Dr. Thrivikram. S

Before you are affected by diabetes, a condition known as pre-diabetes is experienced, which indicates that a person might develop diabetes soon. In case you have pre-diabetes, your blood sugar level will be higher than the usual, but not as much as during diabetes. The condition is called borderline diabetes. During pre-diabetes, the production of insulin hormone gets decreased. You are more likely to get heart diseases and a stroke because of pre-diabetes. 

Diagnosis There are three primary blood tests, which are used for the diagnosis of pre-diabetes: 

1. Fasting plasma glucose test
   • You should not eat anything for eight hours before this blood test.
   • Blood sugar level is considered normal when it is less than 100.
   • If your blood sugar level is between 100 and 125, you are in the pre-diabetes stage.
   • If your blood sugar level is above 125, you are diagnosed with diabetes. 
2. Oral glucose tolerance test
   • First, you need to have a fasting glucose test done and drink a sugary solution (75 gm glucose dissolve in water) after it.  After two hours, another blood test is taken. 
   • Blood sugar level is considered normal when it is lesser than 140. 
   • If your blood sugar level is between 140 and 199, you are in the pre-diabetes stage. 
   • If your blood sugar level is above 200, you are diagnosed with diabetes. 
3. Hemoglobin A1C 
   • This blood test shows the average blood sugar level for three to four months in the past. It helps to check whether pre-diabetes is in control or not. 
   • Blood sugar level is considered normal when it is 5.6%. 
   • If your blood sugar level is between 5.7% and 6.4%, you are in the pre-diabetes stage. 
   • If your blood sugar level is 6.5% or above, you are diagnosed with diabetes. 
   • The test should be redone for checking or verifying the results. 

Lifestyle changes required for managing pre-diabetes Lifestyle changes may help people in managing pre-diabetes and for preventing it from developing into diabetes. Here are some changes and habits you need to practice: 

1. Weight control: If you are obese and overweight, the pre-diabetes may turn into diabetes. Hence, losing some amount of body weight, at least 5% to 10%, makes quite a difference. 
2. Exercise: You should perform moderate exercises regularly, such as swimming, cycling or walking briskly. This helps in the management of pre-diabetes. Aerobic exercise increases the heart rate and should be carried out for better benefits. 
3. Nutrition: You must make some dietary changes as well. Consume food items, which contain low-fat protein. Eat a lot of vegetables and whole grains, limit your calorie intake and reduce the amount of sugar and starchy carbohydrates. Increase your intake of fiber-rich food. 

If you experience a rise in your blood sugar levels, you must consult a doctor immediately. With early diagnosis, you can take preventive measures and will be able to prevent pre-diabetes from developing into diabetes. In case you have a concern or query you can always consult an expert & get answers to your questions!

What is High Blood Pressure?

High blood pressure or hypertension is a condition caused when the force of the blood against the arterial walls exceeds drastically than what it normally is. A blood pressure reading exceeding 140/90 over a prolonged period of time is considered to be ‘high blood pressure’ or diagnosed as ‘hypertension’.

What is Diabetes?

Diabetes is characterized by extremely high levels of blood glucose (blood sugar) in the body, either due to the insufficient secretion of insulin by the pancreas or reduced sensitivity of the body to insulin. This makes your body unable to break down the sugars. At first glance, these two conditions seem completely unrelated, but, according to certain studies, the two conditions do have similar outcomes and could be inter-dependent.

The Connect-

According to the American Diabetes Association, the combination of hypertension and type 2 diabetes is particularly lethal and can significantly raise a person's risk of having a heart attack or stroke. Having type 2 diabetes and high blood pressure also increases your chances of developing other diabetes-related diseases, such as kidney disease, and retinopathy (eye blood vessels), which may cause blindness. There is substantial overlap between diabetes and hypertension, reflecting substantial overlap in their etiology and disease mechanisms. Genetic structure, Obesity, inflammation, oxidative stress, and insulin resistance are thought to be the common pathways. A prospective cohort study in the United States reported that type 2 diabetes mellitus was almost 2.5 times as likely to develop in subjects with hypertension as in subjects with normal blood pressure.

In the Hong Kong Cardiovascular Risk Factor Prevalence Study, only 42% of people with diabetes had normal blood pressure and only 56% of people with hypertension had normal glucose tolerance. There are many minor lifestyle changes that can lower your blood pressure and blood sugar. A brisk walk for 30 to 40 minutes every day, or any aerobic activity can make your heart healthier. In addition to lowering blood pressure and blood sugar, physical activity can strengthen the heart muscle and may reduce arterial stiffness. You may need minor modifications in your diet like, cutting out sugar salt, high-fat meats etc. You can take several servings of vegetables, low-fat dairy products, leans meats and fish or meat substitutes, fruits, whole (not processed) foods, whole-grain pastas, breads, and brown rice etc. While some people can improve their type 2 diabetes and hypertension with lifestyle changes, most require medication.

Depending on their overall health, some people may need more than one medication to reduce their risk. Consult your doctor to choose best possible medicines for your diabetes and / or blood pressure control.