Could you have prediabetes and not know it?

Could you have diabetes and not know it? 

According to the International Diabetes Federation (IDF), 415-million adults around the world — and up to 4.5-million in SA — live with diabetes. These numbers are expected to rise to as high as 642-million by 2040. 

“There are also many people who have the condition but remain undiagnosed and are at risk of serious complications,” says Dr Noluthando Nematswerani, head of the Discovery Health Centre for Clinical Excellence. “Then there are those who are at high risk of developing diabetes in the future and who could make health changes now to delay or prevent this from occurring.”

So if you haven’t already scheduled your annual blood sugar screening check, now is the time to do it. 

“Annual screening checks are very important and are a simple and cost-effective way of picking up warning signs of diabetes and other chronic illnesses as early as possible,” says Nematswerani. “Once we pick up these warning signs, we can apply lifestyle changes that can reverse our risk and also initiate treatment early on to prevent complications.”

Why you shouldn't postpone your screening check 

Over the course of the Covid-19 pandemic, many people have avoided visiting their healthcare practitioners for any form of care not related to Covid-19, including for regular screening checks. This is confirmed by Discovery Health Medical Scheme data.

“With the majority of healthcare providers and an increasing number of their patients vaccinated for Covid-19, we all feel far safer resuming access to care,” says Nematswerani. 

“It’s so important that we reverse the trend of staying away from our doctors or postponing screening checks for fear of contracting Covid-19. If we don’t, we will continue to miss out on critical opportunities to pick up the onset of potentially serious illnesses, like diabetes, as early as possible.

“People underestimate the impact of early diagnosis, and how this helps to avoid the serious complications associated with unmanaged diabetes in the long-term such as heart disease, nerve damage and lower limb amputations, kidney damage, blindness and Alzheimer’s disease.”

Getting to grips with diabetes

Did you know that there are two forms of diabetes? The first, type 1 diabetes, occurs when the body is unable to produce insulin. It generally starts during childhood and is linked to autoimmune disease. 

The second, type 2 diabetes, occurs when the body produces insulin but cannot respond to it effectively. This condition is usually associated with unhealthy lifestyle behaviours (see below) and, to some extent, genetic predisposition.

Diabetes type 2 starts as “prediabetes”, a condition estimated to affect millions of South Africans. 

“This is a condition where blood glucose levels are higher than normal but not high enough for the person to be diagnosed as having type 2 diabetes. This happens when cells in your muscles, fat and liver don't respond well to insulin and can't easily take up glucose, also known as insulin resistance,” explains Nematswerani. 

“People can live unaware they are prediabetic. The most important diabetes prevention and management tools are achieving and maintaining a healthy body weight, engaging in regular exercise and following a healthy diet. Unless we implement healthy lifestyle changes, prediabetes can progress to type 2 diabetes.”

What increases the risk of type 2 diabetes? 

A range of factors contributes to the development of type 2 diabetes:

1. Genetics: If a parent or grandparent has the condition, you have a higher risk of developing type 2 diabetes if your lifestyle habits are unhealthy.
2. Age: As people get older, the chances of developing type 2 diabetes increase, making regular blood glucose screening important as we age.
3. Abdominal weight: Carrying additional weight around the stomach is a major risk factor. Males should have a waist circumference of less than 102cm, and females should have a waist circumference of less than 88cm. You should measure your waist circumference regularly, or include this measurement when you have your health screening check.
4. Being overweight or obese: Being overweight raises the risk significantly. A significant number of patients with type 2 diabetes are overweight or obese, which is why it is important to check your body mass index (BMI) regularly.
5. Inactivity: It is well-documented that exercise plays a critical role in reducing the risk of type 2 diabetes.
6. Diet: A high-kilojoule diet rich in fatty, starchy or sugary foods can all contribute to weight gain, which is the true cause of type 2 diabetes.
7. Smoking: The more a person smokes, the higher their risk of developing diabetes and this habit makes the disease harder to manage too.

“Even if type 2 diabetes runs in your family, a healthy, portion-controlled diet, frequent exercise, stopping smoking (or never smoking at all), and maintaining a healthy body weight can substantially lower one’s chances of developing type 2 diabetes,” says Nematswerani.

“All of us — not only those who have a family history of diabetes — must have a diabetes screening test at least once a year. The process involves a quick and easy finger prick test and can be done by your doctor, or as part of a Vitality Health Check. Talk to your primary care doctor about your diabetes screening, so that you can get the advice you need before going for your test.

“Discovery Health Medical Scheme members can also can find a healthcare professional to carry out their test by using the 'Find a Healthcare Provider' tool when they are logged in on the Discovery website.”

What support does Discovery Health offer to diabetics?

“The Discovery Health Medical Scheme Chronic Illness Benefit provides comprehensive cover for diabetes management,” explains Nematswerani. “And qualifying scheme members who are registered on the Chronic Illness Benefit for type 1 or type 2 diabetes also qualify to register for access to the Diabetes Care Programme, and gain access to a Premier Plus GP, who will help them to actively manage their diabetes.

“The programme gives members and their Premier Plus GP additional cover for diabetes-related healthcare services and access to various tools to monitor and manage the condition and to ensure they get high quality co-ordinated health care and the best outcomes.”

For more information on diabetes, the Diabetes Care Programme, and the Chronic Illness Benefit, visit discovery.co.za.

This article was paid for by Discovery Health.