It’s called prediabetes, characterized by elevated blood sugar that’s dangerously close to the diabetic range, but not quite there yet. And it’s a problem no one can afford to ignore. People with prediabetes are thought to be ten to 15 times more likely to develop type 2 diabetes in their lifetime. The charity Diabetes UK estimates that around 13.5 million people fall into this category – a quarter of all adults in this country. That’s why, within the decade, one in ten British adults is predicted to have type 2 diabetes, a disease that the NHS already spends £10bn each year treating – or ten per cent of its total budget . Metabolic health expert Professor Naveed Sattar, pictured, said long-term uncontrolled high blood sugar wreaks havoc on the whole body, increasing the risk of blindness, kidney failure and erectile dysfunction People with prediabetes are thought to be ten to 15 times more likely to develop type 2 diabetes in their lifetime It is no longer just a disease of middle or older age. The latest figures show that 122,000 people across England with type 2 diabetes are under the age of 40. And these younger patients are at significantly higher risk of adverse health outcomes. For many it means a lifetime of medication, and even in treatment there are no guarantees. Long-term uncontrolled high blood sugar damages the entire body, increasing the risk of blindness, kidney failure and erectile dysfunction. It stops wounds from healing properly, leading to chronic infections and amputations. And people with type 2 diabetes are much more likely to suffer heart attacks, strokes and dementia. Pre-diabetes isn’t just a precursor to problems – it carries its own health risks. Studies show that those with blood sugar levels in the pre-diabetic range are more likely to suffer heart attacks and strokes than the average person. Some even show damage to the eyes or kidneys, according to recent research by scientists at Imperial College London. This may be linked to excess fat, rather than blood sugar levels. But in short, you don’t want to get either condition. And the good news is that you don’t have to. It is becoming increasingly clear that by identifying prediabetes and taking steps to protect future health, it is possible to prevent the disease before it occurs. And it doesn’t involve drugs, surgeries or expensive treatments – just a few lifestyle changes that, with a little grit and determination, anyone can make. The big questions are: what exactly is prediabetes, how do you know if you have it, and what should you do if you do? As Professor of Metabolic Medicine at the University of Glasgow, I have spent decades treating and studying these conditions. And today, in The Mail on Sunday, we’ll outline the latest scientific evidence on pre-diabetes and everything you need to know about how to beat it. To make this simple, we’ve come up with a five-point plan for dealing with prediabetes that anyone can do. If you are overweight – particularly if your body mass index (BMI) is 30 or higher – you are at greater risk. This is known. But the latest evidence shows that when it comes to pre-diabetes, it’s not just how much fat you have, it’s where on the body that really counts If you are overweight – particularly if your body mass index (BMI) is 30 or higher – you are at greater risk. This is known. But the latest evidence shows that when it comes to pre-diabetes, it’s not just how much fat you have, but where on the body that really counts. Some people are genetically predisposed to store excess fat more quickly in the liver and other organs. This so-called ectopic fat is a big risk factor. But as we’ll explain, genetics doesn’t mean our fate is sealed. Losing weight or changing your diet can have a dramatic impact on your blood sugar. It’s advice many of us could do with listening. Even after the Covid pandemic, 63 per cent of adults in England were overweight or obese. And the last few years haven’t helped. Around 40 per cent of us put on an average of half a stone during lockdown, according to a study. The latest figures show that 122,000 people across England with type 2 diabetes are under the age of 40. And these younger patients are at significantly higher risk of adverse health outcomes I emphasize, this is an average. A patient came to my clinic who had turned 3 since I last saw him in 2020. He had stopped commuting and was working from home. Instead of walking 10,000 steps a day – which he did and which burns about 400 calories – he just sat around. The important thing is that he was eating the same amount. You don’t have to be that overweight to develop prediabetes: on average, people with the condition are between half a stone and a stone and a half heavier than people with ideal blood sugar levels. However, on average, people with prediabetes only need to put on a few extra pounds before reaching full-blown diabetes. You don’t have to be that overweight to develop prediabetes: on average, people with the condition are between half a stone and a stone and a half heavier than people with ideal blood sugar levels And that’s what gives us such an ideal opportunity to do something about it before it becomes a problem. And it doesn’t have to be that hard. Despite what you may have heard, experts agree that you don’t need to go on a crash diet, live on meal replacement shakes or cut out carbs to turn things around. I am Asian and have a family history of diabetes, which means I am at a significantly higher risk. I do little things to keep the weight off. I always have a salad with my evening meal as being full means I will eat less carbs or meat. I’ve trained myself to stop taking sugar in my tea and only eat one finger from a KitKat. It means I really enjoy it and I enjoy it a lot more. It’s a treat, not just something I consume mindlessly. All of us can make some simple, sustainable changes. And I’m not exaggerating when I say they can be life-changing. My research found that people with prediabetes can also have high blood pressure. They may also have high levels of triglycerides in the blood – fat deposits linked to heart disease My research found that people with prediabetes can also have high blood pressure. They may also have high levels of triglycerides in the blood – fat deposits linked to heart disease. By preventing these things by keeping your weight down, you will live longer and healthier. Type 2 diabetes is not inevitable. I like to look at pre-diabetes, no matter how serious it is, as a positive thing: discovering it gives us a chance to take control and avoid the worst. Read on to find out how… Prediabetes: What it is – and how do you know if you’re one of the thirteen million at risk Diabetes does not develop overnight. It starts with very subtle “communication problems” within the body’s cells and can take years to seriously affect your health. And that gives us plenty of time to do something about it. But it’s vital to understand whether you may be at risk and how the problem develops. Type 2 diabetes begins life as prediabetes, when blood sugars are abnormally high and, without lifestyle changes, the full-blown disease can occur. In prediabetes, the hormone insulin, which transports sugars from food into our blood, where it is used for energy, does not work as it should. The sugar remains in the blood, raising its levels to higher than normal but not high enough to develop type 2 diabetes or cause obvious symptoms. This begs the question: if there are no symptoms, how do you know if you are at risk? It is becoming increasingly clear that by identifying prediabetes and taking steps to protect future health, it is possible to prevent the disease before it occurs. And it doesn’t involve drugs, surgery or expensive treatments – just a few lifestyle changes that, with a little grit and determination, anyone can make First, it’s worth having a look at the free online questionnaire on the Diabetes UK website (diabetes.co.uk), which analyzes your personal diabetes risk taking into account everything from family history and ethnicity to weight and diet . The results will give you an idea of ​​whether prediabetes is something you should be concerned about either now or in the future. And if it’s a concern, your doctor can arrange a blood test, which we’ll explain in more detail later. But what’s critical is knowing the most important factors that could already be putting you at risk. Here’s how to know if your blood sugar levels are likely to reach the danger zone and what you can do about it. Control your weight – and your waistline The single biggest risk factor for prediabetes is excess body fat. Research shows that the accumulation of fat around or inside the organs can affect how the body’s cells respond to insulin, disrupting blood sugar control. Checking your body mass index, or BMI, gives a good indication of whether this may be the case. People living with obesity – meaning they have a BMI of 30 or more – are up to 80 times more likely to develop diabetes than those with a healthy BMI of less than 22, according to studies. A BMI calculator is available on the NHS website. Anything over 25 is considered overweight. Waist size is also a good risk indicator for diabetes because it is a sign of excess fat near or inside organs such as the liver. This type of fat – known as ectopic fat – significantly impairs insulin function. Men must have a waist measurement of less than 37 inches, while women must…