According to a recent study, a healthy 45-year-old person has a 45% chance of developing prediabetes and 31% of having diabetes in the future.

The key to preventing diabetes lies in monitoring the hydrocarbonated metabolism through continuous measurement of three essential biomarkers: blood glucose, glycosylated hemoglobin and insulin. The objective of Age Management Medicine is to achieve values ​​of excellence across all of the biomarkers, which in practical terms means that those biomarkers associated with the development of said disease need to be reduced to almost zero.

Neolife medical management

Any deterioration in your hydrocarbonated metabolism may not only lead to the onset of diabetes but it may also cause heart attacks, or the onset of Alzheimer’s and cancer in the future.

Any impairment to your glucose metabolism at a previous time in your life is likely to be relevant to your present health so the strategies we propose to our patients are provided in an attempt to control and prevent this type of deterioration. We recommend that such plans be implemented as soon as possible, irrespective of their general health condition.

Any deterioration in your hydrocarbonated metabolism (of glucose) across any of the different levels (normal, prediabetes, type 2 diabetes, use of insulin) is considered to be one the “men of the apocalypse” and an omen in terms of your health. Such changes tend to indicate that the patient may present with potential cardiovascular disease (heart attack, hypertension, stroke), cancer or a neurodegenerative disease (mainly Alzheimer’s) in the future. In reality all of these diseases form part of the ageing process and are arguably therefore related to each other. Notably the deterioration of your glucose metabolism and the onset of diabetes can lead to all the other problems (heart attack, Alzheimer’s disease and cancer). That is why the monitoring and control of the glucose metabolism is so important.

This aspect has been further investigated by the authors of a magnificent study recently published in Lancet (1), in which the risk of developing prediabetes and diabetes has been studied throughout life. The data was obtained from 10,050 participants who participated in the Rotterdam Study and the follow-up period of approximately 15 years. Of the total participants, 1,148 developed prediabetes, 828 developed diabetes and 237 required treatment with insulin. The criteria by which the participants were classified into the different groups were those applied by WHO and are listed as follows:

• Normal: fasting glucose below 108 mg/dL
• Prediabetes: fasting glucose between 108 mg/dL and 125 mg/dL
• Diabetes: glucose above 125 mg/dL

The study calculated that the risk of a healthy person aged 45 developing prediabetes throughout the rest of their life was nearly 50%, whilst the risk of developing diabetes was 31% and of 9% that they would require insulin. People who are already prediabetic at 45 have a 74% risk of becoming diabetic and nearly 50% risk that they will have to use insulin for the rest of their lives. The above risk percentages decrease with age as there is less time to live (and consequently develop the disease) or increase in weight to a level deemed to be overweight.

At the Neolife anti-ageing clinic we closely monitor your hydrocarbonated metabolism (even several times a year) and we do not solely rely on fasting glucose. We also measure your glycosylated hemoglobin and insulin levels. Our application of Age Management Medicine also includes reference ranges to help us better understand the biomarker values. Our objective is to achieve values ​​of excellence across all of the biomarkers, which in practical terms means that those biomarkers associated with the development of said disease need to be reduced to almost zero. All these biomarkers which relate to hydrocarbonated metabolism can be correlated with the risk of developing diabetes and the subsequent cardiovascular, renal, retinal and neurological complications, as well as a reduced level of hope and quality of life.

It is necessary to monitor the glucose, glycosylated hemoglobin and insulin to determine the relative success of the prevention measures undertaken.

Fasting glucose level is an essential biomarker in the diagnosis of diabetes: a value above 125 mg/dL indicates the individual has a high risk of suffering from diabetes in the future; if this parameter is between 108 and 125 mg/dL, then the level is typically indicative of prediabetes; on the contrary, a value below 90 mg/dL is optimal and serves to protect the individual from cardiovascular disease.

The hemoglobin A1C (HbA1C) or glycosylated hemoglobin or glycated hemoglobin is an excellent “whistle blower” and can highlight a diet that is high in carbohydrates. Hemoglobin is found inside the red blood cells and is exposed to glucose so that the glucose molecules adhere to the hemoglobin forming the glycosylated hemoglobin. The percentage of glycosylated hemoglobin depends on the blood glucose levels and the age of the red blood cells that carry the hemoglobin. Since the half-life of red blood cells is 3 months, a high percentage of this biomarker is indicative of a high blood glucose level over the last 3 months. Today HbA1C is used as a biomarker for diabetes and prediabetes as it is more accurate than fasting glucose testing. A value above 6.5% typically indicates diabetes, between 5.7% and 6.5% indicates prediabetes, below 5.7% is considered normal and the optimal value is below 5.1%.

Insulin is a hormone secreted by the pancreas when glucose levels increase after eating and allows glucose to enter the cells (especially the liver, brain and muscles) prior to use as energy. The amount of insulin required to maintain a certain level of blood glucose is an indicator of the resistance and sensitivity of cell receptors in the body to insulin. The measurement of fasting insulin for a given glucose level is often an important indicator of the level of resistance and/or sensitivity of cell receptors to the aforementioned hormone. A normal value should be below 25 mU/L, but a value of excellence is closer to 6 mU/L. The chances of developing diabetes are doubled with a basal insulin of 8 mU/L and multiplied 5-fold in cases where there is a basal insulin of 25 mU/L when compered to a value of 5 mU/L (2).

The strategies to maintain the three biomarkers at their respective levels of excellence are basically two-fold: regular exercise and a low glycemic index diet. Although it is not always easy to maintain a glucose level below 90 mg/dL, a HbA1c of approximately 5% and an insulin of around 6 mU/L is far from impossible. At the Neolife clinic most of our clients achieve their goal, which ensures they can enjoy a magnificent quality of life, health and a sense of well-being.

BIBLIOGRAPHY

(1) van Herpt, T., Stricker, B., Sijbrands, E. et al. “Lifetime risk of developing impaired glucose metabolism and eventual progression from prediabetes to type 2 diabetes: a prospective cohort study” The Lancet, Published Online: 10 November 2015

DOI: https://dx.doi.org/10.1016/S2213-8587(15)00362-9

https://www.thelancet.com/journals/landia/article/PIIS2213-8587(15)00362-9/abstract

(2) Johnson, JL., Duick, DS., Chui, MA, et al. “Identifying Prediabetes Using Fasting Insulin Levels”. Endocr Pract. 2010 Jan-Feb; 16(1):47-52.doi:10.4158/EP09031.OR.