“Pre diabetes”

[Tim]

I have an acquaintance who has just been diagnosed by their GP as being “pre-diabetic”. Apparently this means that she has high blood glucose, but not so high that they will give her any support in terms of dietary advice, drugs or whatever. Essentially she has been told to go away and come back when her diabetes is worse.

My view is that being diabetic is like being pregnant – you can’t be a “bit” or “pre” pregnant and you can’t be a “bit” or “pre” diabetic. What do you lot think and what advice should I pass on?

[Alison]

I think pre-diabetes used to be called “glucose intolerant” ie you’re not dealing with glucose as efficiently as you did. So, your blood sugar is running higher than the norm, but not so high that you’d be formally classed as diabetic. Its an early warning sign really that type 2 could be on the horizon.

In terms of advice, I’d say heed the warning and take action now eg healthy diet, exercise, lose weight etc. That way you reduce the strain on the body and hopefully it starts to use its own insulin more efficiently, thus delaying the onset of Type 2 diabetes.

[Tim]

Is there a formal definition of type two then?

Yup – I concur with the advice; that’s broadly what I’ve said so far. It just seems a little unfair that they don’t get *any* support when they are obviously unwell.

[Alison]

The criteria for diagnosis are here – http://www.diabetes.org.uk/About_us/Our_Views/Care_recommendations/New_diagnostic_criteria_for_diabetes_/ basically a random blood sugar above 11, a fasting blood sugar above 7 or a blood sugar above 11 two hours after having 75g of glucose.

Some lifestyle advice would have been helpful, its much better (and cheaper) to take action early rather than wait until you need drugs. I know a lot of people find WeightWatchers good for this kind of thing – healthy eating, exercise, motivation etc.

[Annette A]

My brother-in-law’s partner’s mother (sounds like 7 degrees of separation…) was given a diagnosis of ‘Type X diabetes’, told it would probably progress to Type 2, and left to get on with it. I suspect what they meant was Syndrome X, and what they actually meant was ‘pre-diabetes’, but as she (a) didnt have the full Type 2 diagnosis and (b) was suffering from alzheimer’s so couldnt actually answer/understand most of the questions they asked (her husband, being elderly, was also somewhat unsure as to what he was supposed to say – ‘is she going to the loo alot more?’ – uhh, she’s incontinent and has been for several years, how do I know…)they didnt see the point of actually doing anything.
My brother-in-law contacted me (of course) and I pointed him to a few useful websites (including DUK) and gave them a few pointers, but we all felt she should have received better care/notice than she did.
[She died last year from alzheimer’s related complications, before Type 2 could be diagnosed, so who knows what would have happened.)

[Tim]

@alison – hmm, I’ve tested said person several times about 11mmol/l with my very own meter. Maybe they will pay attention when their feet rot off?

[Anonymous]

This help at all?? http://www.diabetesatlas.org/content/impaired-glucose-tolerance/

Quote:

Impaired glucose tolerance (IGT) is an asymptomatic condition defined by elevated (though not diabetic) levels of blood glucose two hours after a 75g oral glucose challenge. Along with impaired fasting glucose (IFG), it is now recognized as being a stage in the transition from normality to diabetes. Not surprisingly, IGT shares many characteristics with type 2 diabetes, being associated with obesity, advancing age, insulin resistance and an insulin secretory defect.

[Author]

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