Prediabet – the borderline between diabetes and normal digestion of sugar which is characterized by decrease in production of insulin and/or reduction of a susceptibility to insulin of cages of an organism. The main symptoms – thirst strengthening, frequent desires to an urination, sharp weight reduction, spasms at night, sleeplessness, heat inflows, migraine, a skin itch. The diagnosis of a prediabet is established according to blood tests on glycohemoglobin, sugar level on an empty stomach and after carbohydrate loading. Treatment is based on observance of a low-carbohydrate diet and increase in physical activity, reception of hypoglycemic medicines is in addition appointed.
Diabetes is one of the most widespread endocrinological diseases. At its untimely diagnostics and the wrong treatment there is a high risk of an invalidization, a lethal outcome. A key sign of approach of a disease is increase in concentration of sugar in a blood-groove above the established norms right after acceptance of food. In such cases doctors expose the diagnosis of a prediabet (prediabetes, latent diabetes). This state belongs to boundary – the pathological mechanism is not fixed yet, it is possible to warn diabetes by means of correction of food and physical activity. According to statistical data of researchers from the USA, about 30-40% of people are in a condition of prediabetes. Pathology with an identical frequency is diagnosed for children and adults, for women and men.
Reasons of a prediabet
Violation is caused by a combination of several factors which are subdivided on unchangeable and controllable. The first group of factors is connected with heredity, an ethnic origin, the second – with a way of life, associated diseases. Persons at whom two and more factors come to light enter into risk group on development of diabetes of the second type. Distinguish from the most studied reasons of prediabetes:
- Excess weight. Fatty tissue reduces sensitivity of cages to insulin owing to what digestion of sugar is slowed down. The probability of a prediabet increases at people with IMT more than 25.
- Hypodynamia. The lack of physical activity negatively affects work of the majority of systems of an organism, including endocrine. Level of functioning of a pancreas decreases.
- Improper feeding. Leads consumption of a large amount of the refined sugar to development of a prediabetic state. The organism does not manage to develop enough enzymes and hormones for digestion of carbohydrates.
- Somatic diseases. Violations of digestion of sugar arise at autoimmune diseases, pathologies of endocrine system, chronic diseases of heart, vessels, a liver and kidneys. Often the diagnosis is confirmed at patients with an arterial hypertension, polikistozy ovaries.
- Drug intake. Reception of diabetogenny means can become the reason of frustration. Such medicines are hormonal medicines, in particular – corticosteroids and contraceptives.
- Pregnancy. Gestational diabetes increases probability of development of a hyperglycemia after meal. Also the women bearing a fruit weighing more than 4 kg treat risk group.
- Hereditary otyagoshchennost. Family cases of SD are found in persons with violations of tolerance to glucose. Preventive inspections for the purpose of detection of predisposition are recommended to close relatives of patients.
- Ethnic predisposition. Inhabitants of America and Asia are more subject to diabetes. Prediabet is found in indigenous Americans, the Afro-Americans, Latin Americans, inhabitants Central and Southeast Asia more often.
Insulin – the hormone produced by a pancreas. It provides intake of sugar from blood in various cages of an organism which receive energy from carbohydrates. At healthy people absorption of glucose from a stomach in blood stimulates insulin secretion. Glucose is absorbed by fabrics, its level in plasma decreases in a couple of hours after receipt of food in a stomach. By this time indicators make up to 7,8 mmol/l. At patients with diabetes sugar in blood does not decrease to norm, and there are equal 11,1 mmol/l and above. Values 7,9-11 are intermediate, indicate prediabetes. Violations of process of digestion of glucose cages are the cornerstone two mechanisms – insulin secretion reduction by gland and decrease in sensitivity (increase in resistance) of fabrics to effect of hormone. In both cases there is a condition of a prediabet which is not shown clinically, but can be revealed during laboratory diagnostics.
Symptoms of a prediabet
In most cases this frustration proceeds asymptomatically. It is possible to find violation incidentally by results of laboratory researches. Sometimes the symptoms characteristic of early stages of diabetes develop, but they have less expressed and irregular character. The phenomena of a furunkulez, bleeding of gums, periodontosis and shaking of teeth are possible. The skin and genital itch, dryness of skin, long healing of wounds and grazes, failures of a menstrual cycle, , sexual weakness is found.
Changes of exchange of glucose provoke an imbalance of the majority of hormonal functions of an organism therefore changes of appetite, thermal control, the mode of a dream, mood are noted. Sleeplessness, frequent awakenings at night, heat inflows is characteristic. Sugar condenses blood, it passes on vessels, especially worse on small capillary networks therefore there are violations of sight, head and extremities pains. The organism needs more liquid for blood fluidifying – the feeling of thirst amplifies, urination frequency increases. At the glucose level of 5,5-6 mmol/l this symptom disappears.
Lack of control over the level of sugar leads to formation of diabetes. According to data of World Health Organization, about 2 million people annually die of this disease and its complications in the world. In the absence of the correct treatment the risk of a nephropathy, a retinopathy, a hypoglycemia, ketoacidosis, trophic ulcers, diabetic gangrene with the subsequent amputation of extremities increases. Diabetes promotes formation of malignant neoplaziya, sight loss, development of a stroke and myocardial infarction, formation and aggravation of a renal failure.
Identification of a prediabet is complicated because of weak expressiveness or total absence of clinical signs. Diagnostics is carried out by the doctor-endocrinologist. At the initial stage the patient's survey is conducted – the expert specifies features of a way of life of the patient, existence of a hypodynamia, overeating, the accompanying somatic diseases, a hereditary otyagoshchennost on SD. At detection of characteristic complaints there is a question of differentiation of a prediabetichesky state and actually diseases. Key diagnostic methods are three laboratory tests:
- Glucose on an empty stomach. Sugar of capillary or blue blood after the hunger period is measured not less than 8 hours. For blood normal values (in mmol/l) make of a vein 3,5-5,5, at a prediabeta – 5,6-6,9, at diabetes – from 7,0.
- Glyukozotolerantny test. Two measurements of level of sugar of blood are made: in 8-12 hours of hunger and in 2 hours after loading carbohydrates. Indicators of the second test normal do not exceed 7,8 mmol/l, in borderline – 7,9-11 mmol/l, at SD raise to 11,1 mmol/l or more.
- Glikirovanny hemoglobin (HbA1C). The approximate average value of sugar for the last three months is investigated. Target values make no more than 6,5%, boundary and pathological – 6,6% and above.
Treatment of a prediabet
Change of a way of life of patients is the cornerstone of therapy. The most productive measures are observance of healthy nutrition, moderate, but regular physical activity. Treatment is performed by the endocrinologist, the nutritionist, the physical culture instructor. Despite efforts of experts, efficiency of medical actions more is defined by motivation of the patient. Enter the therapeutic program:
- Diet. Rules of food are discussed with the patient individually. Doctors recommend to reduce the volume of portions, to eat food at least 4-5 times a day. Products with the high content of light carbohydrates – sweets and drinks on the basis of sugar are excluded from the menu. The diet is formed taking into account the products given about a glycemic index, the content of fats. Day caloric content is reduced. Preference is given to the low-fat food containing cellulose and proteins – to vegetables, mushrooms, fish, seafood, meat without fat, to eggs, milk, cheese. From ways of preparation the parovareniye and roasting are the most useful. The particular emphasis is placed on the moderate use of salt and observance of the drinking mode.
- Physical activities. Gradual increase in activity is shown. The system allowing to increase moderately the heart rate, to strengthen a blood-groove in vessels, to stimulate process of aerobic oxidation of fats, a glycogen, glucose is developed. Such occupations improve a condition of cardiovascular system, promote weight reduction. The type of loading is selected individually, personal preferences of the patient and state of his health are considered. Active foot and bicycle walks, sports walking, swimming, in the absence of contraindications – jogging, walking on skis, tennis, team games, occupations in gym are recommended to most of patients.
- Medicamentous correction. In some cases the endocrinologist appoints the hypoglycemic medicines reducing amount of glucose of blood due to increase in sensitivity of cages. Drug treatment is used if observance of dietary recommendations and increase in physical activities do not bring result. A lack of this method is that the organism remains passive, does not use own resources for fight against metabolic violation. There is a risk of formation of dependence on reception of hypoglycemic means.
Forecast and prevention
Prediabet well gives in to correction as this state is dynamic, there is an opportunity to activate the systems of an organism fighting against the increased glucose level. For the prevention of development of pathology it is necessary to pay attention to a diet: to reduce the use of bystry carbohydrates and fats, to control caloric content, to eat food fractionally, small portions. It is worth entering into the plan of day regular trainings by sport and daily half-hour foot walks. People from risk groups need to make periodically tests for determination of level of sugar and cholesterol, to trace arterial pressure, to control body weight.