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Sunday, September 14, 2014
What is impaired glucose tolerance? What will be the treatment? Thank you
Impaired Glucose Tolerance, or IGT, occurs when the fasting glucose concentration (after at least 8 hours of fasting) is in the 100-125 mg/dl range. This can also be termed prediabetes, as levels are elevated but do not meet the diagnostic criteria for Diabetes. These people have a significantly increased risk of developing Diabetes. Most people with prediabetes or IGT do not have symptoms but 10% may develop micro vascular complications of the eye (retinopathy), kidneys (nephropathy), and lower extremities (neuropathy), before actually being diagnosed with Diabetes.
IGT also carries an increased mortality risk. It is estimated that the onset of Diabetes occurs 4-7 years prior to it's diagnosis as many people already have sign of these complications at diagnosis. People with increased risk for developing Diabetes should be educated about lifestyle changes that can significantly slow that progression.
Weight loss, even modest decreases of 7-10%, regular physical activity along with nutritional and smoking cessation counseling are areas of change possible to reduce complications and advancement to Diabetes. Reduction of these risk factors we can control as well as adequate control of others such as high blood pressure, or elevated cholesterol levels will also help to prevent progression to Diabetes.
The American Diabetes Association, ADA, recommends screening for Type 2 diabetes in all asymptomatic people 45 years of age or earlier if there is a family history of Type 2 Diabetes. This should be repeated every three years if negative. Discovering those with potential for diabetes early can trigger the lifestyle changes needed to delay its progression and reduce complications.
Lucy Long, RN, BSN,CDE
Case Western Reserve University