It also is necessary for transport of amino acids, glycogen formation in the liver and skeletal muscles, triglyceride formation from glucose, nucleic acid synthesis, and protein synthesis. In individuals with prediabetes, a failure of pancreatic hormone release, failure of targeted tissues to respond to the insulin present or both leads to blood glucose rises to abnormally high levels. Diagnosis
Prediabetes can be diagnosed with three different types of blood tests:
Fasting blood sugar (glucose) level of:
110 to 125 mg/dL (6.1 mmol/L to 6.9 mmol/L) – WHO criteria
100 to 125 mg/dL (5.6 mmol/L to 6.9 mmol/L) – ADA criteria
Glucose tolerance test: blood sugar level of 140 to 199 mg/dL (7.8 to 11.0 mM) 2 hours after ingesting a standardized 75 gram glucose solution
Glycated hemoglobin (HbA1c) between 5.7 and 6.4 percent, i.e. 38.9 and 46.4 mmol/molLevels above these limits would justify a diagnosis for diabetes. Impaired fasting glucose
Impaired fasting glycemia or impaired fasting glucose (IFG) refers to a condition in which the fasting blood glucose is elevated above what is considered normal levels but is not high enough to be classified as diabetes mellitus. It is considered a pre-diabetic state, associated with insulin resistance and increased risk of cardiovascular pathology, although of lesser risk than impaired glucose tolerance (IGT). IFG sometimes progresses to type 2 diabetes mellitus. Fasting blood glucose levels are in a continuum within a given population, with higher fasting glucose levels corresponding to a higher risk for complications caused by the high glucose levels.
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.