Islets of Hope for persons with prediabetes
Article by Lahle Wolfe, 03/25/2006. For reprint information e-mail Editor@isletsofhope.com
Confused? See our Chart Comparison between Insulin Resistance, Insulin Resistance Syndrome (IRS), Prediabetes, Types 1 and 2 Diabetes, and Gestational Diabetes detailing the symptoms, diagnosis, treatment, and prognosis of these major metabolic disorders.
euglycemia - when a person can no longer maintain normal blood glucose leves either from insulin resistance. or because the pancreas cannot make enough insulin to keep up with the demand.
Glucose - a sugary, sweet tasting drink that is given to a patient for a glucose tolerance test. It is provided by your doctor or the lab giving the test and it often comes in different flavors. Note: they all are pretty disguting but it is important that you drink the amount requested by your doctor to ensure accuracy of the test.
Impaired Glucose Tolerance (IGT) - It is estimated that approximately 20 million people in the U.S have IGT. Those who are at increased risk for developing IGT or type 2 diabetes include those who are overweight, have a family history of diabetes, had/have gestational diabetes, those with hypertension, elevated triglycerides, or another disorder associated with the risk of developing diabetes.
Those with IGT should be under the medical care of a qualified endocrinologist. Treatment may include lifestyle changes, medication, and monitoring blood glucose levels.
Prediabetes - Doctors sometimes call this condition impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), depending on the test used to diagnose it. In a cross-section of U.S. adults aged 40 to 74 tested during the period 1988 to 1994, 33.8 percent had IFG, 15.4 percent had IGT, and 40.1 percent had pre-diabetes (IGT or IFG or both). Applying these percentages to the 2000 U.S. population, about 35 million adults aged 40 to 74 would have IFG, 16 million would have IGT, and 41 million would have prediabetes.
(NIH Publication No. 04–4893, May 2004)
What is prediabetes (or, pre-diabetes)?
IOH Health Tip: Persons with prediabetes, who do nothing about it, will most likely develop type 2 diabetes within 10 years of being diagnosed with prediabetes. But by making healthy changes in your lifestyle now you can reduce this risk significantly, and may even be able to completely reverse prediabetes by "retraining" your body how to properly use its own insulin.
What is prediabetes?
Prediabetes used to be called impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), but in 2005, federal and diabetes experts renamed IFG to prediabetes (some use the spelling pre-diabetes) to help patients better appreciate the serious nature of this metabolic condition and urgency involved in making healthy lifestyle changes in order to avoid the onset of type 2 diabetes (formerly called adult-onset diabetes or noninsulin-dependent diabetes).
Prediabetes is not the same thing as insulin resistance syndrome (IRS), however, people with prediabetes are part of the group of individuals with IRS. When a person has insulin resistance or IRS, the body gradually loses sensitivity to the hormone insulin and this can result in prediabetes.
What is insulin resistance?
Insulin resistance is a metabolic condition that increases the chances of developing prediabetes, type 2 diabetes, and heart disease. The term insulin resistance is used when a person makes insulin but resists the effects of insulin. That is, the normal action of insulin (carbohydrate metabolism) in the body is compromised. When a person is insulin resistant, their cells do not respond to a normal secretion of insulin from the pancreas, so the pancreas has to produce more insulin than normal to move blood glucose (sugar) out of the blood stream and into cells and tissues.
A person that is insulin resistant often has elevated fasting blood glucose (blood sugar) levels, but some patients with insulin resistance may have normal blood glucose (fasting and after meals), and might even "pass" an oral glucose tolerance test (OGTT). But in order to maintain normal glucose levels, a person that is insulin resistance will over produce insulin. When insulin levels are elevated it is called "hyperinsulinemia."
Insulin resistance and hyperinsulinemia are early warning indicators of the risk of prediabetes, type 2 diabetes, or the presence of some other medical disorder like Addison's disease, polycystic ovarian syndrome (PCOS), Cushing's Syndrome, or thyroid problems like Hashimoto's thyroiditis.
Many people with insulin resistance have high blood glucose, carry excess weight around the waist, have high LDL (bad) blood cholesterol levels, low HDL (good) cholesterol levels, high levels of triglycerides (a form fat in the blood), and/or high blood pressure -- all conditions that carry the risk of developing type 2 diabetes and put the heart at risk.
Page Updated 09/01/2006