Q: I have been diagnosed as being borderline diabetes? Could you tell me a little more about what this stage is?
The term borderline diabetes is one that was being used by several physicians until recently. It has now been replaced by the term ‘Prediabetes’. This is a condition in which the plasma glucose falls between normal and standard accepted definitions for diabetes. Both the terms indicate that a person has abnormalities in his or her plasma glucose levels that fall short of standard accepted definitions for frank diabetes.
Normal ranges of blood sugar for fasting (no caloric intake for at least eight hours) is between 60 and 99 mg/dL (3.3–5.5 mmol/L) and for plasma glucose two hours after 75 grams of glucose is had by mouth is less than 140 mg/dL (less than 7.8 mmol/L.
Diabetes is diagnosed when fasting blood sugar is 126 mg/dL or above (7mmol/L or above) or two-hour value after glucose load is 200 mg/dL or above (11.2mmol/L or above) or Haemoglobin A1c is above 6.5 per cent (40mmol/mol). HbA1c reflects the average blood glucose during the last two to three months. Diabetes is also confirmed if a random plasma sugar of more than 200mg/dL (11.1 mmol/L) in a patient with classic symptoms of hyperglycaemia is noted.
The range between the upper end of normal and diabetes itself is the prediabetes range.
For fasting glucose, the range is 100 to 125 mg/dl and for glucose values two hours after a standard 75g oral glucose drink, it is 140 to 199 mg/dl. The former is termed impaired fasting glucose, or IFG, and the latter is termed impaired glucose tolerance, or IGT. When either is present, an individual is described as having prediabetes.
There are at least two reasons why it is important to identify prediabetes. One is that people with prediabetes have a known increased risk of progression to frank Type 2 diabetes and, second, prediabetes, especially of the IGT type, is associated with a significantly higher risk of cardiovascular disease and death. Therefore, knowledge that one has prediabetes necessitates regular follow-up and also permits early intervention to prevent progression to frank diabetes.
Asok Cheriyan is specialist diabetologist and general practitioner at Al Waha Clinic, Dubai. Got a problem? Our fantastic panel of renowned experts is available to answer all your questions related to fashion, well-being, nutrition, finance and hypnotherapy. Email your queries to email@example.com.