Prediabetes: Should you be screened for it?

Diabetes is a range of conditions that cause an overload of sugar in the blood. Increased blood glucose levels can, therefore, be a sign that you have diabetes, or are on the way to developing the disease.

While prediabetes is not a health condition in itself, says Mediclinic Vergelegen endocrinologist Dr Elmo Pretorius, it can be a sign that you are on the way to developing type 2 diabetes.

Dr Pretorius says these levels need to be interpreted carefully. “Diabetes is a man-made diagnosis,” he says, “which means doctors have arrived at the goalposts of what defines diabetes, and what does not, by consensus. There are certain cut-off values that we use to gauge how high, or how dangerous, someone’s blood glucose levels are. Between a person with normal blood sugar and what we would say is someone who is diabetic, there is a range of blood sugar levels: not quite normal, but not quite reaching the criteria for a diabetes diagnosis.”

Prediabetes is the term that reflects this range. If your doctor has warned you may be prediabetic, it means your blood sugar level is higher than normal – but not yet high enough to warrant being classified as type 2 diabetes.

This can become tricky when deciding on a course of treatment, says Dr Pretorius.

Appropriate treatment

“Personally, I don’t feel people within this problematic blood glucose range should be treated with medication,” says Dr Pretorius. “This is more of a warning phase: you are no longer normal, but you are not quite at a level where we would treat you – yet.”

Prediabetes is not symptomatic, so it is unlikely that you would show any warning signs of developing diabetes just yet. But your general practitioner is able to pick up early warning signs that you could be at heightened risk of developing type 2 diabetes – and can put you on a course of treatment to reverse that risk and undo the damage.

Waist size is a common indication of prediabetes, so doctors will usually suggest you are screened if you show signs of increased belly fat. If your screening results are not normal, you will be sent for formal testing to establish a diagnosis. Those tests include the following: