Question Mark by Marco Bellucci (Creative Commons)
Almost always, individuals have pre-diabetes before developing diabetes. Prediabetes is the state in which some but not all of the diagnostic criteria for diabetes are met. In particular, it is the state during which an individual has blood glucose levels that are higher than normal but not high enough to be called diabetes.
So what exactly is it that’s considered “normal” and “not normal”?
A non-diabetic individual exhibits…
· A fasting (no food for eight hours) blood sugar level is between 70 and 99 mg/ dL
· Any random blood sugar level less than 140 mg/ dL
A diabetic exhibits…
· A fasting blood sugar level equal to or greater than 126 mg/dL
· Any random blood sugar level equal to or greater than 200 mg/ dL
(https://www.virginiamason.org/WhatareNormalBloodGlucoseLevels)
From these numbers, you can get a sense of where the blood glucose levels of individuals with prediabetes would lie. What is it, though, that causes this increase in blood sugar levels? We can answer this question by taking a quick look into the body of an individual with pre-diabetes.
Insulin is used to bring glucose into the cell.
http://www.austincc.edu/apreview/EmphasisItems/Glucose_regulation.html
Glucose is our key source of fuel and must be present for our cells to utilize. Glucose cannot enter cells on its own, however, and must be transported inside. For glucose transport to occur, a hormone known as insulin steps in. The role of insulin is to attach to insulin receptor at the surface of the cells, at which point, glucose transporters will come to take glucose into the cells. This crucial hormone is produced by the beta cells of the pancreas.
In an individual with prediabetes, one of two things is beginning to happen.
1)Decreased insulin production:
If the beta cells of the pancreas are under constant stress and are too frequently demanded to produce and secrete insulin, they can become exhausted. At this point, they will begin to make less insulin than is required, and glucose regulation is impaired as a result.
2) Insulin resistance:
In this case, the beta cells of the pancreas have no problem producing insulin. However, insulin is no longer able to carry out its role and fails to regulate glucose transport. The reason for this is that the insulin receptor cells on the cell membrane are failing to bind insulin. In fact, the receptor cells are so used to being surrounded by insulin that they longer react to its presence.
Both of these cases result in insufficient amounts of glucose entering the cells. As a result, glucose accumulates in the blood and blood sugar levels rise.
