Chris Kresser: “What functional ranges and relevant markers would put a person in the prediabetic bracket?” This is from Chi, also.
Prediabetes has a certain definition that’s a conventional definition. I guess there isn’t really such a thing as functional prediabetes that I am aware of. It’s just prediabetes in the United States. It’s when your fasting glucose is above 99 and 126, and A1c is above 5.6, so it’s 5.7 to—I can’t remember the ___ [23:51] cutoff for prediabetes. Those are the cutoffs and that’s what we would define as prediabetes. I guess what I would say is, in the conventional model, what’s kind of weird is that it’s like, “Oh, if you’re at 98, you’re totally fine.” But then as soon as you get to 99, “Oh my gosh, now you have diabetes.” Obviously, it doesn’t work like that. It’s a spectrum, so from a functional perspective, we might say that a fasting glucose of 95 might be okay, especially if it’s just one time. But if that’s 95, and A1c is 5.5, and fasting insulin is, like, 13, which is above the optimal of 7 but still in the lab range, then, yes, I’m going to be looking at that as functionally elevated blood sugar and I’m going to be addressing it so that person does not progress to prediabetes.