Borderline Diabetes (AKA Pre-diabetes)

Although the term 'borderline diabetic' has fallen out of favor with some in the diabetes medical community, many family doctors and some researchers still use it. Borderline diabetes is usually used to describe one of two conditions: fasting blood glucose levels which are an the low end of the diabetes spectrum (126 mg/dl) or impaired ability to properly process glucose, regardless of fasting blood glucose test results.

Beginning in 2002, we also began to hear the term pre-diabetes. The official medical term for these conditions is Impaired Fasting Glucose or Impaired Glucose Tolerance. Currently, the GTT (Glucose Tolerance Test) is used to determine if a person is at risk for developing diabetes, even if their fasting blood sugar levels are normal. This change occurred because the medical community recognizes that NIDD (non-insulin dependent diabetes) is a condition which develops slowly with specific symptoms rather than appearing overnight without warning. One telling precursor to diabetes is an inability to process glucose and insulin normally, conditions which will appear in a glucose tolerance test but not in a simple blood sugar test.

While anyone can develop diabetes, pre-diabetes or 'borderline diabetes,' there are some risk factors which make it more likely. Most commonly the highest risk is carried by overweight people, especially those who carry excess weight in their midsection, those with family history of diabetes, those with a history of vascular disease, women who have PCOS or have given birth to a baby weighing more than 9 pounds, and those from high-risk ethnic groups (blacks, Hispanics, Asian-Americans or Native-Americans.)

The commonly known health risks of diabetes include blindness, kidney failure, heart attack, stroke, loss of limb, and neuropathy. These serious risks are recently being linked with the other conditions within the 'diabetes spectrum.' 'Borderline diabetes' has been closely linked to peripheral and idiopathic neuropathy, polyneuropathy, and increased risk of developing dementia and Alzheimer's disease. With such serious risks even from a 'mild' case or 'borderline' diabetes, certainly measures should be taken to control the disease. (Diabetes 56:211-216, 2007, Muscle Nerve. 2001 Sep;24(9):1225-8)

Thankfully, the adult diabetic (type 2) spectrum of diseases are largely controllable through minor but significant changes in lifestyle and diet for most people. Some research shows that even 30 minutes of exercise three times per week and sustained moderate weight loss of even 20 pounds can bring someone back from the brink of diabetes. Another study showed that individualized counseling regarding weight loss and exercise was more effective than metformin (an insulin sensitizing drug). Naturally, anyone who has a history of diabetic conditions or who is predisposed to such conditions should monitor their health with the help of a physician.