Pre-diabetes affects many women in Singapore, but the problem isn’t often discussed. Even worse, you could have it and not display any symptoms. Here’s what you should know about the potentially dangerous condition.
Pre-diabetes affects many women in Singapore, but the problem isn’t often discussed. Even worse, you could have it and not display any symptoms. Here’s what you should know about the potentially dangerous condition.
Most of us are aware of the risk factors, causes and consequences of Type 2 diabetes. Now here’s a related, less often talked about condition that affects a significant number of Singaporean women every year: pre-diabetes.
With this condition, your blood glucose level (blood sugar level) is higher than normal, but it’s not high enough to be considered diabetes.
According to Dr Stanley Liew, endocrinologist and consultant at Raffles Diabetes & Endocrine Centre, Raffles Hospital, pre- diabetes is usually without symptoms and can only be detected through a blood test. Depending on the blood test used, the condition may be categorised as impaired fasting glucose (IFG) or impaired glucose tolerance (IGT).
Who Is At Risk?
The Ministry of Health’s National Health Survey, last conducted in 2010, revealed that 14.4 per cent of people in Singapore between the ages of 18 and 69 had IGT. The figure was higher in women (15.2 per cent) compared to men (13. 5 per cent) and, unfortunately, those percentages are thought to be on the rise.
How do you know if you should be tested for pre-diabetes? An endocrinologist at Mount Elizabeth Hospital, Dr Daniel Wai recommends being screened if you are over 40, have a family history of diabetes, are overweight or obese, or have been diagnosed with gestational diabetes or have delivered a baby weighing 4kg or more.
Other reasons for a screening include having polycystic ovarian syndrome, which causes insulin resistance and could result in diabetes or pre-diabetes, as well as hypertension, high cholesterol, heart disease or sleep apnoea.
The world standard unit for measuring glucose in blood is mmol/l, which stands for millimoles/litre. A normal fasting glucose reading is 6.1 mmol/l or less. In a pre-diabetic person, that reading is between 6.1 and 6.9 mmol/l, and in a person with diabetes, it is 6.9 mmol/l or higher.
Says Dr Wai: “If you are considered a high-risk person with more than one of the risk factors for developing pre-diabetes, or if you already have a high fasting sugar level, you’ll be given an Oral Glucose Tolerance Test, which measures your body’s ability to use glucose.”
The test involves downing a sweet drink containing 75g of sugar. You’ll be required to fast the night before, which means no drinking or eating until after the test. Your blood is drawn while you’re fasting, and then you’ll be asked to consume the drink in one go. Your blood is drawn a second time, two hours after you’ve had the drink.
“After two hours, if your blood sugar level reads 7.8 mmol/l or less, it’s normal. If you’re prediabetic, your reading will range between 7.8 and 11.0 mmol/l, and if you’re diabetic, that reading will show up as 11.0 mmol/l or higher,” explains Dr Wai.
Even if the test reads normal, it should be repeated every three years if you’re considered in the high-risk group.
If your fasting blood sugar level – after not having anything to eat or drink for eight hours – is elevated, your doctor may recommend an additional screening to diagnose which group of pre-diabetes you fall under – IFG or IGT, adds Dr Yong Lok Sze, a family physician at Lifescan Medical Centre.
Our experts
DR STANLEY LIEW, endocrinologist and consultant, Raffles Diabetes & Endocrine Centre, Raffles Hospital.
DR DANIEL WAI, endocrinologist, Mount Elizabeth Hospital.
DR YONG LOK SZE, family physician, Lifescan Medical Centre.
Why Pre-Diabetes Is Dangerous
Pre-diabetes may not be fullblown diabetes, but it’s still a problem because it means that you’re at a higher risk of developing diabetes and cardiovascular diseases, like heart attack, stroke and peripheral vascular disease.
“Pre-diabetes can progress to diabetes if healthy lifestyle changes are not made,” Dr Liew explains. “Without intervention, pre-diabetes is likely to become diabetes in 10 years or less. The progression to diabetes for patients with pre-diabetes is up to 10 per cent per year.”
How To Lower Your Risk
If you were recently diagnosed with pre-diabetes, these lifestyle changes can also stop it from developing into diabetes. One of the most effective changes you can make is losing weight, particularly if you’re overweight, and exercising more, says Dr Liew. “The US Diabetes Prevention Program revealed that people with pre-diabetes can lower their risk of developing Type 2 diabetes by 58 per cent, simply by losing 7 per cent of their body weight and performing moderate exercise, such as brisk walking, 30 minutes a day, five days a week. ”
Diet changes are also crucial. Says Dr Yong: “You should limit your intake of sugar, sweet treats (cake, candy, jam and honey), and unhealthy fat, such as the kind found in fried food, chips and pastries. At the same time, you should increase your intake of fibre, vegetables and fruit.”
The Diabetic Plate is commonly prescribed to control pre-diabetes or diabetes, Dr Yong adds. This meal-planning approach involves filling half your plate with fruit and non-starchy vegetables (stir-frying, steaming, roasting and boiling are recommended).
Another quarter of the plate should contain whole grains such as multi-grain bread, wholemeal bread or brown rice, and the final quarter of the plate should contain healthy proteins like fish, lean meat, poultry, seafood, eggs and/or low-fat dairy products. You should aim for at least two servings of fish a week. If you are thirsty, choose water over sugary drinks like soda or sweetened tea and coffee.
Other recommended lifestyle changes include keeping your blood pressure and cholesterol levels under control, quitting smoking, and getting between seven and eight hours of sleep every night. SH
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