3 Tests to detect borderline diabetes

India is fast emerging as the diabetes capital of the world

According to the data of International Diabetes Foundation, India has one of the highest burden of diabetes in the world with an estimated 65.1 million (6.5 crores) people suffering from diabetes in 2010. The latest figures in 2015 are about seven crores.

Before people actually develop type 2 diabetes, they may have a condition called "prediabetes" or "borderline diabetes", where the blood sugar (glucose) levels are higher than the standard value, but not high enough to be diagnosed with diabetes. In India, an estimated 77.2 million (7.7 crores) people have prediabetes.

Prediabetes is a warning sign

Detecting borderline diabetes is important because it is a warning sign that the individual is likely to progress to type 2 diabetes in a few years' time. The annual conversion rate of prediabetes is about 5-10%, which means that out of 100 people with prediabetes (borderline diabetes), around 5-10 will turn into diabetics yearly.

Research also indicates that some of the long-term organ-damaging effects of diabetes, especially heart and blood vessel injury may be starting when the person is in prediabetes stage.
The good news, however, is that getting diagnosed in prediabetes stage can give you an opportunity to make some changes to your daily routine that may help you in preventing or delaying the progression to diabetes. With healthy lifestyle changes such as making dietary changes, increasing physical activity and maintaining a healthy weight, you can bring your blood sugars under control.

Three tests to detect borderline diabetes

Early detection and management of borderline diabetes will help in the prevention of progression to full-blown diabetes and prevents the onset of complications of diabetes. There are few tests to detect borderline diabetes, they include:

1. Fasting Plasma Glucose (FPG) or Fasting Blood Sugar (FBS)

This test is done to detect the level of sugar (glucose) in the blood after fasting. After about 8 hours of fasting (not eating or drinking anything except water), which is usually in the morning, before breakfast, blood is drawn for the test.

Diabetes is diagnosed if the fasting blood glucose is between 100 to 125 mg/dL

Fasting Plasma Glucose (FPG) levels
Units = mg/dL	Units = mmol/L	Interpretation
less than 100 mg/dL	below 5.6 mmol/L	Normal
100 mg/dL to 125 mg/dL	5.6 to 6.9 mmol/L	Prediabetes
126 mg/dL or more	7 mmol/L or higher	Diabetes

2. HbA1C

The HbA1C test or A1C test gives an average measure of your blood glucose levels for the past 2 to 3 months. For this test, no fasting is required like the other tests, and a spot sample of blood is enough.

Prediabetes is diagnosed if the HbA1C level is between5.7% to 6.4%.

A1C levels
In Percentage	Interpretation
less than 5.7%	Normal
5.7% to 6.4%	Prediabetes
6.5% or more	Diabetes

3.Oral Glucose Tolerance Test (OGTT)

The OGTT assesses your blood glucose levels in fasting state and about 2 hours after you drink a specially made sweet drink (containing glucose). These two values tell the doctor, how well your body is processing glucose.

Prediabetes is diagnosed when the 2-hour blood glucose levels are between 140 - 199 mg/dl.

Oral Glucose Tolerance Test (OGTT)
When unit is mg/dL	When unit is mmol/L	Interpretation
less than 140 mg/dL	below 7.8 mmol/L	Normal
140 mg/dL to 199 mg/dL	7.8 and 11 mmol/L	Prediabetes
200 mg/dL or more	11.1 mmol/L or higher	Diabetes