But you could be pre-diabetic.

You may not have diabetes. But you could be pre-diabetic. What is this condition and how can you reverse it? A quick guide

TRY AS you might, it’s hard to be positive when your doctor says those dreaded words: “You have diabetes”. But should your doctor tell you you’re pre-diabetic, you have every reason to be positive. Because this means your blood sugar is high, but not high enough to qualify you as diabetic. And the condition is reversible – with just a few changes in your life, your blood sugar could go back to normal.

What is pre-diabetes?

First you must understand what diabetes is. Most of the food you eat is converted into glucose, or sugar, for your body to use as energy. Insulin, a hormone produced by the pancreas, helps the glucose get into the cells of your body. But when your body either doesn’t make enough insulin or cannot use its insulin effectively, the sugar builds up in the blood and, over time, harms blood vessels, the heart, the nerves, the kidneys, the eyes and feet. The damage to the blood vessels increases the risk of heart disease and strokes. This is diabetes.

If you are diagnosed as prediabetic, you are on the way to diabetes, says Dr Sandeep Kharab, endocrinologist, Asian Institute of Medical Sciences, Faridabad. Your blood glucose levels are higher than normal, but not high enough to be classified as diabetes.

But there are no screening programmes in India for the early detection of pre-diabetes. “Very often people stay in this stage for many years without detection,” says Dr A K Jhingan, diabetes expert and chairman, Delhi Diabetes Research Centre. “Symptoms develop so gradually, people often don’t recognise them. And some people have no symptoms at all. Only tests can determine if their sugar is in the normal range.”

Businessman Rajat Kashyap learned this the hard way when, after years of drinking sugary soft drinks, eating erratically and seldom exercising, he fainted at the office. A week later, he fainted again. Blood tests revealed abnormally high blood sugar and 32-year-old Kashyap was diagnosed with pre-diabetes. “I was surprised, because there was no family history at all,” says Kashyap. “I guess it happened because of my poor eating habits. I have been on medication since, and I exercise regularly.”

How do you know you’re pre-diabetic?

Awareness and early detection can put a lid on this disorder. But often, even the obvious symptoms of diabetes (increased appetite, constant thirst and high urine formation) are ignored, and the disease is usually caught at an advanced stage, when much of the damage is irreversible.

“Quite often it is accidentally caught only during tests done for other malaises. Which is why those with risk factors like obesity, high work stress, sedentary lifestyle, faulty diet and family history of diabetes must undergo an extensive health check-up at least once a year, and those without risk factors should take it once in two years,” says Dr Pradeep Gadge, consultant diabetologist at Gadge's Diabetes Centre, and Breach Candy Hospital, Mumbai. “Sometimes when all tests show normal, but there is still some doubt, a specialised test called HBA1C can tell doctors about the blood sugar levels of the last three months and give us a better picture.”

If you have a history of diabetes in your family, make sure you take blood sugar tests regularly – even if you’re under 30. Ritika Sharma, a Delhi-based media professional did not, though her mother had diabetes. Instead, she continued to indulge her sweet tooth till the day she realised that eating sweets made her restless and anxious. Sure enough, after her blood tests, she was diagnosed with pre-diabetes. “I was shocked – and immediately began working with a diet counsellor to lose the 15 kilos I had piled up after college,” says Sharma.

How to get your blood sugar back to normal

Stay near your optimum

weight: Obesity is believed to account for 80-85 per cent of the risk of developing Type 2 diabetes. “When you carry excess weight, you are more likely to develop insulin resistance, a condition in which your body is unable to use the hormone insulin to convert glucose (sugar) to energy, which results in high blood sugar levels. Being overweight also raises your risk of high blood pressure, cholesterol and triglycerides, all of which increase your pre diabetes risk even more,” explains Dr Gadge. “Losing even 5-10 kg can help reduce the risk substantially.” His advice? Get at least 150 minutes of physical activity, such as brisk walking, every week.