Prediabetes: A Wake-Up Call

The Science of Sleep and Glucose Metabolism

While you sleep, several hormonal and neurological changes influence glucose homeostasis. The key players involved include:

• Insulin: Secreted by the pancreas to regulate blood sugar
• Cortisol: A stress hormone that rises in the early morning and affects glucose production
• Growth Hormone: Released in pulses during deep sleep, influences glucose uptake
• Leptin and Ghrelin: Regulate appetite and are disrupted by poor sleep

Poor or fragmented sleep alters this balance, making your body more insulin resistant, and less capable of managing glucose effectively.

Diagnostic Criteria

Prediabetes is diagnosed based on the following test values:

• Fasting Blood Sugar (FBS): 100 to 125 mg/dL
• HbA1c (Glycated Hemoglobin): 5.7 to 6.4 percent
• Oral Glucose Tolerance Test (OGTT): 140 to 199 mg/dL at 2 hours

These values indicate impaired glucose tolerance or impaired fasting glucose, both of which are markers of insulin resistance.

Why You Should Take Prediabetes Seriously

Prediabetes is not harmless. It increases your risk for:

• Type 2 diabetes
• Cardiovascular disease
• Non-alcoholic fatty liver disease

Even mild elevations in blood glucose can cause long-term damage to blood vessels and nerves.

Common Risk Factors

You may be at higher risk of developing prediabetes if you:

• Are overweight or obese (especially abdominal obesity)
• Lead a sedentary lifestyle
• Have a family history of type 2 diabetes
• Have high blood pressure or high triglyceride levels
• Have polycystic ovary syndrome (PCOS)
• Are over the age of 35
• Have had gestational diabetes during pregnancy

Symptoms: Often Silent but Sometimes Subtle

Prediabetes typically has no clear symptoms, but some people may notice:

• Unusual fatigue
• Increased thirst or urination
• Darkened skin on the neck, armpits, or knuckles (Acanthosis Nigricans)
• Slow healing of minor wounds

These are often missed or attributed to stress or aging, which delays timely diagnosis.

Can Prediabetes Be Reversed?

Yes. This is what makes it a wake-up call, not a life sentence.

Clinical studies, including the Diabetes Prevention Program (DPP), show that lifestyle changes can reduce the risk of developing diabetes by up to 58 percent.

What You Can Do Right Now

1. Get Tested

Ask your doctor for an annual blood sugar test if you are at risk. HbA1c is a good indicator of long-term sugar levels and does not require fasting.

We at Orthomed Clinic in Bangalore has some of best in class systems to check prediabetes.

2. Lose Just a Little Weight

Losing even 5 to 7 percent of your body weight can dramatically improve insulin sensitivity.

3. Move More

Engage in moderate activity like walking, cycling, or swimming for at least 150 minutes per week. Exercise helps lower insulin resistance and reduces belly fat.

4. Watch What You Eat

Follow a low glycemic index diet with plenty of fiber, lean protein, and healthy fats. Avoid refined carbs and sugary drinks.

5. Prioritize Sleep and Stress Management

Poor sleep and chronic stress raise cortisol levels, which in turn increase blood sugar. Aim for 7 to 9 hours of quality sleep and practice stress-reducing habits.

6. Avoid Smoking and Limit Alcohol

Both contribute to insulin resistance and cardiovascular risk.

Medical Monitoring and Follow-Up

If you are diagnosed with prediabetes, your doctor may recommend:

• Annual HbA1c testing
• Lipid profile and blood pressure monitoring
• Lifestyle counselling or structured programs
• In some cases, metformin may be prescribed for high-risk individuals, especially those with obesity or PCOS

Prediabetes is your body’s early warning system. It is not a disease to ignore. Instead, it is an opportunity to take control before the damage becomes permanent.

With the right choices, you can delay or even prevent the onset of type 2 diabetes.

You don’t have to be perfect. You just need to start making better decisions consistently. The earlier you act, the more power you have.