If you have blood glucose level higher than normal but not high enough to diagnose it as diabetes, than you have prediabetes. The risk of developing diabetes is very high among prediabetics in compare to general population. In one study (Diabetes Prevention Program) it was estimated that approximately 11 percent of prediabetics develop diabetes (type 2 diabetes) every year. It is estimated that a major percentage of prediabetics develop diabetes within ten years.

All ages and all the races are susceptible to prediabetes, although some ethnic groups are at greater risk of developing prediabetes and diabetes, e.g. African Americans, Asian Americans.

The University Group Diabetes Program (UGDP), a study on diabetes was conducted in the United States in the year 1970. The study found that the cardiovascular mortality was higher among diabetics treated with oral hypoglycemic drugs than those treated with diet and exercise alone or with insulin. After the study report was published, there was decline in the use of oral hypoglycemic drugs for treatment of diabetes. Later many studies were conducted, some of the studies supported the claim of UGPD and some refuted the claims.

The controversy generated by the report of the study (UGDP) was settled by UKPDS permanently and at present there is no controversy of the status of oral hypoglycemic drugs in treatment of diabetes mellitus type II. The UKPDS has proved that there is no increase in cardiovascular mortality due to use of sulfonylureas (Glimepiride, Glipizide, Glyburide, Glibenclamide etc.) and metformin (both of these groups are commonly prescribed these days in management of type-2 diabetes). In the study patients receiving these drugs were observed for more than 10 years and no increase in cardiovascular mortality was reported.

A small percentage of hemoglobin (the iron containing pigment in red blood cells which is responsible for oxygen transport in our body) binds to which results in formation of glycosylated hemoglobin. The binding of glucose to hemoglobin is very strong and remain for the rest of the life of red blood cells (RBC), and the life of red blood cells is approximately 120 days. Glycosylated hemoglobin is also known as HbA1c.

The level of glycosylated hemoglobin is dependent on the glucose level of blood, especially long term level of glucose in blood. The higher the blood glucose level the higher is the percentage of glycosylated hemoglobin and vice versa. Also the longer the blood glucose level remains high the higher is the percentage of glycosylated hemoglobin in blood.

There are few agents which can be used (and sometimes used, albeit not commonly) in treatment of diabetes, mainly type-2 diabetes. These uncommon agents include Guargum, Glucomannan etc.

Guargum:

This is a dietary fiber, a polysaccharide derived from Indian cluster beans known as Guar in India. Guargum forms a viscous gel on contact with water. Guargum is administered few minutes before meal or it can be mixed with food. Guargum slows down gastric emptying time, intestinal transit time as well as reduce absorption of carbohydrates (glucose, sucrose etc.). The postprandial rise in glucose level is reduced, although overall lowering of blood glucose is minimal. Guargum also reduce blood (serum) cholesterol by approximately 10%. Guargum is not absorbed, but fermented in colon.