Patients should monitor for signs and symptoms of type 2 diabetes mellitus such as increased thirst, increased urination, and feeling tired. Causes
The cause of prediabetes is multifactorial and is known to have contributions from lifestyle and genetic factors. Ultimately prediabetes occurs when control of insulin and blood glucose in the body becomes abnormal, also known as insulin resistance. Risk factors for prediabetes include family history of diabetes, older age, women who have a history of gestational diabetes or high birth weight babies (greater than 9 lbs. ).The increasing rates of prediabetes and diabetes suggest lifestyle and/or environmental factors that contribute to prediabetes. It remains unclear which dietary components are causative and risk is likely influenced by genetic background. Lack of physical activity is a risk factor for type 2 diabetes and physical activity can reduce the risk of progressing to type 2 diabetes. Pathophysiology
Normal glucose homeostasis is controlled by three interrelated processes. These processes include gluconeogenesis (glucose production that occurs in the liver), uptake and utilization of glucose by the peripheral tissues of the body, and insulin secretion by the pancreatic beta islet cells. The presence of glucose in the bloodstream triggers the production and release of insulin from the pancreas beta islet cells. The main function of insulin is to increase the rate of transport of glucose from the bloodstream into certain cells of the body, such as striated muscles, fibroblasts, and fat cells.
Fasting and "acute perturbations" are not needed for HbA1c test and it reveals average glycemic control over 3-month period. HbA1c less than 5.6% is considered normal. Glucose status can also be tested through fasting blood sugar (FBS) and requires a blood sample after a patient has fasted for at least eight hours, so it might not be as convenient. Patients who have gotten oral blood samples taken say it feels as if part of a normal procedure, and dentists say it is convenient.In a study that analyzed data from 10,472 adults from 2013 to 2014 and 2015 to 2016, it was revealed that screening for risk of prediabetes in the dental setting has the potential to alert an estimated 22.36 million adults. Diabetes may be asymptomatic for a long time, but since it would be wasteful to test every patient at the dental office, utilizing known risk factors may guide who is ideal for testing. Since a history is already taken at a dental office, a few additional questions would help guide a dentist on narrowing down who the test is recommended for. For example, people with high BMI are at higher risk for diabetes. A study done by the School of Dentistry, Diabetes Research Centre, Mazandaran University of Medical Sciences in Sari, Iran found a relation between periodontitis and the prediabetic condition, and this could be another tool to help guide who might be recommended to take the test.