What Is Prediabetes?
The vast majority of patients with type 2 diabetes initially had prediabetes. Their blood glucose levels where higher than normal, but not high enough to merit a diabetes diagnosis. The cells in the body are becoming resistant to insulin.
Studies have indicated that even at the prediabetes stage, some damage to the circulatory system and the heart may already have occurred.
Diabetes Is A Metabolism Disorder
Diabetes (diabetes mellitus) is classed as a metabolism disorder. Metabolism refers to the way our bodies use digested food for energy and growth. Most of what we eat is broken down into glucose. Glucose is a form of sugar in the blood - it is the principal source of fuel for our bodies.
When our food is digested, the glucose makes its way into our bloodstream. Our cells use the glucose for energy and growth. However, glucose cannot enter our cells without insulin being present - insulin makes it possible for our cells to take in the glucose.
Insulin is a hormone that is produced by the pancreas. After eating, the pancreas automatically releases an adequate quantity of insulin to move the glucose present in our blood into the cells, as soon as glucose enters the cells blood-glucose levels drop.
A person with diabetes has a condition in which the quantity of glucose in the blood is too elevated (hyperglycemia). This is because the body either does not produce enough insulin, produces no insulin, or has cells that do not respond properly to the insulin the pancreas produces. This results in too much glucose building up in the blood. This excess blood glucose eventually passes out of the body in urine. So, even though the blood has plenty of glucose, the cells are not getting it for their essential energy and growth requirements.
How To Determine Whether You Have Diabetes, Prediabetes or Neither
Doctors can determine whether a patient has a normal metabolism, prediabetes or diabetes in one of three different ways - there are three possible tests:
The A1C test
- at least 6.5% means diabetes
- between 5.7% and 5.99% means prediabetes
- less than 5.7% means normal
The FPG (fasting plasma glucose) test
- at least 126 mg/dl means diabetes
- between 100 mg/dl and 125.99 mg/dl means prediabetes
- less than 100 mg/dl means normal
An abnormal reading following the FPG means the patient has impaired fasting glucose (IFG)
The OGTT (oral glucose tolerance test)
- at least 200 mg/dl means diabetes
- between 140 and 199.9 mg/dl means prediabetes
- less than 140 mg/dl means normal
An abnormal reading following the OGTT means the patient has impaired glucose tolerance (IGT)
Why Is It Called Diabetes Mellitus?
Diabetes comes from Greek, and it means a "siphon". Aretus the Cappadocian, a Greek physician during the second century A.D., named the condition diabainein. He described patients who were passing too much water (polyuria) - like a siphon. The word became "diabetes" from the English adoption of the Medieval Latin diabetes.
In 1675, Thomas Willis added mellitus to the term, although it is commonly referred to simply as diabetes. Mel in Latin means "honey"; the urine and blood of people with diabetes has excess glucose, and glucose is sweet like honey. Diabetes mellitus could literally mean "siphoning off sweet water".
In ancient China people observed that ants would be attracted to some people's urine, because it was sweet. The term "Sweet Urine Disease" was coined.
Controlling Diabetes - Treatment Is Effective And Important
All types of diabetes are treatable. Diabetes type 1 lasts a lifetime, there is no known cure. Type 2 usually lasts a lifetime, however, some people have managed to get rid of their symptoms without medication, through a combination of exercise, diet and body weight control.
Patients with type 1 are treated with regular insulin injections, as well as a special diet and exercise.Researchers from the Mayo Clinic Arizona in Scottsdale showed that gastric bypass surgery can reverse type 2 diabetes in a high proportion of patients. They added that within three to five years the disease recurs in approximately 21% of them. Yessica Ramos, MD., said "The recurrence rate was mainly influenced by a longstanding history of Type 2 diabetes before the surgery. This suggests that early surgical intervention in the obese, diabetic population will improve the durability of remission of Type 2 diabetes." (Link to article)
Patients with Type 2 diabetes are usually treated with tablets, exercise and a special diet, but sometimes insulin injections are also required.
- If diabetes is not adequately controlled the patient has a significantly higher risk of developing complications.
- Complications linked to badly controlled diabetes:
- Eye complications - glaucoma, cataracts, diabetic retinopathy, and some others.
- Foot complications - neuropathy, ulcers, and sometimes gangrene which may require that the foot be amputated
- Skin complications - people with diabetes are more susceptible to skin infections and skin disorders
- Heart problems - such as ischemic heart disease, when the blood supply to the heart muscle is diminished
- Hypertension - common in people with diabetes, which can raise the risk of kidney disease, eye problems, heart attack and stroke
- Mental health - uncontrolled diabetes raises the risk of suffering from depression, anxiety and some other mental disorders
- Hearing loss - diabetes patients have a higher risk of developing hearing problems
- Gum disease - there is a much higher prevalence of gum disease among diabetes patients
- Gastroparesis - the muscles of the stomach stop working properly
- Ketoacidosis - a combination of ketosis and acidosis; accumulation of ketone bodies and acidity in the blood.
- Neuropathy - diabetic neuropathy is a type of nerve damage which can lead to several different problems.
- HHNS (Hyperosmolar Hyperglycemic Nonketotic Syndrome) - blood glucose levels shoot up too high, and there are no ketones present in the blood or urine. It is an emergency condition.
- Nephropathy - uncontrolled blood pressure can lead to kidney disease
- PAD (peripheral arterial disease) - symptoms may include pain in the leg, tingling and sometimes problems walking properly
- Stroke - if blood pressure, cholesterol levels, and blood glucose levels are not controlled, the risk of stroke increases significantly
- Erectile dysfunction - male impotence.
- Infections - people with badly controlled diabetes are much more susceptible to infections
- Healing of wounds - cuts and lesions take much longer to heal
Some Facts And Myths Regarding Diabetes
Many presumed "facts" are thrown about in the paper press, magazines and on the internet regarding diabetes; some of them are, in fact, myths. It is important that people with diabetes, pre-diabetes, their loved ones, employers and schools have an accurate picture of the disease. Below are some diabetes myths: