Sedentary lifestyle without any physical activities often leads to many diseases. However, as India currently harbours the second-largest population of people living with diabetes, the precursor to it, pre-diabetes, has become a concern across the nation.
Pre-diabetes is a state just before diabetes. It gradually progresses to clinical diabetes mellitus if not checked at the right moment.
“Individuals in the pre-diabetes state have a 3.6-8.7% chance of progressing to diabetes with each passing year. All the cardiovascular adverse events increase steadily in the pre-diabetes range of blood glucose and so are the chances of a heart attack. But fortunately, the pre-diabetes state is reversible or at least checked if intervened properly,” said endocrinologist Dr Sambit Das, Professor and Senior Consultant, KIMS Super Speciality Hospital, and a Fellow of the American Association of Clinical Endocrinology.
How to know about pre-diabetes
According to medical literature, when fasting blood glucose in an individual is greater than 100 mg/dl (milligram per decilitre) and less than 126 mg/dl, it is known as impaired fasting glucose (IFG) and when to postprandial sugars after 75 gram of glucose load is greater than 140 mg/dl and less than 200 mg/dl is known as impaired glucose tolerance (IGT). Both IFG and IGT are known as pre-diabetes. Nowadays, glycosilated haemoglobin (otherwise known as HbA1C) level between 5.7% and 6.4% is also taken as pre-diabetes or borderline diabetes.
However, Dr Das explained that since the condition of pre-diabetes is clinically asymptomatic, it needs regular screening of people who are at maximum risk. Testing should be done for the people who are more than 45 years old.
People of any age who are overweight or obese with any of the additional risk factors like physical inactivity, family history of diabetes, high-risk ethnic population, women who delivered a baby weighing >9 pounds, hypertension, low good cholesterol (HDL cholesterol level <35 mg/dl) and/or high triglyceride level >250 mg/dl, should also be screened. If results are normal, testing should be repeated at least at three-year intervals.
Dr Das said a healthy lifestyle that includes healthy food, regular exercise and maintenance of ideal body weight can reverse or at least halt the progression of this condition. In very high-risk patients, a drug known as metformin is also added to the lifestyle changes, but it should be taken only when prescribed by a doctor.
Ways to avoid pre-diabetes
Moderate physical activity of at least 150 min/week significantly reduces the progression to frank diabetes. Brisk walking of 20-30 minutes a day is strongly recommended for people with this condition.
A regular and moderate diet low in calories and low in fat should be followed. One should stay away from junk food, sweets, bakery products, nuts, ghee or butter, red meat, all sweetened aerated beverages and fresh fruit juices.
A person’s food should be rich in dietary fibres like fresh fruits, salads, vegetables and sprouts. Beverages like clear vegetable soups, tender coconut water, skimmed buttermilk, rasam or red tea can be taken any time of the day without adding any calories.