Diabetes
Prediabetes and type 2 diabetes
Short answer
Prediabetes is the stage when blood sugar is above normal but still below the diabetes threshold. The doctor's practical cutoffs:
- fasting blood sugar of 100 mg/dL or higher — a warning sign;
- 110 mg/dL (6.1 mmol/L) or higher — you must see an endocrinologist;
- HbA1c of 5.5–6% — a warning sign; 6% or higher — time to see a doctor.
Measures taken at this stage reduce the risk of progressing to diabetes.
International (ADA) criteria. Review your result with your doctor.
General information
- International criteria (ADA):
- prediabetes: fasting blood sugar 100–125 mg/dL, HbA1c 5.7–6.4%;
- diabetes: fasting blood sugar ≥126 mg/dL, HbA1c ≥6.5%.
- Normal blood sugar does not mean metabolic health. “Having a normal blood sugar does not always mean that you are metabolically healthy.” Insulin resistance can be present even when blood sugar is normal, and it is the most important risk factor for type 2 diabetes → Insulin resistance, acanthosis and skin tags.
- Treatment. The basis is proper nutrition, physical activity and weight loss. When needed, medicines are added → Diabetes treatment and follow-up.
In the doctor's practice
- The doctor stresses that prediabetes should not be treated with indifference. A post by the doctor describes one such patient: someone who had prediabetes for a long time, stayed indifferent, and at the next examination came in already with a diagnosis of diabetes.
- If there are symptoms of diabetes, it is enough to simply have the fasting blood sugar checked for early detection.
Q&A
My fasting blood sugar is 100–110 mg/dL. What should I do?
This is a warning sign. If it is 110 mg/dL or higher, do not make decisions on your own, and see an endocrinologist.
There is diabetes in my family. Should I get checked too?
Yes. If first-degree relatives (mother, father, sister, brother) have diabetes, there is a chance that you have it too. That is why a preventive check-up is important.
Why does blood sugar rise during an infection or steroid treatment?
According to the doctor's explanation during the COVID-19 period, during illness both eating habits are disrupted and the medicines used in treatment raise blood sugar. During this time:
- eat healthily; eat fruit in the amount you need, not in large quantities; use plenty of vegetables;
- stay away from carbohydrate-rich foods (bread, potatoes, flour-based foods, jam, fruit juice) as much as possible;
- drink enough fluids;
- whenever possible, walk at a moderate pace for 30–40 minutes a day;
- contact your endocrinologist from the first days that your blood sugar gets out of control.