Ways to Detect Borderline Diabetes

Question: What's borderline diabetes? How do you detect it? Is there an exercise or diet regime you can follow to keep it at bay?

Answer: Borderline diabetes is also referred to as prediabetes, a condition in which the blood glucose values are more than normal, but not sufficiently high enough to term the patient diabetic. It is also commonly referred to as impaired glucose tolerance. Dr CV Harinarayan, consultant endocrinologist, Fortis Hospitals, Bengaluru, says, Borderline cases can become full blown if you don't take adequate care. The conversion rate in India itself is 15 percent per year. Your chances of developing atherosclerosis and coronary artery disease become high even if you have borderline diabetes. Dr Pradeep Rama Rao, MD, consultant endocrinologist, Columbia Asia Hospital, Bengaluru, adds, You also lose 85 percent of your pancreatic function if you have borderline diabetes.The worst is that most patients with borderline diabetes have no symptoms at all, and are unaware of their condition.

The only way to detect is by the two blood tests which are used to determine diabetes:

• fasting plasma glucose test (FPG),
• oral glucose tolerance test (OGTT).

The first is usually conducted after overnight fasting (8 to10 hours). It is relatively easy and inexpensive. You have impaired glucose tolerance or prediabetes if your blood glucose is 126mg/dl or above (normal blood-sugar levels measure less than 110mg/dl after the fasting glucose test). You are a prediabetic if the second test reveals your blood glucose levels to be 140-199mg/dl (normal blood sugar levels measure less than 140mg/dl after the oral. Diabetes glucose tolerance test), and you have diabetes if your blood glucose is 200 mg/dl or above.

Reasons & Precautions for Borderline Diabetes

• The major reasons for prediabetes include a family history of the disease, poor dietary habits and a high-stress, hectic lifestyle. Various trials on the prevention of diabetes have shown that correct diet and exercise regimes are more effective than drugs. So, if you have borderline diabetes, you need to change your lifestyle completely
• If you are overweight, consult a specialist and lose weight to improve your blood-sugar levels and prevent diabetes
• To cut down on your stress levels, do yoga, and try meditation and stress-management techniques (it is difficult in the beginning, but get some good guidance and persevere for a month at least - if you do this, it will become much easier) and think positive (this too needs practice
• Try and think-through your fears and come to terms with the worst-case scenario and what you can do to tackle the problem - this will help you deal with irrational fear)

Dr Dwarakanath, CS, MD, DM, endocrinologist, Apollo Hospitals, Bengaluru, says, Exercise to manage diabetes. Your regime should have at least 150 minutes of aerobic exercises every week - either brisk walk, yoga, jogging or swimming. Start with a lowintensity routine and then increase it gradually. If you are 40 years and above, consult a doctor to check if it's okay for you to start exercising. Mukesh Batra, CMD, Dr Batra's, Mumbai, adds, Don't overdo it, it is better to workout for 10 minutes, thrice a day.

• Exercise for about 30 to 45 minutes a day, at least thrice a week
• For best results, combine your aerobic activity and strength-training
• Allow time for warm ups and cooldowns after stretching exercises
• Sustain aerobic activity at a moderate level rather than opting for intense and short routines
• Choose an activity or regimen you enjoy and throw in a variety to keep up interest
• Try jogging, swimming, cycling, and walking or any outdoor sports - these are simple enjoyable workouts

At-a-glance

You may have borderline or prediabetes if you:

• Gain excessive weight in less than two months
• Have marked weight-loss in spite of an increase in appetite
• Feel thirsty frequently
• Need to urinate too frequently (almost 3 litres in 24 hours)
• Have a genital infection
• Constantly feel fatigued
• Have blurred vision

Must-do for Prediabetics:

• Eat six small meals instead of three per day
• Include complex carbohydrates such as ragi, oats, whole wheat and jowar in your diet
• Avoid desserts, sugar, soda, cheese, coconut oil, fried food, alcohol and processed food
• Cut down on simple sugars such as honey and jaggery
• Include healthy fats such as olive oil, canola, soya bean and rice bran, instead of butter, ghee and lard
• Include fresh fruits, green leafy vegetables, bran, low-fat, skinless meat, egg white, skimmed milk, oats, nuts, almonds and walnuts in your diets
• Do not starve yourself, but be careful to limit the intake of certain food items such as proteins and the overall quantity you eat
• Drink at least 8 to 9 cups of water per day. It helps to accelerate your metabolism, leading to weight loss. It also acts as a natural appetite suppressant, satiating your hunger
• Avoid consuming starchy food items - they are relatively difficult to digest

Inputs received from Good Housekeeping

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