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Want to know more about prediabetes? Below you will find answers to the most commonly asked questions about prediabetes.

Want to know more about prediabetes? Below you will find answers to the most commonly asked questions about prediabetes.

Prediabetes happens when your body is struggling to keep your blood sugar levels within a healthy range. This causes your blood sugar to be higher than normal, but not quite high enough to be considered diabetes. Having prediabetes means that you are likely to progress to have type 2 diabetes in the future1, but you can take steps to help lower your risk of developing diabetes and reverse your prediabetes.
15.5% of Malaysian adults aged 20 to 79 have prediabetes however, not everyone who has prediabetes are aware of their condition2.

Prediabetes happens when the insulin in your body does not work as well as it should. Insulin helps much glucose builds up in your blood. When the insulin does not work properly, too much glucose builds up in your blood. Higher levels than normal can indicate prediabetes3.

Prediabetes is a precursor to diabetes. The difference between prediabetes and type 2 diabetes is in how high the blood sugar levels are. Prediabetes is when your blood sugar exceeds normal levels but do not climb high enough to warrant a diagnosis of type 2 diabetes1.

Impaired fasting glucose (IFG)

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It describes the early stage of type 2 diabetes1 where people still have a chance to prevent/delay the progression to developing type 2 diabetes through medication and lifestyle changes.

Without intervening through lifestyle changes or medicine, people with prediabetes will eventually develop type 2 diabetes3. In fact, about 5% to 10% of those with prediabetes go on to develop type 2 diabetes each year4.
Yes! Prediabetes can cause an array of health complications including stroke, eye disease, heart disease, type 2 diabetes, nerve disease, protein in urine, and kidney disease5.

Yes. The probability of developing prediabetes and type 2 diabetes is increased if there is a family history of the disease5.

You are at risk for developing prediabetes if you4:

  • Are > 30 years old
  • Are ≤ 30 years old with risk factors


The risk factors that can contribute to the development of prediabetes for ≤30 years old are4:

  • Overweight/obesity
  • High blood pressure
  • High cholesterol
  • History of giving birth to children/child with a higher than average birth weight (generally over 4kg6)
  • Gestational diabetes (high blood sugar levels that develops only during pregnancy7)
  • Family history of diabetes
Smoking, having an unhealthy diet and exercising less than 3 times a week8.

Prediabetes do not always have any signs or symptoms. You can have prediabetes for years and be completely unaware until more serious health problems occur5. That is why it is important to go for regular health screenings or take our online prediabetes risk calculator to find out whether you are at risk of prediabetes.

Signs and symptoms of prediabetes may include9:

  • Increased thirst
  • Frequent urination
  • Excess hunger
  • Fatigue
  • Blurred vision


Another possible sign of prediabetes is darkened skin on certain parts of the body. Affected areas can include the neck, armpits, elbows, knees, and knuckles3.

A high score may indicate that you are at a higher risk of having prediabetes. We would recommend you speak to your doctor on having your blood sugar level checked. Always consult your doctor if you suspect you may have prediabetes and start taking steps to control your blood sugar levels10.

There are several blood tests for prediabetes such as11:

  • Glycated haemoglobin (A1C) test
  • Fasting blood sugar test
  • Oral sugar tolerance test


The A1C test is one of the commonly used tests to diagnose prediabetes. It is a simple blood test that measures your average blood sugar levels over the past 3 months.

You should be tested for prediabetes if you are 30 years old and above, of if you have one or more of the following known risk factors of prediabetes4:

  • Overweight/obesity
  • High blood pressure
  • High cholesterol
  • History of giving birth to children/child with a higher than average birth weight (generally over 4kg6)
  • Gestational diabetes (high blood sugar levels that develops only during pregnancy7)
  • Family history of diabetes


You should continue to test for prediabetes every year even if your initial screening for prediabetes was negative12.

If you have any of the risk factors or notice any signs or symptoms of prediabetes, you should ask your doctor about getting your blood sugar tested8.

A blood test to check for your prediabetes or diabetes status is normally carried out during your annual health screening, but it depends on the health screening package requested13.

If prediabetes and diabetes screening is not included in your annual health screening package, it is important that you ask your doctor to include the test and do not skip your annual health screening.

You can have prediabetes for years without any clear symptoms, so it often flies under the radar until you experience more serious health problems. If you are concerned that you may have prediabetes, talk to your doctor about getting your blood sugar tested5.
Getting tested for prediabetes can help you detect your condition and manage it before it is too late. More than 84% of people with prediabetes do not know they have the condition5, and people with prediabetes often develop type 2 diabetes within 5 years if it is not detected and managed4. Prediabetes can also cause other health complications, including stroke, eye disease, heart disease, and kidney disease5.

Yes. You can prevent prediabetes with healthy lifestyle changes and medication if required14.

Here are some things you can do to lower your risk15:

  • Lose weight and keep it off.
  • Move more.
  • Eat healthy foods most of the time.


Ask your doctor about what other changes you can make to prevent prediabetes.

Yes. Medication and lifestyle modifications have been proven to delay or prevent type 2 diabetes16. Talk to your doctor to know what works best for you.
A healthy lifestyle is the first step to help you bring your blood sugar level back to normal, or at least keep it from rising toward the levels seen in type 2 diabetes. If you are at high risk of progressing into type 2 diabetes, your doctor might recommend taking medication3.

Eating a healthy diet can help you maintain a normal blood sugar level.

Exercising regularly can also help lower your blood sugar by increasing insulin sensitivity, which allows the cells in your body to use insulin more efficiently3.

A variety of foods can help you achieve your goals without compromising taste or nutrition, as long as you follow these 2 tips3:

  • Choose foods that are low in fat and calories and high in fibre.
  • Focus on fruits, vegetables, and whole grains.
Regular physical activity does not mean having to go to the gym regularly. It simply means getting 30 minutes of moderate activity per day, every day5.

These FAQs are provided for your information and convenience. They are not intended to be medical advice. Please consult your doctor for any questions and concerns you may have about prediabetes.

REFERENCES

  1. Adam G Tabák, Christian Herder, Wolfgang Rathmann, Eric J Brunner and Mika Kivimäki. 2012. Prediabetes: a high-risk state for diabetes development. Lancet 379(9833): 2279-2290. doi:10.1016/S0140-6736(12)60283-9.
  2. International Diabetes Federation. 2020. Malaysia: Diabetes Report 2010 – 2045.
    https://www.diabetesatlas.org/data/en/country/120/
    my.html.
  3. National Institute of Diabetes and Digestive and Kidney Diseases. 2018, May. Insulin Resistance & Prediabetes. https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance#develop.
  4. Mohamed, M. July 2020. Management of prediabetes in Malaysian population: An experts’ opinion. Medical Journal of Malaysia, 420.
  5. Centers for Disease Control and Prevention. 2020, June 11. The Surprising Truth About Prediabetes. https://www.cdc.gov/diabetes/library/features/truth-about-prediabetes.html.
  6. Ministry of Health Malaysia. 2021. Large For Gestational Age (LGA). http://www.myhealth.gov.my/en/large-for-gestational-age-lga/.
  7. Elpida Vounzoulaki, Kamlesh Khunti, Sophia C Abner, Bee K Tan, Melanien J Davies and Clare L Gillies. 2020. Progression to type 2 diabetes in women with a known history of gestational diabetes: systematic review and meta-analysis. BMJ 369: m1361. doi: https://doi.org/10.1136/bmj.m1361.
  8. Centers for Disease Control and Prevention. 2021, April 23. Diabetes Risk Factors. https://www.cdc.gov/diabetes/basics/risk-factors.html.
  9. American Diabetes Association. 2021. Diabetes Symptoms. https://www.diabetes.org/diabetes/type-1/symptoms.
  10. Lim, H. M., Chia, Y. C., & Koay, Z. L. (2020). Performance of the Finnish diabetes risk score (FINDRISC) and modified Asian FINDRISC (ModAsian FINDRISC) for screening of undiagnosed type 2 diabetes mellitus and dysglycaemia in primary care. Primary Care Diabetes, 14(5), 494-500.
    https://doi.org/10.1016/j.pcd.2020.02.008.
  11. Burant CF, Young LA, American Diabetes Association. Medical Management of Type 2 Diabetes. 7th ed. Burant CF, Young LA, Eds. Alexandria, VA, American Diabetes Association, 2012.
    https://care.diabetesjournals.org/lookup/google-scholar?link_type=googlescholar&gs_type=article&q_txt=.+Medical+Management+of+Type+2+Diabetes.+7th+ed.+Burant+CF%2C+Young+LA%2C+Eds.+Alexandria%2C+VA%2C+American+Diabetes+Association%2C+2012.
  12. Ministry of Health. 2015. Malaysian T2DM guidelines clinical practice guideline. 5th edition. MOH/P/PAK/303.15(GU). https://www.moh.gov.my/moh/resources/Penerbitan
    /CPG/Endocrine/3a.pdf.
  13. Ministry of Health Malaysia. 2021. Pemeriksaan Kesihatan. https://hkkb.moh.gov.my/orang-awam-hkkb/maklumat-bayaran-caj?download=32:caj-bayaran-warganegara-pemeriksaan-kesihatan-pdf.
  14. American Diabetes Association. 2020. With prediabetes, action is the best medicine. h ttps://www.diabetes.org/diabetes-risk/prediabetes.
  15. National Institute of Diabetes and Digestive and Kidney Diseases. 2016, December. Preventing Type 2 Diabetes. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-type-2-diabetes.
  16. Diabetes Prevention Program Research Group. 2002. Reduction in the Incidence Of Type 2 Diabetes with Lifestyle Intervention or Metformin. The New England Journal of Medicine. 346; 6: 393-403.

REFERENCES

  1. Adam G Tabák, Christian Herder, Wolfgang Rathmann, Eric J Brunner and Mika Kivimäki. 2012. Prediabetes: a high-risk state for diabetes development. Lancet 379(9833): 2279-2290. doi:10.1016/S0140-6736(12)60283-9.
  2. International Diabetes Federation. 2020. Malaysia: Diabetes Report 2010 – 2045.
    https://www.diabetesatlas.org/data/en/country/120/
    my.html.
  3. National Institute of Diabetes and Digestive and Kidney Diseases. 2018, May. Insulin Resistance & Prediabetes. https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance#develop.
  4. Mohamed, M. July 2020. Management of prediabetes in Malaysian population: An experts’ opinion. Medical Journal of Malaysia, 420.
  5. Centers for Disease Control and Prevention. 2020, June 11. The Surprising Truth About Prediabetes. https://www.cdc.gov/diabetes/library/features/truth-about-prediabetes.html.
  6. Ministry of Health Malaysia. 2021. Large For Gestational Age (LGA). http://www.myhealth.gov.my/en/large-for-gestational-age-lga/.
  7. Elpida Vounzoulaki, Kamlesh Khunti, Sophia C Abner, Bee K Tan, Melanien J Davies and Clare L Gillies. 2020. Progression to type 2 diabetes in women with a known history of gestational diabetes: systematic review and meta-analysis. BMJ 369: m1361. doi: https://doi.org/10.1136/bmj.m1361.
  8. Centers for Disease Control and Prevention. 2021, April 23. Diabetes Risk Factors. https://www.cdc.gov/diabetes/basics/risk-factors.html.
  9. American Diabetes Association. 2021. Diabetes Symptoms. https://www.diabetes.org/diabetes/type-1/symptoms.
  10. Lim, H. M., Chia, Y. C., & Koay, Z. L. (2020). Performance of the Finnish diabetes risk score (FINDRISC) and modified Asian FINDRISC (ModAsian FINDRISC) for screening of undiagnosed type 2 diabetes mellitus and dysglycaemia in primary care. Primary Care Diabetes, 14(5), 494-500.
    https://doi.org/10.1016/j.pcd.2020.02.008.
  11. Burant CF, Young LA, American Diabetes Association. Medical Management of Type 2 Diabetes. 7th ed. Burant CF, Young LA, Eds. Alexandria, VA, American Diabetes Association, 2012.
    https://care.diabetesjournals.org/lookup/google-scholar?link_type=googlescholar&gs_type=article&q_txt=.
    +Medical+Management+of+Type+2+Diabetes.+
    7th+ed.+Burant+CF%2C+Young+LA%2C+Eds.
    +Alexandria%2C+VA%2C+American
    +Diabetes+Association%2C+2012.
  12. Ministry of Health. 2015. Malaysian T2DM guidelines clinical practice guideline. 5th edition. MOH/P/PAK/303.15(GU). https://www.moh.gov.my/moh/resources/Penerbitan
    /CPG/Endocrine/3a.pdf.
  13. Ministry of Health Malaysia. 2021. Pemeriksaan Kesihatan. https://hkkb.moh.gov.my/orang-awam-hkkb/maklumat-bayaran-caj?download=32:caj-bayaran-warganegara-pemeriksaan-kesihatan-pdf.
  14. American Diabetes Association. 2020. With prediabetes, action is the best medicine. h ttps://www.diabetes.org/diabetes-risk/prediabetes.
  15. National Institute of Diabetes and Digestive and Kidney Diseases. 2016, December. Preventing Type 2 Diabetes. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-type-2-diabetes.
  16. Diabetes Prevention Program Research Group. 2002. Reduction in the Incidence Of Type 2 Diabetes with Lifestyle Intervention or Metformin. The New England Journal of Medicine. 346; 6: 393-403.