Do You Have Prediabetes?

According to the World Health Organization, 347 million people have diabetes worldwide, and more than 80% of deaths caused by the disease occur in low- and middle-income countries. However, early detection of prediabetes, along with lifestyle and diet changes can help patients prevent the onset of type 2 diabetes. Diagnosis and treatment of prediabetes can help ward off other complications of type 2 diabetes, such as heart and blood vessel, kidney and eye diseases.

You may be more familiar with the diagnosis of diabetes, which means there is too much glucose (sugar) in your blood. However, prediabetes, also known as “borderline diabetes” is a health condition where a patient’s glucose level is too high to be considered normal, but not high enough to indicate diabetes. Those with prediabetes rarely experience symptoms, but are at higher risk for heart disease.

“You might be prediabetic for years and not convert to diabetic,” said Dr. Patrick Evivie, who specializes in internal medicine and diabetic management. The goal is to make “lifestyle changes—exercise and diet, lose 10-20 pounds of body weight; do moderate exercise, 30 minutes of brisk walking five days per week and watch your diet.”

When a general physical or check-up is given, we check the blood sugar, which is how prediabetes is tested, said Evivie, MD, who is a member of the Association of Nigerian Physicians in the Americas.

There are three blood tests that detect prediabetes:

• hemoglobin A1c, measures blood sugar over two to three months
• fasting blood glucose, requires overnight fasting for eight hours
• Oral glucose tolerance test (OGTT), requires one blood test after fasting, then after drinking a glucose liquid, the blood test is performed two hours later

Test results for the A1c measuring 5.7% to 6.4% indicate prediabetes. When a fasting blood glucose test is given, blood sugar levels above 100 milligrams per deciliter (mg/dl), but below 126 mg/dl, is considered prediabetic. When the test registers 126 mg/dl or more, it indicates diabetes. If the OGTT test results in 140 to 199 mg/dl, then you are prediabetic.

It is much better to manage prediabetes than to allow your health status to change to diabetic.

“The complications of being diabetic are huge,” said Evivie. “Type 2 [diabetes] is the most prevalent type. It is the leading cause of blindness in this country; the leading cause of kidney failure, and the leading cause of nontraumatic amputation—not caused by trauma.”

Diabetes also brings Western culture health challenges to Nigeria.

“Diabetes is one of the leading causes of heart disease,” said Dr. Michael Etomi, who specializes in internal medicine, and is president of the Association of Nigerian Physician in the Americas. “It could result in heart attack and stroke. Stroke is already prevalent in Nigeria. It is called double jeopardy because we have infectious disease and we are also importing Western diseases, like cardiovascular disease.”

Etomi and Evivie made several observations and recommendations to prevent the onset of diabetes:

• Know your family history. “It is so critical,” said Evivie. “Your chance of being diabetic is higher than the general population [if your family has a history of diabetes]. If you were pregnant and had gestational diabetes that increases your risk of being diabetic down the road.”
• You need to have a regular physical, at least once per year. “It will include checking your blood pressure, your cholesterol if you’re over 25, and also your blood sugar,” said Evivie.
• Nigerian Diet. “Traditional Nigerian families eat meals at a specific time of the day, proportionate with carbs, protein and fat,” said Etomi, who specializes in internal medicine. “We ate the complex carbohydrates and rich in fiber—yams, cassava, coco yams. We ate a lot of fish, snails, and forms of protein. We’ve moved away to a lot ofprocessed foods with the nutrients removed. We are losing some of the traditional complex carbohydrate foods.”
• Exercise. “In this generation and the next one, we are moving too fast and eating poor food choices,” said Etomi. “Forefathers walked to their farms. You rarely saw people over weight. Not only do we have a shift to poor diet choices, you have less exercise. As we begin to have lots of children who have changes in their diet and exercise, it reduces the lifespan of people for up to 20-30 years. We already have diseases like malaria. Now, we are having chronic diseases. It has taken away the lives of people who could contribute so much to the country.”