Obesity, the technical word for being ‘fat’ is defined as a BMI of 25 or more for people of Indian subcontinent and it increase not only your chance of prediabetes, diabetes and metabolic syndrome but also death from all causes (health risks of obesity)
What is common among all of these conditions is the phenomenon of ‘insulin resistance’ in which the carbohydrate and fat metabolism mechanisms in the body are deranged
Insulin is a hormone made in the pancreas, an organ located behind the stomach. Insulin plays a major role in metabolism—the way the body uses digested food for energy. With the help of insulin, cells throughout the body absorb glucose and use it for energy
Insulin resistance is a metabolic disorder in which the body produces insulin but does not use it effectively. When people have insulin resistance, glucose builds up in the blood instead of being absorbed by the cells, leading to type 2 diabetes or prediabetes
Metabolic syndrome, also called insulin resistance syndrome, is a group of traits and medical conditions linked to overweight and obesity that puts people at risk for both cardiovascular diseases (CVD) and type 2 diabetes
People with metabolic syndrome
So, how do you get to know whether you have prediabetes, metabolic syndrome or diabetes?
The gold standard test to diagnose these conditions is Fasting Blood Glucose( FBG)
Fasting blood value of <110 mg/dL as defined by WHO (or <100 as defined by ADA/AACE) is normal.
A Fasting Blood Glucose (FBG) value of 126 mg/dL or more is diagnostic of diabetes, although a repeat FBG or HbA1c test is needed to confirm this diagnosis
IFG (Impaired Fasting Glucose) type of prediabetes
But if your FBG lies between 110 and 125 (or 100 and 125 as per ADA), you, most likely, have IFG/ prediabetes. To confirm that you have prediabetes, you need to have one of the two additional tests: Oral Glucose Tolerance Test (OGTT) or HbA1c
IGT (Impaired Glucose Tolerance) type of prediabetes
If your 2 hour blood glucose level in OGTT (with ingestion of 75gm load of sugar) is between 140 and 199 mg/dL, you have IGT (Impaired glucose Tolerance) type of prediabetes, if it is more than 200, you have diabetes. If however, this level is lower than 140 mg/dl, you have IFG (Impaired Fasting Glucose)
The risk of a person with IGT getting diabetes is six times higher and with both IFG and IGT is 12 times higher than a person with normal levels
Glycosylated hemoglobin or HbA1c
HbA1c can also be used for screening for diabetes or prediabetes. But to confirm the diagnosis blood sugar levels FBG and PP (Post Prandial/post meal) Blood Sugar are needed. Also, in certain conditions use of HbA1c may not be warranted (To know more: go to: ‘HbA1c in diagnosis and management of diabetes‘)
HbA1c level of 6.5% or more is diagnostic of diabetes, HbA1c less than 6% (or 5.7% as per ADA) is considered normal, whereas values between 6 and 6.5% are suggestive of prediabetes
Metabolic syndrome
Metabolic syndrome is defined for Indians as the presence of any three of the following:
So, what should you do if you get diagnosed with prediabetes or metabolic syndrome: the answer is lifestyle modification for prediabetes management
CHECK OUT: Our references for recommendations on weight management