Borderline diabetes and prediabetes are one and the same and the former is used informally. It is a condition that can develop before type 2 diabetes but not all people suffering from it will get diabetes. To put it in simple words, prediabetes is a health condition where your blood sugar levels are higher than normal but not enough to be diagnosed as type 2 diabetes. The good thing is that it is very much reversible and all you have to do is to introduce some healthy lifestyle changes to your life and stick to them to avoid the metabolic disease. (Also read: Diabetes: Bedtime rituals that can help manage blood sugar)
Diabetes is a chronic medical condition in which the body is unable to properly use and store glucose which is body’s main source of energy. Type 2 diabetes is caused by a combination of genetic and environmental factors, and is characterised by insulin resistance or an inability to produce enough insulin to manage blood sugar levels. Prediabetes or borderline diabetes is usually asymptomatic and you could have it for years without even knowing it. It can increase your changes of having type 2 diabetes, heart disease and stroke. If you have risk factors for diabetes, a regular health-check-up is a must to diagnose prediabetes.
“Pre-diabetes sometimes referred to as ‘borderline diabetes’, is a condition which can develop before type 2 diabetes and increases one’s risk of developing type 2 diabetes. Therefore, it can be considered as a precursor of type 2 diabetes. Although the term borderline diabetes is not used in scientific literature. Fortunately, the progression of pre-diabetes to diabetes is not inevitable. Many people, according to research, can stop the progression of borderline diabetes to type 2 diabetes and even return to normal by making changes to their lifestyle. Maintaining a healthy weight, engaging in regular physical activity, and consuming nutritious foods can assist in maintaining normal blood sugar levels,” says Dr. Ranjit Unnikrishnan- Vice-Chairman, Dr. Mohan’s Diabetes Specialities Centre.
What exactly is borderline diabetes?
“Borderline diabetes is a condition in which blood sugar levels are higher than normal but not high enough to be classified as diabetes. For instance, if your fasting blood glucose level is greater than or equal to 126 mg/dl, you are considered to have diabetes, while you are considered normal if your fasting blood glucose is below 100 mg/dl. Therefore, you may have borderline diabetes if your fasting blood sugar is 120 mg/dl,” says Dr. V. Mohan – Chairman and Chief Diabetologist, Dr. Mohan’s Diabetes Specialities Centre.
What symptoms may be present
Dr V. Mohan says borderline diabetes is only diagnosed through a blood test, and the vast majority of the time, there are no symptoms.
The diabetologist says if the condition progresses to overt diabetes, one may experience diabetes-related symptoms such as:
• Frequent urination
• Increased thirst
• Increase in hunger
• Blurred vision
• Numbness or tingling in the feet or hands
• Delay in wound healing
Why should borderline diabetes be a cause for concern?
Dr Mohan says borderline diabetes is a warning sign that you may develop type 2 diabetes, a more serious condition, in the future. Approximately a third of people with borderline diabetes progress to diabetes, and this progression is faster and more likely among Indians. Also, if you have borderline diabetes, you are more likely to get cardiovascular disease (heart and blood vessel disease), especially if you have other risk factors like high cholesterol, high blood pressure and smoking.
How is borderline diabetes diagnosed?
For borderline diabetes to be diagnosed, a blood glucose test is necessary. It is possible to perform a fasting blood glucose test, a glucose tolerance test, or an HbA1c test. To confirm the diagnosis, the test may need to be repeated multiple times.
Who should go for these tests?
If you have risk factors for diabetes, you should think about having yourself tested. These include
– Being overweight or obese
– Being older
– Having diabetes in the family
– Having had diabetes during pregnancy or given birth to a large child.
“The Indian Diabetes Risk Score (IDRS) is a useful tool for determining a person’s likelihood of developing diabetes. The risk score is calculated by answering four questions and taking a waist measurement with an inch tape. You should have a blood test to determine whether you have diabetes or borderline diabetes if your scores are 60 or higher,” says Dr Mohan.
How can borderline diabetes be managed?
No matter how likely diabetes is in your family, adopting a healthy lifestyle can lower your pre-diabetes risk. It also has the potential to aid in reversing borderline diabetes back to normal and slowing down the progression.
Lifestyle changes to reverse borderline diabetes
Dietician Umasakthy suggests some healthy lifestyle changes to reverse prediabetes.
• Consume nutritious foods
• Maintain regular physical activity
• Begin a weight loss programme if overweight
“It has been demonstrated that losing as little as 5% of one’s body weight can reduce the risk of development of diabetes from borderline diabetes. In a similar vein, reducing carbohydrate intake, increasing protein intake, and switching to healthy fats can assist in returning borderline diabetes to its normal state. Medication may also help in some cases. You can talk to your diabetologist for help,” says Umasakthy.