Pre-Diabetes, Getting to the Heart of the Matter

What is Pre-diabetes?

Pre-diabetes is defined by blood glucose levels that are higher than normal, but lower than diabetes thresholds. There are generally 2 types, namely Impaired Glucose Tolerance (IGT) and Impaired Fasting Glucose (IFG). See your Doctor to determine if you have pre-diabetes.

How can we manage pre-diabetes?

The multi-prong approach to management of pre-diabetes include:

  1. Lifestyle intervention (individualized to each patient, see your Doctor to tailor your advice)
    • Adopting a healthy diet (aim to reduce total caloric intake)
      • Healthy plate
      • Reduced intake of fat
      • Reduced intake or avoidance of sweetened food & beverages
      • Reduced intake or avoidance of alcohol
    • Increased physical activity
    • Smoking cessation (if applicable)
  2. Behavioral changes (individualized to each patient) & sustaining it
  3. Medication (in select individuals. See your Doctor to determine if you require medications)

Around 14% of Singaporeans have IGT, and about 35% of pre-diabetic will progress to type 2 diabetes mellitus (T2DM) within 8 years if left untreated. People with diabetes are 2 to 3 times more likely to have cardiovascular diseases (CVD).

Complications of Diabetes

The complications of diabetes are countless and includes ischemic heart disease (heart), development of  heart failure, stroke (brain), renal failure (kidney), retinal disease (eye), peripheral vascular diseases (e.g. blood vessels of the legs/arms) amongst others.

There are increasingly more trials showing that some glucose-lowering agents exert important cardio-protective effects, significantly reducing the incidence of stroke, cardiovascular death, heart attack, heart failure and occurrence of hospitalization for heart failure.

An estimated 425 million adults worldwide have diabetes and the number is projected to rise to 629 million by year 2045 if nothing is done. The need to prevent as well as treat diabetes have never been greater.


AUTHOR: Dr. Ang Teck Kee, Consultant & Interventional Cardiologist, Livingstone Cardiology

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