’re di­a­betic,” ex­plains Dr Koh.

A Na­tional Health Sur­vey in 2010 showed that 4.4 per cent of adult Singaporeans have pre-di­a­betes. Dr Koh says about a third of pre­di­a­bet­ics who don’t do any­thing to cor­rect their con­di­tion be­come di­a­bet­ics within five years.

The risk for pre-di­a­betes hikes with age and hits 22.6 per cent of people be­tween 60 and 69 years old, says Dr Daniel Wai, a con­sul­tant from Park­way East Hospi­tal’s Di­a­betes En­docrine and En­dovas­cu­lar Cen­tre. “Pre-di­a­bet­ics have a 40 per cent chance of de­vel­op­ing heart dis­ease, stroke and other com­pli­ca­tions re­lated to di­a­betes, like di­a­betic eye dis­ease, di­a­betic nerve prob­lems and kid­ney prob­lems,” he cau­tions.

What Causes Pre-di­a­betes?

Fam­ily his­tory, for one, along with obe­sity and a seden­tary life­style, says Dr Wai. “Since pre-di­a­betes has no phys­i­cal symp­toms, many people re­alise that they have the con­di­tion only too late, when it has al­ready de­vel­oped into full-fledged di­a­betes,” he points out.

Reg­u­lar med­i­cal check-ups are the only way to de­ter­mine if you are pre-di­a­betic, and this is es­pe­cially im­por­tant if you are obese and have a fam­ily his­tory of the dis­ease. “If you have fatty liver or high lev­els of triglyc­erides, you may be prone to pre-di­a­betes as well,” adds Dr Koh.

Pre-di­a­betes usu­ally af­fects adults and could lead to type two di­a­betes – this is when the body pro­duces in­sulin but it is not enough or the body de­vel­ops in­sulin re­sis­tance, a con­di­tion when the body does not use the hor­mone prop­erly.

“If you’re pre-di­a­betic and your con­di­tion isn’t cor­rected over the years, your pan­creas will even­tu­ally run out of in­sulin and you may re­quire in­sulin jabs,” Dr Koh warns.

Women who suf­fered from ges­ta­tional di­a­betes dur­ing preg­nancy are also at risk of pre-di­a­betes in the fu­ture. “Ex­ces­sive weight gain dur­ing preg­nancy may el­e­vate blood su­gar lev­els, which usu­ally re­turn to nor­mal post-preg­nancy. But you’ll be more prone to pre-di­a­betes and di­a­betes in fu­ture,” says Dr Koh.

Man­ag­ing the Con­di­tion

Los­ing weight is key. Many pre­di­a­bet­ics don’t be­come di­a­betic if they man­age their con­di­tion well.

Dr Koh ex­plains why: “Weight loss will make all your cells more sen­si­tive to the in­sulin be­ing pro­duced and al­low your pan­creas to do its job. If a di­a­betic, who weighed over 100kg but has shed 20 per cent of his body weight, can get rid of his di­a­betic sta­tus through the huge weight loss, the same goes for a pre-di­a­betic. So this con­di­tion can be con­trolled, for sure.”

Pre-di­a­bet­ics may be pre­scribed med­i­ca­tion and sup­ple­ments like chromium and vi­ta­min D to lower their blood su­gar and re­duce weight, says Dr Koh.

But ul­ti­mately, a life­style change is the best way to stave off the con­di­tion, as med­i­ca­tion is never a per­ma­nent fix, stresses Dr Wai. “Once pa­tients stop tak­ing the medicine, the pre-di­a­betes will come back. So live a health­ier life now.”

Dr Koh agrees: “Let’s say your par­ents were over­weight and had di­a­betes. You’ll have the ge­netic ten­dency to turn out like them too. But if you con­trol your weight very well and stick to a healthy diet, you can prob­a­bly avoid the same fate.” SH

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