Borderline Diabetes

Borderline diabetes is also called “prediabetes”. It means that your blood glucose levels are higher than they are in normal people but are not high enough to be considered as having type 2 diabetes.  Prediabetes is a risk factor for developing type 2 diabetes within the next ten years.  If you suffer from borderline diabetes, the complications of diabetes may already be beginning even though you don’t actually have diabetes yet.

Just because you have prediabetes doesn’t mean you will inevitably get diabetes.  If you change your lifestyle and incorporate a healthy diet along with an increase in exercise as part of your new lifestyle, you may be able to lose some weight so that the blood sugar levels return to normal and you won’t have diabetes.

Signs and Symptoms of Borderline Diabetes

Most of the time, there are no symptoms with prediabetes.  If you have a condition known as acanthosis nigricans, however, it could mean you will develop type 2 diabetes.   Acanthosis nigricans involves having areas of dark skin on the armpits, knuckles, knees, and neck.

If the borderline diabetes has turned into type 2 diabetes, you may experience increased thirst, tiredness, increased urination, and blurry vision, which are typical signs of an elevated blood sugar condition.

Causes of Borderline Diabetes

No one knows what causes borderline diabetes but it appears to be partially hereditary.  There have been some genes identified that lead to insulin resistance, which is the underlying problem in type 2 diabetes.  Being inactive or having excessive fat around the abdomen also increase the chances of your having borderline diabetes.  The underlying cause is insulin resistance, which means that the insulin cannot put glucose into the cells to be used for the production of cellular energy.

You get sugar in your body from eating carbohydrates.  Any carbohydrate-containing food can cause elevations in blood sugar, even foods that you don’t consider to be sweet.  Sugar goes into the blood and enters the cells with the help of insulin.  Insulin is made by the pancreas and normally does a good job of putting glucose into the cells.  In borderline diabetes, the insulin can’t do its job so the blood sugar rises.

Risk Factors for Borderline Diabetes

The risk factors for borderline diabetes are the same ones that put you at risk for having type 2 diabetes.  They include the following:

• Excess weight. Being obese or overweight can increase your risk of having prediabetes. The more fat that is on your body, especially around the abdomen, the more resistant are your cells to insulin.
• Decreased activity. The less active you are and the less exercise you get, the greater is the chance you can develop borderline diabetes.  If you are physically active, your weight is usually more likely to be normal so you won’t have borderline diabetes.
• Waist size. If you are a man with a waist size of 40 inches or more or a woman with a waist size of 35 inches or more, you have a greater chance of having insulin resistance.
• Family history. If you have a first degree relative with diabetes type 2, you have an increased chance of having borderline diabetes.
• Age. You can develop prediabetes at any age but the risk goes up as you age.  People over the age of 45 are more likely to develop prediabetes because they have less muscle mass and more weight on their bodies.
• Race. People who are American Indians, Pacific Islanders, African Americans, Hispanics, or Asian have a greater chance of having borderline diabetes.
• Polycystic ovarian syndrome. Women with polycystic ovaries have a greater incidence of prediabetes.  They also have an increased risk of obesity, excess hair growth, and irregular periods.
• Gestational diabetes. If you had gestational diabetes during pregnancy, you have a greater chance of having borderline diabetes and type 2 diabetes later in life.
• Sleep issues. If you have obstructive sleep apnea, you have a greater chance of having insulin resistance.  The same is true of people who do shift work that involves working at night and sleeping during the day.

Complications of Borderline Diabetes

The most common complication of borderline diabetes is type 2 diabetes.  This increases your risk of developing strokes, heart disease, amputations, blindness, kidney disease, elevated cholesterol levels and hypertension (high blood pressure).

Tests for Borderline Diabetes

According to the American Diabetes Association, you should have a fasting blood sugar checked on a regular basis once you reach 45 years of age.  If you are overweight or have a family history, you should be tested for borderline diabetes at an earlier age.  Reasons you might want to be tested earlier in life for borderline diabetes include the following:

• Having a positive family history for type 2 diabetes
• Having no exercise
• Being of a race that has a high incidence of type 2 diabetes
• Having gestational diabetes
• Having a baby that weights more than 9 pounds at birth
• Having elevated cholesterol levels
• Having high blood pressure
• Having polycystic ovarian syndrome

Testing for borderline diabetes can mean having a fasting blood sugar that is between 100 and 125 mg/dL or having a hemoglobin A1c level, which is a measure of how much sugar is on your red blood cells.  A normal hemoglobin A1c is 5.7 percent.  If your hemoglobin A1c is between 5.7 and 6.4, it means that you have prediabetes.  Any level greater than 6.4 percent means you have type 2 diabetes.

You can also have an oral glucose tolerance test to diagnose borderline diabetes mellitus.  In this test, you are given a sweet beverage to drink and your blood sugar is checked before drinking the solution as well as at 1-3 hours after drinking the solution. Elevated blood sugar levels on any of these readings means that you have borderline diabetes or type 2 diabetes.  Any blood sugar level between 140 and 199 mg/dL indicates borderline diabetes or impaired glucose tolerance.

Treatment for Borderline Diabetes

For those who find out they have prediabetes, the best option is to begin lifestyle changes that help you decrease your weight and bring your blood sugars down.  Some things you might want to do is eat foods that are low in calories, fat, and simple carbohydrates and that are high in fiber.  This means eating a lot of whole grains, fruits, and vegetables.  You can also begin an exercise program that involves at least 30 minutes of exercise at least 4 days per week.   Losing weight will go a long way toward decreasing the chances that borderline diabetes will turn into type 2 diabetes.

References:

Prediabetes. http://www.mayoclinic.org/diseases-conditions/prediabetes/basics/definition/con-20024420.  Accessed 5/11/16.