According to the American Diabetes Association (ADA), prediabetes is a condition where blood glucose levels are higher than normal, but not yet high enough to be diagnosed as diabetes. Patients with diabetes almost always went through a period of prediabetes, most of the time without noticing any change. The risk factors for prediabetes are basically the same as those for diabetes. These include age over 45 years, positive family history of diabetes, elevated body weight (accompanied by hyperinsulinemia or insulin resistance), present metabolic syndrome (elevated blood pressure, elevated cholesterol and body weight), physical inactivity, etc.

Symptoms may or may not be present. The most common symptoms are diabetes, dry mouth, thirst, frequent urination, increased food intake, etc., and some of the complications that occur in diabetes may also occur.

Prediabetes is manifested in two conditions - impaired fasting glycemia and impaired glucose tolerance. Impaired fasting glycemia is diagnosed with recorded elevated fasting glycemic values ​​with a regular finding on the oral glucose tolerance test, while with impaired glucose tolerance we have higher than normal values ​​in the second hour of the oral glucose tolerance test, but still lower than 11.1 mmol/l. Some patients may have both conditions at the same time.

The following criteria are used for diagnosis: measured fasting glycemia of 5.6 mmol/l - 6.9 mmol/l, value of glycosylated hemoglobin HbA1c 5.7% - 6.4% and value of glycemia measured in the second hour during an oral glucose tolerance test of 7.8 mmol/l – 11.1 mmol/l.

Most often, the prefix "pre" in the name of prediabetes gives an underestimating effect and sense of the overall meaning of this condition, which is taken quite lightly, and even forgotten that it exists at all. It should be known that at this stage the process of damage to the small blood vessels of the heart, eyes, brain, kidneys already begins. According to the American Diabetes Association, these patients have an ongoing risk of developing type 2 diabetes (25-40% risk over the next 5 years) and an increased risk of cardiovascular disease.

The good news is that this condition can be completely reversed and the body can return to a healthy homeostasis, or at least delay the onset of diabetes for a longer period of time.

By reducing by 5-7% of the total body weight and regular moderate physical activity (30 minutes a day during 5 days of the week) the risk of developing diabetes is significantly reduced, and the state of pre-diabetes is withdrawn.

At the Jean Mitrev Clinic, we are available to promptly diagnose prediabetes and intervene correctly, so that we can return to the right healthy path as soon as possible.

Dr. Juliana Mihajlovska, specialist endocrinologist

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