What Is Pre-Diabetes? With Dr. James R. Gavin

Dr. James R. Gavin discusses living with diabetes and addresses the question: What is pre-diabetes?

BDO: What is Pre-Diabetes?

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Dr. Gavin: So, the notion of ‘pre-diabetes’ is an important concept to get your arms around. Because first and foremost, we have about 30 million people in this country with diabetes. We have almost 90 million people with pre-diabetes.

Now, what is that saying? It says basically that diabetes is one of those diseases that exist on a continuum. It’s like blood pressure. Yeah. People who have normal blood pressure and then you have people who have lower levels of increases in their blood pressure then you have people who have malignant hypertension.

Okay? So, it’s a continuum. Diabetes is like that. We make the diagnosis of diabetes on the basis of one metric and that’s blood sugar levels. You get above a certain level of blood sugar whether it’s your fasting, your post-meal blood sugar or your A1C the average blood sugar that we can measure if it’s above a certain threshold, we call that diabetes. Normal, we know what normal fasting glucose is supposed to be. We know what normal post-meal blood sugar is supposed. We know what a normal A1C looks like. It’s that in-between area that is pre-diabetes. And now, we’ve got numbers that correspond to the fasting level.

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The post-prandial or post-challenge level and the A1C that defines pre-diabetes. Those people are at high risk for going on to develop full-blown diabetes. Those people with pre-diabetes are also at high risk for complications like heart attacks and strokes. Not as high as diabetes, these are also people who have other problems like hypertension.

Now, the good news you can prevent people from developing full-blown diabetes even when they have pre-diabetes. We saw that in the diabetes prevention program. Intensive lifestyle change, dietary changes, increase physical exercise, getting some weight reduction can absolutely prevent you from developing full-blown diabetes. And there are some medications that are also useful, but a lot can be accomplished with lifestyle change.