Months, years, and even decades before developing full-fledged Type 2 diabetes, many people develop a condition termed pre-diabetes. They have blood sugar levels that are too high to qualify as normal, but not quite high enough to require diabetes treatment. The reason many people with these conditions go undiagnosed, however, is that their doctors almost always rely on blood tests taken while the patient is fasting.

When fasting blood sugar readings range between 100 to 125 mg/dL (5.5 to 7 mmol/L) doctors put the patient on watch for future diabetic developments. These readings mean that for some reason, too much sugar is floating around in your bloodstream. It may be because your body:

• doesn’t make enough insulin
• you eat more food for fuel than you can handle
• for some reason your insulin isn’t working right, or
• a combination of all these factors

The problem with relying on fasting sugar levels, however, is that sometimes they don’t detect an important part of the pre-diabetic condition known as impaired phase 1 secretion.

The insulin-producing beta cells of the pancreas don’t churn out insulin at the same rate all the time. They spend all their energy making pro-insulin, which they “unzip” to get sugar levels down when they are highest, which is about 90 to 120 minutes after eating, when sugars are digested from food.

Pre-diabetics often have an “unzipping” defect. The beta cells are so burdened by toxic free radicals they just can’t get their work done fast enough to keep blood sugar levels in check after meals. They can, however, release enough insulin to get fasting sugar levels back down to normal or nearly normal the next morning. Only after a period of years, as most of the beta cells die off, do fasting blood sugar levels get so high that the doctor then makes a diagnosis of Type 2 diabetes.

Don’t rely on fasting readings alone. If you blood sugar levels go up to 140 to 199 mg/dL (7.8 to 11 mmol/L) after you eat, this is also a sign that you have pre-diabetes. An occasional blood test that isn’t taken while you are fasting can give you an early warning years sooner, giving you precious time to control and even reverse your pre-diabetes.

You may be asking… what’s the big deal? Why should you worry? You haven’t been diagnosed with Type 2 diabetes… yet! Pre-diabetes, diabetes and obesity are associated with an increased risk of developing many other health problems. People don’t wake up one day to discover they’ve suddenly developed Type 2 diabetes. The progression from normal to pre-diabetic and then to Type 2 diabetic typically occurs over many years.