What Is Pre-Diabetes & What Can We Do To Help?

Article by Rachel Suzette

It is estimated that nearly 7 million people within the UK are borderline diabetic – or pre diabetic (DiabetesUK, 2022). The hormone insulin is needed to breakdown glucose within your blood. Glucose is usually carried around the body where it is absorbed and made into energy (Diabetes.co.uk, 2022). Too much glucose in your blood (hyperglycaemia) can have serious health implications including causing permanent damage to the nerves in your hands and feet, sight-loss and can cause life threatening conditions such as diabetic ketoacidosis (when there is a severe lack of insulin in the body and your body can longer use glucose for energy, if left unchecked this can lead to your blood becoming acidic) (DiabetesUK, 2022).

What are the types of diabetes?

Diabetes mellitus is a serious metabolic disease which briefly comes in two forms;

Type 1:

Caused because your body attacks cells in your pancreas preventing you from making insulin (auto-immune disease). It is not understood what causes type 1 diabetes but it doesn’t have anything to do with diet or lifestyle (DiabetesUK, 2022).

Type 2:

Occurs when the pancreas releases insulin but it doesn’t work properly. When this happens, blood glucose levels continue to rise and more ineffective insulin is released. Type 2 diabetes is normally caused due to lifestyle issues (such as weight gain, too little exercise and an unhealthy diet).

Pre-diabetes can develop into type 2, but not type 1 (NICE, 2022).

What does it mean to be pre-diabetic?

Pre-diabetes can be described in basic terms as the ‘grey area’ between normal blood sugar levels and diabetic levels. Characterised by blood glucose levels that are higher than normal but not yet high enough to be classed as diabetes, effectively a person with this diagnosis isn’t able to process glucose as efficiently as they should be able to (DiabetesUK, 2022). Other medical terms to describe pre-diabetes include; Impaired fasting glucose (IFG), Impaired glucose tolerance (IGT), Impaired glucose regulation (IGR) and Non- diabetic hyperglycaemia. A simple blood test can diagnose pre-diabetes (NICE, 2022).

What are the symptoms?

There are no symptoms of pre-diabetes, so its important to understand the symptoms of type 2 diabetes if you are at risk, as if you have noticed symptoms it is likely that you have already developed it.

Symptoms may include; (DiabetesUK, 2022)

  • Going to the toilet more often

  • Feeling more tired

  • Losing weight without trying

  • Genital itching or thrush

  • Cuts and wounds taking longer to heal

  • Blurred vision

  • Feeling extremely thirsty

What are the risk factors?

It’s also important to understand the risk factors that may make someone more likely to develop pre-diabetes and diabetes (DiabetesUK, 2022; NICE, 2022);

  • Obesity and inactivity - Obesity accounts for 80%-85% of the overall risk for developing type 2 diabetes.

  • Family history – People with a family history of diabetes are 2-6 times more likely to develop diabetes than those without.

  • Ethnicity – People of Asian, African and Afro-Caribbean ethnicity are 2-4 times more likely to develop diabetes than white people.

  • History of gestational diabetes – There is a seven fold increased risk to those who developed gestational diabetes during pregnancy and a sixfold risk of development to those children born from mothers who developed gestational diabetes. 

  • Polycystic ovary syndrome

What can you do to help?

If pre-diabetes is identified early on, it can be reversed and you can prevent developing type 2 diabetes. As obesity and diet/lifestyle has been heavily shown to increase the risk of development, changes to these factors should be addressed when trying to lower blood glucose levels.

It has been shown that people who make dietary changes and increase their physical activity can prevent the development of type 2 diabetes. Some things which may help to prevent the progression of diabetes include;

  • Losing a moderate amount of weight - 5%-7% of bodyweight.

  • Regular physical activity - around 150 minutes a week of moderate exercise such as a brisk walk for 30 minutes a day. Walking after a meal has also been shown to slow the release of glucose from the food you have eaten!

  • Increase intake of fibre and complex carbohydrates– such as brown pasta, wholegrain rice and wholegrain bread. These slow the release of glucose into the blood compared to their white counterparts, preventing a rapid spike in glucose levels.

  • Stop smoking – smoking increases the risk of not only heart disease and lung cancer but also insulin resistance and type 2 diabetes.

(DiabetesUK, 2022; NICE, 2022; Reynolds and Venn, 2018)

Knowing how to manage and overcome pre-diabetes can be difficult and it’s important to consult your doctor if you have been diagnosed, as they can offer advice and direct you to helpful services. It can also be helpful to consult a specialist registered dietitian or nutritionist who can provide advice on foods and other practical strategies to maintain a healthy diet.

This blog was written by Rachel Suzette. With 8 years of experience in the hospitality industry as a chef, she is a real foodie. Realising during the covid-19 pandemic that I had a real passion for understanding what we should be eating and why I started my undergraduate degree in Food and Nutrition at Birmingham City University. She is also a volunteer with The Message: Community Grocery, who help people who struggle to afford their weekly shop, providing them with a low cost shopping experience. Rachel would also like to complete a Masters in Obesity and weight management and eventually become an AfN registered nutritionist. I am passionate about sharing science backed information about food, debunking diet myths and banishing bad diet culture. Helping people to have a positive mindset around food and realise that their nutrition can help them live a healthier and happier life. Find her on Instagram: @rachel.suzette.

References:

Diabetes.co.uk, 2022. Prediabetes or borderline diabetes is a metabolic condition and growing global problem that is closely tied to obesity.. [online] Diabetes. Available at: <https://www.diabetes.co.uk/pre-diabetes.html>

DiabetesUK, 2022. Prediabetes. [online] Diabetes UK. Available at: <https://www.diabetes.org.uk/preventing-type-2-diabetes/prediabetes>

DiabetesUK, 2022. Type 1 diabetes. [online] Diabetes UK. Available at: <https://www.diabetes.org.uk/diabetes-the-basics/types-of-diabetes/type-1>

DiabetesUK, 2022. What is DKA (diabetic ketoacidosis)?. [online] Diabetes UK. Available at: <https://www.diabetes.org.uk/guide-to-diabetes/complications/diabetic_ketoacidosis?gclid=EAIaIQobChMI483q35-l-QIVABoGAB19QQi1EAAYASAAEgLTwPD_BwE>

NICE, 2022. Diabetes - type 2 | Health topics A to Z | CKS | NICE. [online] Cks.nice.org.uk. Available at: <https://cks.nice.org.uk/topics/diabetes-type-2/>

NICE, 2022. Diagnosis in adults | Diagnosis | Diabetes - type 2 | CKS | NICE. [online] Cks.nice.org.uk. Available at: <https://cks.nice.org.uk/topics/diabetes-type-2/diagnosis/diagnosis-in-adults/

NICE, 2022. Polycystic ovary syndrome | Health topics A to Z | CKS | NICE. [online] Cks.nice.org.uk. Available at: <https://cks.nice.org.uk/topics/polycystic-ovary-syndrome/>

Reynolds, A. and Venn, B., 2018. The Timing of Activity after Eating Affects the Glycaemic Response of Healthy Adults: A Randomised Controlled Trial. Nutrients, 10(11), p.1743.

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