Diabetes is one of the diseases that has been growing at an alarming rate every year. Characterized by the increase in blood glucose levels (sugar) together with the body’s inability to process and use this sugar as it should, many people already suffer from the disease and are unaware of it, or simply cannot identify it through symptoms, which are often almost silent. That’s why it’s important to always do routine tests to assess your health. The sooner it is discovered, the better the response to treatment will be, especially if the condition only serves as a warning, with changes in blood glucose levels indicating that the patient has pre-diabetes and needs to take care so the disease is not diagnosed in fact.

What is Pre-Diabetes?

Pre-diabetes is a warning given through a laboratory blood test indicating the patient’s increased risk of developing type 2 diabetes. It is not a diagnosis of the disease, but a warning that blood glucose levels are outside the normal range and should be carefully managed so that they do not rise further and lead to full-blown disease. When receiving this warning, the patient should take the treatment seriously and be aware of the risks even at this stage of the condition. This is because research in the area shows that people with pre-diabetes are at higher risk of cardiovascular problems than the rest of the population. Other health issues observed with greater severity in pre-diabetics were: kidney problems, nerve damage, and eye changes.

Causes of Pre-Diabetes

There is much talk about acquired diabetes, referring to type 2 diabetes, but how and when does it happen? Few people know the causes of pre-diabetes or only receive guidance once the warning appears that the disease is near. So, there’s nothing better to prevent the disease than being aware of the causes and everything that can lead to a diagnosis. With the stressful lives people lead today, being completely focused on professional and academic lives, health is being left further and further aside, until the body starts giving signs, just as a car needs fuel to run, the body also needs to be properly supplied in order to keep going. But unfortunately, most people only remember to take care of their body when it starts crying for help. Among the main causes of pre-diabetes are poor diet, physical inactivity, and excessive weight gain; obviously, we cannot leave out family genetics, which has a strong influence. Except for the last cause—family history—the others can all be avoided through good habits and changes to daily routine.

Tests for Diabetes Diagnosis

When suspicious symptoms are observed or simply by a doctor’s request in routine check-ups, diabetes can be investigated and diagnosed through blood laboratory tests. Even in common blood tests it is possible to detect when blood glucose is altered, which will prompt the doctor to request more specific tests to assess blood sugar levels.

Fasting Blood Glucose

The fasting blood glucose test, also known as fasting glucose, is a laboratory blood test focused on measuring the glucose levels circulating in the blood. To obtain an accurate analysis, it is necessary to have fasted for 8 to 12 hours, with only water being allowed. It is through this test that pre-diabetes or even the presence of diabetes itself is analyzed. The test can be performed specifically to monitor blood sugar or together with other, more specific tests, to give a clearer and more detailed result to the patient. Reference values are:

  • Normal blood glucose: Below 110 mg/dl;
  • Altered blood glucose: between 110 mg/dl and 125 mg/dl;
  • Diabetic: above 126 mg/dl;
  • Low blood glucose / hypoglycemia: below 70 mg/dl.

If the result is above 125 mg/dl, the test should be repeated for confirmation. It is recommended to confirm with at least 2 blood samples to diagnose diabetes. But if the result is between 110 and 125 mg/dl, it indicates that the patient is pre-diabetic and needs specific follow-up to prevent the disease from fully developing.

Glycated Hemoglobin

Hemoglobin (Hb) is a protein found in our bloodstream, more precisely in red blood cells, and its function is to carry oxygen in the blood. These red blood cells have a lifespan of about 90 days, during which time they bind to glucose, becoming what is known as glycated hemoglobin (HbA1c). When glucose levels are highly altered, glycated hemoglobin also appears altered. The glycated hemoglobin test can assess an average of these changes over the last 90 days, although this may vary, since it is not possible to determine exactly how long red blood cells last. By evaluating over a longer period, it is possible to indicate whether it is a temporary imbalance or a persistent one over recent months. Reference values are:

  • Healthy people: between 4.5% and 5.7%;
  • Pre-diabetic: between 5.7% and 6.4%;
  • Diabetic: above 6.5%

For consideration of the results, the doctor will analyze several factors regarding the patient, such as risk factors, symptoms, and the presence of chronic complications. Additional evaluation tests may be requested, or appropriate treatment may be started right away, depending on the case.

Oral Glucose Tolerance Test

The oral glucose tolerance test, also known in labs as the glucose curve or OGTT, is performed by drawing blood while fasting and after ingestion of a very sweet liquid provided by the lab. Samples are collected in the following order: fasting, 1 hour after ingestion, 2 hours after ingestion, and 3 hours after ingestion. The patient must stay in the lab the entire time. This test is usually requested during pregnancy to investigate gestational diabetes. Reference values are:

  • Healthy people: Up to 140 mg/dl;
  • Pre-diabetic: between 140 and 199 mg/dl;
  • Diabetic: Over 200 mg/dl.

Based on the results and lab reference ranges, the doctor will indicate the appropriate treatment and follow-up for the patient.

Does Pre-Diabetes Affect Fertility?

Uncontrolled diabetes can cause serious complications in the lives of both men and women, and one of these complications is affecting fertility. Pre-diabetes can serve as a warning so that high levels of blood glucose do not go on to affect fertility in either sex. In men, poorly controlled glucose may cause disturbances in protein and fat metabolism, as well as increasing sperm DNA fragmentation, which reduces semen quality and increases the likelihood of malformations or miscarriage. Diabetic men may have problems with erections or, in some cases, retrograde ejaculation, where sperm travel up to the bladder instead of through the urethra. In women, glucose imbalance can affect the menstrual cycle and thus prevent ovulation, making fertilization difficult and increasing the risk of miscarriage. Diabetic women are at risk for early menopause, leading to permanent infertility. The best way to prevent this is, as soon as pre-diabetes is detected, to follow medical instructions carefully, change eating habits, and start exercising. Only in this way is it possible to reverse the condition and control blood glucose levels. If you wish to become pregnant, in addition to all these precautions, we recommend using fertility vitamins like FamiFerti and ViriFerti, which not only meet all the body’s vitamin needs but also enhance ovulation, the uterus, and endometrium in women, and strengthen sperm, as well as improve DNA and semen production in men. You can purchase them here in our virtual store. Attend regular medical check-ups and always carry out routine laboratory tests. The discovery of any disease, even if it is just a warning like pre-diabetes, is the best way to seek appropriate treatment and reduce complications. Photo: Agência Brasil Fotografias