Is 'Borderline' Diabetes Really Diabetes?

Q: I just learned that I'm a "borderline" diabetic, even though my blood glucose reading was very close to normal. Now I'm not sure what to do. Should I be consistently checking my blood sugar level, eating differently, or taking medication as though I actually have diabetes? I don't want to develop diabetes, but I don't want to take unnecessary precautions either.

A: Great question! Now that you've been diagnosed with prediabetes, prevention is key. Prediabetes is characterized by either impaired fasting glucose (IFG) or impaired glucose tolerance (IGT). Both of these terms refer to the level of sugar in the bloodstream, and they're both ways of saying that you have prediabetes.

If your fasting glucose level (a test in which blood is drawn after six hours without food) is between 100 and 125 mg/dl, you have IFG. If your blood sugar level two hours after a glucose challenge test is between 139 and 200 mg/dl, you have IGT.

Okay — now that we have the classification straight, why should you be worried about these numbers if yours are not in the diabetic range? Here's why: As your blood glucose rises above the normal level, your risk of developing damage in the body's small blood vessels, and ultimately your risk of a heart attack or stroke, also rises. In addition, having abnormal glucose levels is a risk factor for developing outright diabetes in the future.

By bringing you blood sugar levels back in the normal range, you can probably prevent the onset of diabetes and other complications, such as coronary artery disease. It is not absolutely essential to frequently check your glucose levels at home as long as you and your doctor monitor them periodically.

The precautions that you can and should take to prevent complications and the onset of diabetes consist of the same habits you'd cultivate to stay healthy in general. These include exercising, eating healthfully and not excessively, and maintaining your ideal body weight. One study showed that among a group of individuals who had prediabetes, those who lost as little as 7 percent of their body weight delayed the onset of diabetes or prevented it. There are also medicines that have been shown to prevent diabetes. While I do not recommend medicines to all people with prediabetes, it might be advisable in some cases. I wish you luck in this journey toward health.