Diabetes is a chronic disease that cannot be cured, but can be successfully controlled. However, it is often possible to prevent its development if the prediabetes disease, pre-diabetes, is detected in time. What is it, how is prediabetes manifested and treated?

1. Prediabetes - symptoms,
indicators, can it be cured
 Diabetes is a chronic disease that cannot be cured,
but can be successfully controlled. However, it is
often possible to prevent its development if the pre-
diabetes disease, pre-diabetes, is detected in time.
What is it, how is prediabetes manifested and
treated?

2. Disease Definition
 Prediabetes is a disorder of carbohydrate metabolism in
which the level of sugar in the blood rises. It already
exceeds normal levels, but is not yet so high that we can
talk about the development of diabetes. For many years,
prediabetes was considered an intermediate state
between normal and type 2 diabetes. Recently, it has
come to be considered an independent disease that
precedes type 2 diabetes.
 According to the results of a large-scale all-Russian study,
every fifth Russian has prediabetes 1 . Unfortunately, many
people do not know that pathological changes occur in
their body and, in particular, in carbohydrate metabolism.
Violations affect primarily the system that controls blood
glucose levels.

3. In healthy people, sugar levels are controlled by
several hormones, most notably insulin, which is
synthesized by pancreatic beta cells . In pre-
diabetes, due to insufficient production of insulin
and / or a decrease in sensitivity to it, the body does
not respond to the hormone properly.
Glucose cannot fully penetrate the cells to be a
source of energy, and accumulates in the
bloodstream. This leads to a change in blood sugar
levels - blood glucose and glycated hemoglobin
levels. They exceed the established norms, but do
not reach the values corresponding to diabetes .

4. Causes and risk factors for
prediabetes
 The exact cause of the disease is unknown. However, several
factors have been identified that may play an important role
in its development. Consider the leading risk factors that
contribute to the onset of the disease.
 Excess body weight is considered one of the leading risk
factors. The higher the body weight, the lower the tissue
sensitivity to insulin. Especially dangerous is abdominal obesity,
in which excess fat is concentrated in the abdomen. With
abdominal obesity, along with an increase in the body mass
index, the waist circumference increases by more than 94 cm
in men and 80 cm in women.
 Unbalanced Diet: It is known that the risk of prediabetes is
increased if the diet is rich in red and processed meat, sugar-
sweetened drinks. But if the menu is dominated by fruits,
vegetables, nuts, whole grains, olive oil, the risk of
carbohydrate metabolism disorders is reduced .

5. Lack of physical activity - an active lifestyle
regularly uses glucose as a source of energy,
and the sensitivity of tissues to insulin increases.
Family history of diabetes mellitus - the likelihood
of developing prediabetes increases if there is a
history of diabetes in the family.
Age - the risk of developing prediabetes
increases after age 45, which may be due to
age-related decline in physical activity, a
decrease in muscle mass and an increase in
body weight. However, prediabetes can occur
at any age.

6. Diabetes mellitus during pregnancy (gestational)
can be transient and resolve after childbirth.
However, a history of gestational diabetes or having
a baby weighing more than 4.1 kg increases the
chance of developing prediabetes in the future.
Polycystic ovary syndrome is an endocrinological
disease in which the functioning of the ovaries is
disrupted. This leads to irregular or absent ovulation,
increased production of male sex hormones
(androgens), increased insulin synthesis, and other
endocrine changes.
.

7. In addition, with this disease, the likelihood of
developing prediabetes 2-4 increases .
Obstructive sleep apnea syndrome, in which
there are frequent pauses in breathing during
sleep. Typically, obstructive sleep apnea is
accompanied by loud snoring.

8. Symptoms of the disease
 A feature of prediabetes is the absence of clear clinical
symptoms. Organs and tissues in this disease, unlike
diabetes, are still well supplied with energy, so a person
usually feels good.
 Rarely, prediabetes can cause symptoms that indicate
a health problem, such as :
 decrease in working capacity;
 increased fatigue;
 prolonged wound healing.
 It is not uncommon for people with prediabetes to be
overweight, have hypertension, or have heart disease.
Prediabetes also often occurs in association with non-
alcoholic fatty liver disease, gouty arthritis.

9. Diagnostics
 Since there are no specific signs of prediabetes, it is
very important for those at high risk to have their blood
glucose levels checked regularly.
 Current guidelines suggest that people over the age of
45 should have their blood sugar checked at least
every three years.
 It is necessary to be examined annually for those who:
 is obese;
 has a family history of diabetes (parents, siblings);
 physically inactive or inactive;

10. according to the results of previous
studies, has an increased level of
sugar;
suffers from impaired lipid metabolism -
the level of high-density lipoproteins
(“good cholesterol”) is less than 0.9
mmol / l and / or triglycerides more
than 2.8 mmol / l;
suffers from polycystic ovary syndrome,
non-alcoholic fatty liver disease,
arterial hypertension, acanthosis
nigricans.

11. Indicators of carbohydrate
metabolism in prediabetes
 The diagnosis of prediabetes is established with
the following blood sugar level of:
 glycated hemoglobin - 6-6.4% (normal <6%);
 fasting plasma glucose - ≥5.6 and <6.0 mmol / l
(norm <5.6);
 oral glucose tolerance test (glucose tolerance
test, 2 hours after taking glucose) - ≥7.8 and <11.1
mmol / l (norm <7.8).

12. Prediabetes treatment
 Each year, 11% of people with prediabetes develop
type 2 diabetes. In addition, prediabetes increases
the likelihood of developing cardiovascular disease,
increases the risk of damage to the nerves
(neuropathy), eyes (retinopathy), kidneys
(nephropathy) 6 . Consider what to do to prevent
complications, prevent the development of
diabetes and normalize blood glucose levels.
 Adjust your diet A pre-diabetic diet
 should be rich in fruits, vegetables, and whole grains.
The fat content in the diet should be reduced.
 Be physically active

13.  Moderate exercise 30-60 minutes per day most days of the
week (at least 150 minutes per week) is required to
maintain normal physical activity.
 Monitor body weight
 With increased body weight (body mass index over 25
kg/m2), it is necessary to take measures to reduce weight,
primarily through a balanced low-calorie diet and
increased physical activity.
 Stop smoking
 Take antidiabetic drugs if prescribed by a doctor.
 Compliance with all the doctor's recommendations,
lifestyle changes can normalize carbohydrate metabolism
and prevent the transition of potentially curable
prediabetes into a chronic disease, diabetes mellitus.