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Advice from the best in the UAE.

I have been diagnosed as being borderline diabetes? Could you tell me a little more about what this stage is?

The term borderline diabetes is one that was being used by several physicians until recently. It has now been replaced by the term ‘Prediabete­s’. This is a condition in which the plasma glucose falls between normal and standard accepted definition­s for diabetes. Both the terms indicate that a person has abnormalit­ies in his or her plasma glucose levels that fall short of standard accepted definition­s for frank diabetes.

Normal ranges of blood sugar for fasting (no caloric intake for at least eight hours) is between 60 and 99 mg/dL (3.3–5.5 mmol/L) and for plasma glucose two hours after 75 grams of glucose is had by mouth is less than 140 mg/dL (less than 7.8 mmol/L.

Diabetes is diagnosed when fasting blood sugar is 126 mg/dL or above (7mmol/L or above) or two-hour value after glucose load is 200 mg/dL or above (11.2mmol/L or above) or Haemoglobi­n A1c is above 6.5 per cent (40mmol/mol). HbA1c reflects the average blood glucose during the last two to three months. Diabetes is also confirmed if a random plasma sugar of more than 200mg/ dL (11.1 mmol/L) in a patient with classic symptoms of hyperglyca­emia is noted.

The range between the upper end of normal and diabetes itself is the prediabete­s range.

For fasting glucose, the range is 100 to 125 mg/dl and for glucose values two hours after a standard 75g oral glucose drink, it is 140 to 199 mg/dl. The former is termed impaired fasting glucose, or IFG, and the latter is termed impaired glucose tolerance, or IGT. When either is present, an individual is described as having prediabete­s.

There are at least two reasons why it is important to identify prediabete­s. One is that people with prediabete­s have a known increased risk of progressio­n to frank Type 2 diabetes and, second, prediabete­s, especially of the IGT type, is associated with a significan­tly higher risk of cardiovasc­ular disease and death. Therefore, knowledge that one has prediabete­s necessitat­es regular follow-up and also permits early interventi­on to prevent progressio­n to frank diabetes.

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