Pre-diabetes describes a condition in which blood glucose levels are higher than normal, although not high enough to be diagnosed with type 2 diabetes. Pre-diabetes has no signs or symptoms. People with pre-diabetes have a higher risk of developing type 2 diabetes and cardiovascular (heart and circulation) disease. Two million Australians have pre-diabetes and are at high-risk of developing type 2 diabetes.
Without sustained lifestyle changes, including healthy eating, increased activity and losing weight, approximately one in three people with pre-diabetes will go on to develop type 2 diabetes.
There are two pre-diabetes conditions:
- Impaired glucose tolerance (IGT) is where blood glucose levels are higher than normal but not high enough to be classified as diabetes.
- Impaired fasting glucose (IFG) is where blood glucose levels are escalated in the fasting state but not high enough to be classified as diabetes.
- It is possible to have both Impaired Fasting Glucose (IFG) and Impaired Glucose Tolerance (IGT)
Risk factors for pre-diabetes are similar to those for type 2 diabetes which are:
- Being overweight – especially those who have excess weight around the waistline (ie: more than 94cm for men and more than 80cm for women).
- Being physically inactive.
- Having high triglycerides and low HDL-C (good cholesterol) and/or high total cholesterol.
- Having high blood pressure.
- Having a family history of type 2 diabetes and/or heart disease.
Other people at risk include:
- Women with Polycystic Ovarian Syndrome*.
- Women who have had diabetes in pregnancy (gestational diabetes) or given birth to a big baby (more than 4.5kgs).
- Those from Aboriginal and Torres Strait Islander background.
- Those from certain ethnic backgrounds such as the Pacific Islands, Asia and the Indian sub-continent.
For more information refer to the Polycystic Ovarian Syndrome and Diabetes information sheet.
If you are diagnosed with pre-diabetes, the treatment involves the same lifestyle changes that are recommended for people diagnosed with diabetes. For most, this will include regular physical activity, healthy eating and if necessary losing weight.
You can learn about the type 2 diabetes prevention programs available in your state here.
People with pre-diabetes are also at increased risk of heart disease, so controlling blood pressure and blood cholesterol and triglycerides is also important.
A healthy eating plan for losing weight and reducing the risk of type 2 diabetes should include a reduction in total energy (kilojoule) and fat intake, particularly saturated fat foods such as butter, full fat dairy products, fatty meats, takeaway foods, biscuits, cakes and pastries. Instead choose a wide range of high fibre, low GI carbohydrate foods such as wholegrain breads and cereals, legumes and fruit. To work out a meal plan that’s right for you, visit an accredited practicing dietitian.
To find a dietitian in your area, contact:
- The Dietitians Association of Australia or call 1800 812 942
- the NDSS Helpline on 1300 136 588.
Regular physical activity
Regular physical activity helps your body to use insulin better and to feel fit and healthy. Aim to do at least 30 minutes of ‘moderate intensity’ physical activity (such as brisk walking or swimming) on most, if not all, days of the week or three 20-minute sessions of ‘vigorous intensity’ exercise per week (such as jogging, aerobics class, strenuous gardening). Try to include some resistance training twice a week to improve the way your muscles work, such as body weight exercises or lifting weights such as cans of food.
Starting a regular activity program – and sticking to it – can often be made a lot easier by joining up with a group or motivated friend to encourage you to keep going.
*Before starting any new type of physical activity, always talk to your doctor.
Can Type 2 diabetes be avoided?
Being diagnosed with impaired glucose metabolism doesn’t mean that you will get type 2 diabetes but you are at a 10-20 times greater risk than those with normal blood glucose levels.
Strong evidence shows that type 2 diabetes can be prevented in up to 58% of cases in the high risk (pre-diabetes) population by eating well and exercising.
A Type 2 diabetes risk assessment is easy using the Diabetes Australia Risk Calculator based on the AUSDRISK – the Australian Type 2 Diabetes Risk Test. A score of 12 or more means a person is at high risk , should see their doctor for blood tests and seek a diabetes prevention program (lifestyle behaviour change).
How do you know you have one of these conditions?
Any glucose test, fasting or not, that shows higher than normal blood glucose levels, needs to be checked further. The doctor may therefore order an Oral Glucose Tolerance Test (OGTT) to find out more about the patient’s glucose metabolism. The results of this laboratory test show four possible diagnoses:
- Normal glucose levels
- Impaired Fasting Glucose
- Impaired Glucose Tolerance
- Type 2 diabetes
*‘Fasting’ means having nothing to eat for 8 hours before the test.
Download the NDSS Information Sheet: Pre-diabetes