From the Guidelines
A fasting glucose level of 111 mg/dL indicates prediabetes, meaning your blood sugar is higher than normal but not yet high enough to be diagnosed as type 2 diabetes. This condition is characterized by an intermediate glucose level that does not meet the criteria for diabetes but is higher than what is considered normal. According to the most recent and highest quality study 1, a fasting glucose level between 100 mg/dL and 125 mg/dL is considered impaired fasting glucose (IFG) or prediabetes.
Key Points to Consider:
- The normal fasting glucose range is below 100 mg/dL, while diabetes is diagnosed at 126 mg/dL or higher.
- With prediabetes, lifestyle modifications are crucial, including:
- Weight loss if overweight
- Regular physical activity (aim for at least 150 minutes of moderate exercise weekly)
- Dietary changes such as reducing refined carbohydrates and sugars while increasing fiber intake
- No medications are typically prescribed at this stage unless other risk factors are present.
- It's essential to have your glucose levels rechecked in 6-12 months and consider an oral glucose tolerance test for further evaluation.
- Prediabetes is reversible, but without intervention, approximately 15-30% of people with prediabetes will develop type 2 diabetes within 5 years 1.
- The elevated glucose occurs because your body is developing insulin resistance, where cells don't respond properly to insulin, causing glucose to remain in your bloodstream rather than entering your cells for energy.
Importance of Early Intervention:
Early detection and management of prediabetes can significantly reduce the risk of developing type 2 diabetes and its associated complications, such as cardiovascular disease, nephropathy, and retinopathy. The American Heart Association recommends aiming for a normal blood glucose level through lifestyle modifications, including a healthy diet and regular physical activity 1. By taking proactive steps, individuals with prediabetes can improve their glucose control, reduce their risk of developing type 2 diabetes, and maintain a better quality of life.
From the Research
Fasting Glucose Level of 111 mg/dL
A fasting glucose level of 111 mg/dL indicates a condition known as impaired fasting glucose (IFG) or prediabetes 2. This condition is characterized by elevated glucose levels that are not sufficient to be classified as diabetes but represent the development of insulin resistance.
Definition of Prediabetes
Prediabetes is defined by the American Diabetes Association as a fasting plasma glucose between 100 and 125 mg/dL (5.6 - 6.9 mmol/l) and/or a 2-h plasma glucose during an oral glucose tolerance test (OGTT) between 140 and 199 mg/dL (7.8 - 11.0 mmol/l) 2.
Implications of Impaired Fasting Glucose
Impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) are two core defects of type 2 diabetes, manifesting as insulin resistance and β-cell dysfunction 3. However, the site of insulin resistance and shape of β-cell dysfunction differ between IFG and IGT.
Key Points to Consider
- A fasting glucose level of 111 mg/dL falls within the range of impaired fasting glucose (IFG) or prediabetes 2.
- Prediabetes predisposes patients to develop diabetes and macrovascular disease 2.
- The diagnosis of diabetes is established on one of the following criteria: a fasting plasma glucose ≥ 126 mg/dl, a casual plasma glucose ≥ 200 mg/dl, a 2-h plasma glucose during the 75-g oral glucose tolerance test (OGTT) ≥ 200 mg/dl, and/or an HbA1c ≥ 6.5% 2.
- Achieving glycemic control in patients with prediabetes through lifestyle and pharmacologic interventions can effectively prevent or delay the development of diabetes and its associated complications 4.
Screening and Diagnosis
The performance of A1C and fasting capillary blood glucose (FCG) tests as mass screening tools for diabetes and prediabetes has been evaluated, with FCG measurement performing better than A1C in some populations 5. However, the threshold of fasting plasma glucose defining IFG and the adequacy of HbA1c as a correct diagnostic tool for prediabetes is still debated 2.