MOSCOW, February 19, Tatyana Pichugina.More and more often, doctors talk about the reversibility of prediabetes, when blood sugar levels begin to gradually increase. According to the American Diabetes Association, only seventy percent of cases progress to type II diabetes. together with experts, he understands what this condition is and how to recognize it.
What is prediabetes
Diabetes mellitus does not appear immediately in one day, it is preceded by a long-term hidden stage. Carbohydrate metabolism malfunctions, but outwardly it is practically not manifested. Only slightly elevated blood glucose levels indicate problems. This is called prediabetes.
There are two stages. If fasting glucose is impaired, the blood glucose level is 5.6-6.9 millimoles per liter. For impaired glucose tolerance – 7.8-11 millimoles per liter.
In 2021, half a billion adults were counted with the first stage of prediabetes and more than three hundred million with the second. A Russian NATION study in 2013 found this condition in 19.3 percent of participants. The prospects are not at all rosy: it is estimated that by 2045 another ten percent will increase. In general, a quarter of humanity is prone to diabetes by one measure or another.
Among the risk factors – heredity, obesity, age (over 45 years).
For early detection of prediabetes, scientists are actively using artificial intelligence. For example, researchers from Canada comparedseven machine learning models on a large sample of digitized medical data from across the country. 60 percent were predicted to have prediabetes. The AI also identified three main signs: age, body mass index and taking blood pressure medications.
What does high sugar mean
When glucose enters the body with food, insulin is injected into the blood to break it down and supply all cells and tissues with energy. Insulin is produced by beta cells of the pancreas. They may not function for some reason, for example, as a result of genetic mutations (in Europeans, they counted as many as 120 variants that contribute to impaired carbohydrate metabolism), or become depleted due to heavy load. In addition, body tissues sometimes lose sensitivity to insulin; it accumulates, but does not participate in the processing of glucose.
“For an accurate diagnosis, laboratory tests are needed. Venous blood is donated on an empty stomach. In a healthy person aged 18 to 59 years, blood glucose is 4.1-6.1 millimoles per liter. Anything higher is prediabetes or diabetes. Also carried out analysis for glycated hemoglobin, which shows the average concentration of glucose in the blood over the last three months. If the result is up to six percent inclusive – the person is healthy, 6-6.4 percent – you should consult a doctor to eliminate the risk of carbohydrate metabolism disorders. Indicator 6.5 percent or higher indicates diabetes,” explains gastroenterologist at the Hemotest laboratory, candidate of medical sciences Ekaterina Kashukh.
According to calculations by the Institute of Diabetes of the National Medical Research Center for Endocrinology of the Ministry of Health, carried out in 2022, every fifth or sixth Russian has prediabetes, and every 13-14th has diabetes. “And many have no idea about their diagnosis,” the doctor emphasizes.
There is also anonymized data from Hemotest for 2023. Glycated hemoglobin was higher than normal in 14 percent of those tested, and glucose in 3.2 percent. In addition, 13.5 percent had elevated insulin, which may indicate insulin resistance.
However, a one-time jump in blood sugar is not a reason to panic, points out endocrinologist at the Moscow Center named after A.R. Dovzhenko, candidate of medical sciences Yuliana Belova. This can be due to stress, heavy physical activity, taking certain medications, and even accidentally swallowing toothpaste. However, if you are at risk, it is better to retake the test and visit a doctor.
“Excess weight, blurred vision, skin rashes or itching, high blood pressure, heart pain, pain or numbness in the legs are negative factors. Risk prediabetes also increases with age and in people with a family history of type II diabetes,” says the endocrinologist.
How to avoid prediabetes
The risk can be significantly reduced by lifestyle changes, primarily diet.
“If poor nutrition leads to obesity or even just the appearance of a large belly at a normal weight, then individuals predisposed to diabetes may develop a cascade of hormonal imbalances, which will result in prediabetes,” explains Belova.
In any case, it is not good for anyone to indulge in fast food and sweets. According to the doctor, it is now recommended to reduce the share of simple carbohydrates (syrups, sweets, confectionery, added sugars) to ten percent of the diet, and limit fruits, which serve as a source of natural glucose and fructose, to two servings per day.
Some foods can cause a sharp spike in blood glucose. Doctors in this case use the glycemic index. The higher it is, the faster sugar is released. These are, for example, dates, white bread, pastries, sweets, honey, fruit juices, beer, ice cream, chips. Nutritionists recommend combining such foods with fiber and vegetable fats to slow down the absorption of carbohydrates. But there is a nuance.
“One dish may contain ingredients with different glycemic indexes. Glucose absorption depends on their combination, as well as on the intestinal microflora. Therefore, now experts pay less attention to the glycemic index and advise more adherence to the principles of balanced nutrition,” – notes Kashukh.
The insidiousness of prediabetes is that it progresses into diabetes and imperceptibly undermines health, affecting vital organs, Belova concludes. If you notice it in time, adjust your diet and lifestyle, and visit a doctor, then carbohydrate metabolism disorders can be reversed or stabilized for a long time.
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