Prediabetes: Understanding the Risks and Taking Control
An estimated 1.4 million adults in our country have prediabetes, a condition where blood sugar levels are elevated but not high enough to be diagnosed as type 2 diabetes.1 While not yet a disease, prediabetes significantly increases the risk of developing type 2 diabetes and cardiovascular disease.1, 2 Many individuals are unaware they have prediabetes, as symptoms are often absent. This raises critical questions: What exactly is prediabetes? Why is it so prevalent? And, most importantly, what steps can be taken to prevent progression to full-blown diabetes?
What is Prediabetes?
Prediabetes serves as a precursor to type 2 diabetes. In type 2 diabetes, the body either doesn’t produce enough insulin or doesn’t effectively use the insulin it does produce, leading to elevated blood sugar levels.1 These high levels can cause symptoms like increased thirst, frequent urination and fatigue, and can lead to serious health problems, including cardiovascular disease and kidney problems.1
In prediabetes, blood sugar levels are mildly elevated, but not yet high enough to meet the diagnostic criteria for diabetes.1 most people experience no noticeable symptoms. However, it’s a crucial warning sign, indicating an increased risk of developing type 2 diabetes and cardiovascular issues.
The Link Between Prediabetes and Cardiovascular Disease
Research consistently demonstrates a strong association between prediabetes and an increased risk of cardiovascular disease. A study analyzing data from over 427,000 individuals in the UK Biobank found that those with prediabetes faced a greater risk of coronary artery disease, stroke, and heart failure compared to those with normal blood sugar levels.3 The increased risk persisted even after accounting for factors like obesity and medication use.3
a study presented at ENDO 2022 revealed that prediabetes is a strong independent risk factor for heart attacks.4 Analyzing data from over 1.79 million hospitalizations for heart attacks, researchers found that individuals with prediabetes had a 25% increased odds of experiencing a heart attack compared to those without prediabetes.4 They also faced a 45% increased likelihood of needing percutaneous intervention and nearly double the risk of requiring heart bypass surgery.4
Prediabetes is associated with increased risk of cardiovascular disease and heart failure.2
How is Prediabetes Diagnosed?
Diagnosing prediabetes requires a blood sugar test. While a comprehensive test is used in research settings, a simpler fasting blood sugar test can be performed by a general practitioner.1 If results fall within a gray area, it may indicate prediabetes.1
The Diabetes Fund offers a risk calculator to assess an individual’s likelihood of developing type 2 diabetes.1 If the calculator indicates an increased risk, consulting a doctor for blood sugar testing is advisable.1
What Causes Prediabetes?
Obesity is a significant contributor to prediabetes. Approximately 50% of adult Dutch individuals are overweight, placing a strain on the pancreas to maintain healthy blood sugar levels.1 Over time, this strain can lead to pancreatic exhaustion, insufficient insulin production, and prediabetes and diabetes.1
Can Prediabetes Be Reversed?
Yes, prediabetes can often be reversed through lifestyle modifications, often without the demand for medication.1 A healthier lifestyle, encompassing dietary changes, increased physical activity, and weight management, is the most effective approach.1
Specifically, the following are recommended:
- Dietary Changes: Eating more consciously and making healthier food choices.
- Increased Physical Activity: Engaging in regular exercise.
- Weight Management: Losing weight if overweight or obese.
These changes can assist restore normal blood sugar levels. Medication may be considered if lifestyle changes are insufficient.1
Prevention is Key
Preventing prediabetes and type 2 diabetes requires a societal shift towards healthier lifestyles. Government initiatives, such as a sugar tax on sugary foods and drinks (planned for 2030) and restrictions on marketing unhealthy products to children, are steps in the right direction.1
Supermarkets also have a role to play in promoting healthier choices, but currently, the availability of unhealthy options often outweighs healthier alternatives.1
Undetected Diabetes: A Hidden Problem
Prediabetes isn’t the only condition going undetected. Approximately 400,000 people in the Netherlands have type 2 diabetes without knowing it.1 This underscores the importance of regular health checkups and utilizing resources like the Diabetes Fund’s online Diabetes Risk Test, which recently saw 200,000 completions in a single day.1
Undiagnosed type 2 diabetes can lead to irreversible damage, including nerve damage, eye problems, dementia, kidney failure, and cardiovascular disease.1
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