It’s a condition that affects millions but causes no symptoms. Most of its sufferers will feel and look absolutely fine. Yet it is a precursor to type 2 diabetes, one of the world’s leading causes of death and disability.
It’s called prediabetes, characterized by elevated blood sugar that’s dangerously close to, but not quite in, the diabetes range. And this is a problem that no one can afford to ignore.
People with prediabetes are thought to be ten to 15 times more likely to develop type 2 diabetes in their lifetime. The charity Diabetes UK estimates that around 13.5 million people are in this category – a quarter of all adults in this country. That’s why within the decade, one in ten British adults is predicted to have type 2 diabetes, a disease the NHS already spends £10bn treating each year – or ten per cent of its entire budget.
Professor Naveed Sattar, an expert in metabolic health, pictured, said long-term uncontrolled high blood sugar wreaks havoc throughout the body, increasing the risk of blindness, kidney failure and erectile dysfunction
People with prediabetes are thought to be ten to 15 times more likely to develop type 2 diabetes in their lifetime
It is no longer just a disease of middle or older age. The latest figures show that 122,000 people in England with type 2 diabetes are under the age of 40. And these younger patients are at significantly higher risk of adverse health outcomes. For many, this means a lifetime of medication, and even for treatment, there are no guarantees. Long-term uncontrolled high blood sugar destroys the entire body, increasing the risk of blindness, kidney failure and erectile dysfunction. It stops wounds from healing properly, leading to chronic infections and amputations. And people with type 2 diabetes are much more likely to suffer heart attacks, strokes and dementia.
Prediabetes isn’t just a precursor to problems—it carries its own health risks. Studies show that those with blood sugar levels in the pre-diabetic range are more likely to suffer heart attacks and strokes than the average person. Some even experience eye or kidney damage, according to recent research by scientists at Imperial College London. This may be related to excess fat rather than blood sugar levels.
But in short, you don’t want to get either condition. And the good news is, you don’t have to.
It is becoming increasingly clear that by detecting prediabetes and taking steps to protect future health, it is possible to prevent the disease before it occurs.
And it doesn’t involve drugs, surgery, or expensive treatment—just a few lifestyle changes that anyone can make with a little courage and determination.
The big questions are: what exactly is prediabetes, how do you know if you have it, and what should you do if you do?
As Professor of Metabolic Medicine at the University of Glasgow, I have spent decades treating and studying these conditions. And today, in The Mail on Sunday, we outline the latest scientific evidence on pre-diabetes and everything you need to know about how to beat it.
To make it simple, we’ve come up with a five-point plan for dealing with prediabetes that anyone can do.
If you’re overweight—especially if your body mass index (BMI) is 30 or more—you’re at greater risk. This is well known. But the latest evidence suggests that when it comes to pre-diabetes, it’s not just how much fat you have, but where in the body it’s located.
If you’re overweight—especially if your body mass index (BMI) is 30 or more—you’re at greater risk. This is well known. But the latest evidence suggests that when it comes to prediabetes, it’s not just how much fat you have, it’s where in the body it’s located.
Some people are genetically predisposed to store excess fat more quickly in the liver and other organs. This so-called ectopic fat is a big risk factor. But as we’ll explain, genetics doesn’t mean our fate is sealed. Losing weight or changing the way we eat can have a radical impact on high blood sugar. This is advice that many of us can afford to listen to.
Even entering the Covid pandemic, 63 per cent of adults in England were overweight or obese. And the past few years haven’t helped. Around 40 per cent of us put on an average of half a stone during the lockdown, according to one study.
The latest figures show that 122,000 people in England with type 2 diabetes are under the age of 40. And these younger patients are at significantly higher risk of adverse health outcomes
I emphasize, this is average. A patient came to my clinic who had put on a 3 since I last saw him in 2020. He had stopped commuting and was working from home. Instead of taking 10,000 steps a day—which he did and burning about 400 calories—he just sat. Most importantly, he ate the same amount.
You don’t have to be that overweight to develop prediabetes: on average, people with the condition are between half a stone and a stone and a half heavier than people with ideal blood sugar levels. On average, however, people with prediabetes need to gain a few more pounds before they progress to full-blown diabetes.
You don’t have to be that overweight to develop prediabetes: on average, people with the condition are between half a stone and a stone and a half heavier than people with ideal blood sugar levels
And that’s what gives us such an ideal opportunity to do something about it before it becomes a problem. And it doesn’t have to be that hard. Despite what you may have heard, experts agree that you don’t have to go on a crash diet, live on meal replacement shakes or cut out carbs to make a difference.
I am Asian and have a family history of diabetes which means I am at a significantly higher risk.
I do little things to keep my weight off. I always have a salad with my dinner as being full means I will eat less carbs or meat. I trained myself to stop taking sugar in my tea and only eat one KitKat finger. It means I really taste it and enjoy it a lot more. It’s a pleasure, not just something I mindlessly consume.
Each of us can make a few simple, sustainable changes. And I’m not exaggerating when I say they can be life-changing.
My research found that people with prediabetes can also have high blood pressure. They may also have high levels of triglycerides in the blood – fatty deposits that are linked to heart disease
My research found that people with prediabetes can also have high blood pressure. They may also have high levels of triglycerides in the blood – fatty deposits that are linked to heart disease.
By preventing these things by keeping your weight low, you will live a longer and healthier life.
Type 2 diabetes is not inevitable. I like to look at pre-diabetes, as serious as it is, as a positive thing: finding it gives us a chance to take control and avoid the worst.
Read on to find out how…
Pre-diabetes: what it is – and how to know if you’re one of the thirteen million at risk
Diabetes does not develop overnight. It starts with very subtle “communication problems” in the body’s cells and can take years to seriously affect your health. And that gives us plenty of time to do something about it.
But it’s vital to find out if you may be at risk and how the problem develops.
Type 2 diabetes begins life as prediabetes, when blood sugar is abnormally high, and without lifestyle changes, full-blown disease can strike. In prediabetes, the hormone insulin, which transports sugars from food into our blood where it is used for energy, does not work as it should. The sugar stays in the blood, raising its levels to higher than normal, but not high enough to develop type 2 diabetes or cause obvious symptoms.
Which begs the question: if there are no symptoms, how do you know if you’re at risk?
It is becoming increasingly clear that by detecting prediabetes and taking steps to protect future health, it is possible to prevent the disease before it occurs. And it doesn’t involve drugs, surgery or expensive treatments – just a few lifestyle changes that anyone can make with a little courage and determination
First, it’s worth looking at the free online questionnaire on the Diabetes UK website (diabetes.co.uk), which analyzes your personal risk of diabetes, taking into account everything from family history and ethnicity to weight and diet. The results will give you an idea of whether prediabetes is something to worry about now or in the future.
And if it’s a concern, your GP can arrange a blood test, which we’ll explain in more detail later.
But what is crucial is to be aware of the most important factors that may already be putting you at risk. Here’s how to know if your blood sugar levels are likely to reach the danger zone, and what you can do about it.
Check your weight – and your waistline
The biggest risk factor for prediabetes is excess body fat.
Research shows that fat accumulation around or in organs can affect the way cells in the body respond to insulin, disrupting blood sugar control. Checking your body mass index or BMI gives a good indication of whether this may be happening.
People living with obesity—that is, those who have a BMI of 30 or more—are up to 80 times more likely to develop diabetes than those with a healthy BMI of less than 22, according to studies. A BMI calculator is available on the NHS website. Anything over 25 is considered overweight.
Waist size is also a good indicator of diabetes risk because it is a sign of excess fat near or in organs such as the liver. This type of fat – known as ectopic fat – significantly impairs insulin function.
Men should have a waist circumference of less than 37 inches, while women should keep…
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