If you are regularly experiencing tingling, burning, numbness, and pain in your feet, you may be prediabetic -- a sign that your body’s insulin levels are rising, said Dr. Sudhir Kumar, a Hyderabad-based neurologist on 7 April.

Prediabetes can be defined as the presence of higher-than-normal blood sugar levels and a high risk of developing Type 2 diabetes.

Diabetes, known to increase the risk of heart attack, stroke, and other serious illnesses, is “taken seriously, however, prediabetes is not given the seriousness it deserves,” said Dr Sudhir, a neurologist at Indraprastha Apollo Hospitals.

Data show that about 136 million people in India, or 15.3 per cent of the population of the country are prediabetic -- a stage which can act as a wake-up call and prevent diabetes.

“People with prediabetes also have a higher risk of stroke, heart attack, peripheral neuropathy (damage of nerves), and retinopathy (which can lead to vision impairment),” Dr Sudhir said.

One can easily gauge their diabetes levels using a simple blood test called the HbA1C. The haemoglobin A1c (glycated haemoglobin, glycosylated haemoglobin, HbA1c, or A1c) test is used to evaluate a person's level of glucose control.

It shows an average of the blood sugar level over the past 90 days and represents a percentage. For many people, the diabetes monitoring test HbA1C may show 6 per cent and is usually considered normal.

However, it is not, said the doctor. “Glycosylated haemoglobin (HbA1C) of 6 per cent is not normal,” Dr Sudhir said.

“An HbA1C of greater than 5.7 is referred to as prediabetes. More than 10 per cent of patients with prediabetes can have tingling, burning, numbness, and pain in feet, a condition referred to as prediabetic neuropathy.

“For an HbA1c test to classify as normal, or in the non-diabetic range, the value must be below 5.7 per cent. Anyone with an HbA1c value of 5.7 per cent to 6.4 per cent is considered to be prediabetic, while diabetes can be diagnosed with an HbA1c of 6.5 per cent or higher,” he explained.

The doctor, however, cautioned that the target of HbA1C below 5.7 per cent is “recommended only for healthy people, or people with diabetes/prediabetes who are not on medications.”

For those taking anti-diabetic medications, “the ideal HbA1C level is 6.5 per cent”. “This is because stricter control in people taking anti-diabetic medications may lead to hypoglycemia (low blood sugar), which can cause severe complications,” he explained.

The key to lowering the HbA1C levels is via “carbohydrate restriction in the diet.”

“This can be achieved by avoiding or restricting sugar, jaggery, honey, etc. Sugar-sweetened beverages (soft drinks, packed fruit juices) and sweets should be avoided,” the doctor said.

He also advised minimising the “intake of rice, roti, idli, dosa, potatoes, and fruits”, and suggested a combination of aerobic exercises and strength training.