Understanding pre-diabetes and insulin resistance

What is pre-diabetes?

Pre-diabetes is a condition where the blood glucose levels (blood sugar) in the body are higher than normal but not high enough for a type 2 diabetes diagnosis.

Two million Australians live with pre-diabetes and have a higher risk of developing type 2 diabetes and heart disease if they don’t make healthy lifestyle changes.

Pre-diabetes has no signs or symptoms, but factors like your family or medical history, and various lifestyle elements, increase your risk of developing the condition.

You are more likely to develop pre-diabetes if:

• You have a family history of type 2 diabetes.
• You are a woman with Polycystic Ovarian Syndrome.
• You are a woman with a history of gestational diabetes.

Lifestyle risk factors for pre-diabetes include:

• being overweight
• being physically inactive
• high blood pressure
• smoking
• poor sleep
• high cholesterol.

Lifestyle risk factors for pre-diabetes can be managed with healthy changes to your lifestyle.

The science behind insulin resistance

Insulin is a hormone produced in the pancreas that balances blood glucose levels in the body.

Insulin resistance is when the body no longer responds to insulin the way it should, which results in higher blood glucose levels.

Identifying pre-diabetes early

Pre-diabetes often has no signs or symptoms, but there are diagnostic blood tests that can detect the condition. The most common is a fasting blood glucose or a non-fasting random blood glucose test. If required, a doctor may ask for an Oral Glucose Tolerance Test to find out more.

There are two types of pre-diabetes conditions that a test can identify:

1. Impaired fasting glucose. This is when blood glucose levels are higher when fasting but not high enough to be classified as diabetes.
   
   
2. Impaired glucose tolerance. This is when the blood glucose levels are higher than normal two hours after an oral glucose tolerance test, but not high enough to be classified as diabetes.

Diagnostic tests play an important role in identifying pre-diabetes early so you can manage the condition and make healthy lifestyle changes. Talk to your doctor if you suspect you may be at risk of pre-diabetes.

Lifestyle changes to manage pre-diabetes

The two biggest changes you can make to manage pre-diabetes and reduce the risk of developing type 2 diabetes is to achieve a healthy weight and increase the amount of exercise and physical activity you do.

If you’re above a healthy weight range, a loss of 5 – 10% of your body weight may help lower your blood glucose levels.

Healthy eating is another way to help manage pre-diabetes. Eat a variety of foods including vegetables, wholegrains, lean meats, low-fat dairy foods, and fruit. Choose low GI carbohydrates like breads and pasta, and limit the amount of saturated fats in your diet. Saturated fats are commonly found in fried foods, pastries, ice cream, chips, and whole-fat dairy products. If you need additional support, a dietician can help guide you towards a healthy diet.

It is recommended to do at least 30 minutes of moderate intensity physical activity, like a brisk walk or a swim, every day. Unsure where to start? An exercise physiologist can help develop an exercise plan and show you how to do all the exercises properly. Always talk to your doctor before you start any type of regular physical activity.

If you smoke, another lifestyle change to make is to quit. Smoking increases the risk of developing type 2 diabetes, which may lead to heart disease. Quitting smoking can be difficult but there’s lots of support available. Talk to your doctor about the best ways to quit smoking.

Medical interventions for pre-diabetes

Healthy lifestyle changes are the best way to manage pre-diabetes.

If you are diagnosed with pre-diabetes, your doctor may recommend that you have your blood pressure checked regularly to make sure it stays within the target range. Your doctor may also arrange for another oral glucose tolerance test within 12 months of your diagnosis.

Speak to your doctor as soon as possible if you begin to develop symptoms of diabetes.

Living with pre-diabetes

You may need to make some changes to manage pre-diabetes, but you don’t have to do it alone.

Talk to your family and friends about your condition so they understand how important it is that you make lifestyle changes and how they can best support you.

You may want to ask family and friends to help you exercise, or find ways to get active as a group. Family and friends can also support you when it comes to healthy food choices – they may want to join you and make a change, too.

Doctors, dietitians and exercise physiologists can provide additional support and advice to help you manage pre-diabetes.

The National Diabetes Services Scheme and Diabetes Australia offer a variety of support services for people living with pre-diabetes, including mental health and wellbeing resources.