Question: Is the term “borderline diabetes” a misnomer? Does it really mean adult onset diabetes (type II diabetes)?
Answer: There are two types of diabetes ( type I and type II). Patients with Type I diabetes lack insulin, and need insulin injections for survival. Patients with type II diabetes have insufficient insulin or resistance of body cells to insulin action. Exercise, diet, weight loss, and oral medications can be effective in controlling high blood glucose in many patients with type II diabetes. Insulin injections are used when these measures fail to adequately control blood glucose levels.
The term “borderline diabetes” has been used to refer to type II (adult onset diabetes) patients whose blood glucose are well controlled with diet and/ or oral medications. These patients do have diabetes mellitus as diagnosed by abnormal fasting blood glucose and glucose tolerance tests. They are also at risk of future complications of diabetes. Close and continued monitoring is important to prevent worsening of blood glucose levels and to reduce future diabetes complications.
“Borderline diabetes” has also been used to describe patients who do not have diabetes mellitus. Their fasting blood glucose levels are normal, but their oral glucose tolerance test is minimally abnormal (not in levels seen in diabetic patients). These patients may have body cells that are resistant to the action of insulin, causing impaired glucose tolerance (but not overt diabetes). Some of these patients may develop diabetes later in life.