Prediabetes doesn't usually have any signs or symptoms

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

Classic signs and symptoms that suggest you've moved from prediabetes to type 2

diabetes include:

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

Risk factors

The same factors that increase the odds of getting type 2 diabetes also increase the risk of prediabetes. These factors include:

● Weight.​ Being overweight is a primary risk factor for prediabetes. The more fatty tissue you have — especially inside and between the muscle and skin around your abdomen — the more resistant your cells become to insulin.
● Waist size.​ A large waist size can indicate insulin resistance. The risk of insulin resistance goes up for men with waists larger than 40 inches and for women with waists larger than 35 inches.
● Diet.​ Eating red meat and processed meat, and drinking sugar-sweetened beverages, is associated with a higher risk of prediabetes. A diet high in fruits, vegetables, nuts, whole grains and olive oil is associated with a lower risk of prediabetes.
● Inactivity.​ The less active you are, the greater your risk of prediabetes. Physical activity helps you control your weight, uses up sugar for energy and makes the body use insulin more effectively.
● Age.​ Although diabetes can develop at any age, the risk of prediabetes increases after age 45.
● Family history.​ Your risk of prediabetes increases if you have a parent or sibling with type 2 diabetes.
● Gestational diabetes.​ If you had diabetes while pregnant (gestational diabetes), you and your child are at higher risk of developing prediabetes. If you've had gestational diabetes, your doctor will likely check your blood sugar levels at least once every three years.
● Polycystic ovary syndrome.​ Women with this common condition — characterized by irregular menstrual periods, excess hair growth and obesity — have a higher risk of prediabetes.
● Sleep.​ People with obstructive sleep apnea — a condition that disrupts sleep repeatedly — have an increased risk of insulin resistance.
● Tobacco smoke.​ Smoking may increase insulin resistance. Smokers also seem to carry more weight around the middle.

Other conditions associated with prediabetes include:

● High blood pressure
● Low levels of high-density lipoprotein (HDL) cholesterol, the "good" cholesterol
● High levels of triglycerides — a type of fat in your blood

When these conditions occur with obesity, they are associated with insulin resistance

The combination of three or more of these conditions is often called metabolic syndrome.

Complications

The most serious consequence of prediabetes is progression to type 2 diabetes. That's because type 2 diabetes can lead to:

● High blood pressure
● High cholesterol
● Heart disease
● Stroke
● Kidney disease
● Nerve damage
● Vision problems, possibly loss of vision
● Amputations

Prediabetes has been linked with unrecognized (silent) heart attacks and can damage your kidneys, even if you haven't progressed to type 2 diabetes.

Prevention

Healthy lifestyle choices can help you prevent prediabetes and its progression to type 2 diabetes — even if diabetes runs in your family. Try to:

● Eat healthy foods
● Get at least 150 minutes of moderate aerobic physical activity a week, or about 30 minutes on most days of the week
● Lose excess weight
● Control your blood pressure and cholesterol
● Don't smoke

Diagnosis

The American Diabetes Association (ADA) recommends that diabetes screening for most adults begin at age 45. The ADA advises diabetes screening before age 45 if you're overweight and have additional risk factors for prediabetes or type 2 diabetes

There are several blood tests for prediabetes.

Glycated hemoglobin (A1C) test

This test shows your average blood sugar level for the past three months. The test measures the percentage of blood sugar attached to the oxygen-carrying protein in red blood cells called hemoglobin. The higher your blood sugar levels, the more hemoglobin you'll have with sugar attached.

● An A1C level below 5.7% is considered normal
● An A1C level between 5.7% and 6.4% is considered prediabetes
● An A1C level of 6.5% or higher on two separate tests indicates type 2 diabetes

Certain conditions can make the A1C test inaccurate — such as if you're pregnant or have an uncommon form of hemoglobin.

Fasting blood sugar test

A blood sample is taken after you fast for at least eight hours or overnight

● A fasting blood sugar level below 100 milligrams per deciliter (mg/dL) — 5.6 millimoles per liter (mmol/L) — is considered normal.
● A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 7.0 mmol/L) is considered prediabetes. This result is sometimes called impaired fasting glucose.
● A fasting blood sugar level of 126 mg/dL (7.0 mmol/L) or higher indicates type 2 diabetes.

Oral glucose tolerance test

This test is usually used to diagnose diabetes only during pregnancy. A blood sample is taken after you fast for at least eight hours or overnight. Then you'll drink a sugary solution, and your blood sugar level will be measured again after two hours.

● A blood sugar level less than 140 mg/dL (7.8 mmol/L) is considered normal.
● A blood sugar level from 140 to 199 mg/dL (7.8 to 11.0 mmol/L) is considered prediabetes. This is sometimes referred to as impaired glucose tolerance.
● A blood sugar level of 200 mg/dL (11.1 mmol/L) or higher indicates type 2 diabetes

If you have prediabetes, your doctor will typically check your blood sugar levels at least once a year.

Children and prediabetes testing

Type 2 diabetes is becoming more common in children and adolescents, likely due to the rise in childhood obesity. The ADA recommends prediabetes testing for children who are overweight or obese and who have one or more other risk factors for type 2 diabetes. These
other risk factors include:

● Family history of type 2 diabetes.
● Race. Children who are African American, Hispanic, Native American, Asian American and Pacific Islander are at higher risk.
● Low birth weight.
● Being born to a mother who had gestational diabetes.

The ranges of blood sugar level considered normal, prediabetic and diabetic are the same for children and adults.

Children who have prediabetes should be tested annually for type 2 diabetes — or more often if the child experiences a change in weight or develops signs or symptoms of diabetes, such as increased thirst, increased urination, fatigue or blurred vision

Treatment

Healthy lifestyle choices can 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

To prevent prediabetes from progressing to type 2 diabetes, try to:

● Eat healthy foods.​ Choose foods low in fat and calories and high in fiber. Focus on fruits, vegetables and whole grains. Eat a variety of foods to help you achieve your goals without compromising taste or nutrition.
● Be more active.​ Aim for at least 150 minutes of moderate or 75 minutes of aerobic activity most days of the week.
● Lose excess weight.​ If you're overweight, losing just 5% to 7% of your body weight — about 14 pounds (6.4 kilograms) if you weigh 200 pounds (91 kilograms) — can reduce the risk of type 2 diabetes. To keep your weight in a healthy range, focus on permanent changes to your eating and exercise habits.
● Stop smoking.​ Smoking may up your risk of developing type 2 diabetes.
● Take medications as needed.​ If you're at high risk of diabetes, your doctor might recommend metformin (Glumetza, others). Medications to control cholesterol and high blood pressure might also be prescribed

Children and prediabetes treatment

Children with prediabetes should undertake the lifestyle changes recommended for adults with type 2 diabetes, including:

● Losing weight
● Eating fewer refined carbohydrates and fats, and more fiber
● Reducing portion sizes
● Eating out less often
● Spending at least one hour every day in physical activity

Medication generally isn't recommended for children with prediabetes unless lifestyle changes aren't improving blood sugar levels. If medication is needed, metformin (Glumetza, others) is usually the recommended drug

ENrolment form should consist of this medical history extension form:

Diabetes History Form

https://mckinley.illinois.edu/sites/default/files/docs/diabetes_history.pdf

General Information

1. Education : Major Expected Graduation
2. Marital Status: Single Married Other
3. How many people live in your household?
4. Is there anyone who will help you in your diabetes care? Yes No If yes, who
5. Do you work outside of taking classes? Yes No Where Hours/week
6. Diabetes provider at home Phone

Diabetes History

1. How long have you had diabetes? What type? Type 1 Type 2 Gestational Unknown
2. List any family members with diabetes
3. How would you rate your understanding of diabetes? Good Fair Poor
4. What areas of diabetes would you like to learn more about? Diet Stress Blood testing Low blood sugar Insulin pumps Pills for diabetes Exercise Sick days Complications High blood sugar Pregnancy and diabetes
5. How do you learn best? Written material Verbal discussion Hands on
6. What is your goal for this session? Learn more about diabetes Help with meal planning Better blood sugar control Weight management

Nutrition

1. Has your weight changed in the last 3 months? Yes No I have Gained Lost lbs. Was this weight change intentional? Yes No
2. How many times do you eat per day? Meals Snacks
3. How often do you eat/drink the following? (per week) Fruits Vegetables Sweets Fast Food Milk (fat free, Juices Cheese Alcohol Water 1%, 2%, whole)
4. How often per week do you eat away from home? Where
5. How is your food prepared? Fried Baked Broiled Grilled
6. How would you describe your portions? Small Average Large
. Any special diet needs or practices?
8. Have you ever been told you have High cholesterol High triglycerides High blood pressure
9. What diet plan do you typically follow? Carb counting Calories a day Other
10. How is your insulin dosage calculated? N/A Carbs to units insulin (type ) Fixed dose per meal (type ) Adjustable dose dependent on blood glucose.
11. Complete the food history table below including amount and how typically prepared Breakfast Lunch Dinner Snack Snack Snack (over) place label here
Name:
UIN:
Date:
Diabetes History Form – page 2

Medication

1. If you take insulin: (if no skip to 6) Do you use? A syringe Insulin pen Insulin pump Insulin inhaler
2. What injection sites are used?
3. Where do you keep your insulin?
4. Do you reuse your syringes? Yes No How many times before disposal?
5. How/where do you dispose of your syringes?
6. Do you use pills for your diabetes medication? Yes No If yes, list amount and frequency below:

Monitoring

1. Do you test your urine: For sugar? Yes No For ketones? Yes No How often
2. Do you test your blood sugar? Yes No How often? Typical results
3. Do you keep a record of you results? Yes No

Exercise

1. Do you exercise regularly? Yes No What type? How often? For how long?
2. List any problems you have with exercise:

Complications

1. If you have ever had a low blood sugar reaction? How did you feel? How did you treat it? How often has this occurred?
2. Do you carry a source of sugar with you? Yes No
3. Have you ever had to be given glucagons? Yes No
4. If you have ever had High blood sugar: How did you feel? How did you treat it? How often has this occurred?
5. What is your daily blood sugar normal range?
6. Are you aware of the long term complications of Diabetes? Yes No
7. Do you have any of the following? Eye problems Heart problems Kidney problems Numbness/pain Sexual problems Dental problems

Please Explain Medical History

1. When was your last: Physical? Eye exam? Dental exam?
2. Do you smoke? Yes No If yes, how much? For how many years?
3. Do you drink alcohol? Yes No If yes, how much?
4. Have you ever been hospitalized with diabetes? Yes No Number of times
5. Have you been in the emergency department because of your diabetes? Yes No How
6. Do you wear a medical identification bracelet or necklace? Yes No
7. Have you ever had a Pneumonia vaccination? Yes No When?
8. Have you received a Flu shot within the year? Yes No

Other

Please list any other information that you feel would be important for your provider to know that would assist them in

Address

IDC Block, First Floor, Tulasi Multispeciality Hospital, GunturivariThota, 5th lane, Old Club Road Guntur, 522001.