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What Is Prediabetes? Symptoms, Treatments, and More

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What Is Prediabetes? Symptoms, Treatments, and More

What is prediabetes? How do you know if you have it? How is it diagnosed? And what can you do about it if you have it? Get answers to your questions and learn more about this prevalent condition that is a precursor to type 2 diabetes.

What is prediabetes?

Prediabetes is a serious health condition where blood sugar levels are higher than they should be, but not high enough to be considered type 2 diabetes. Currently, more than 88 million American adults – more than one in three – have prediabetes, says the CDC (Centers for Disease Control and Prevention), but more than 84% of these folks don’t know they have it.

Why is prediabetes so serious?

You might not think that prediabetes is something to worry about. After all, it’s “pre” and not diabetes. But if you have prediabetes, it’s a wakeup call to jump into action. Here’s why: left untreated, prediabetes can progress to type 2 diabetes. Type 2 diabetes, in turn, can lead to a host of complications, including high blood pressure, heart disease, stroke, kidney disease, eye problems, nerve damage, and even amputation.

What causes prediabetes?

Prediabetes stems from a condition called insulin resistance. Insulin is a hormone that is made by the pancreas and that helps move glucose (sugar) into cells to be used for energy. With prediabetes, insulin doesn’t work as well as it should to move glucose from the bloodstream into cells. The pancreas then goes into overdrive to make more insulin to help cells respond. But after a while, the pancreas tires out and can’t keep making more insulin. When this happens, blood sugar levels start to rise, leading to prediabetes and eventually, type 2 diabetes.

How long does it take for prediabetes to become type 2 diabetes?

With prediabetes, the window of opportunity to take action is relatively short. In fact, many people with prediabetes can develop type 2 diabetes within five years. One reason that people don’t act is that they may not know they have prediabetes; it can go undetected for a long time until type 2 diabetes shows up.

What are symptoms of prediabetes?

Here’s the tricky part: many people have no symptoms of prediabetes. This explains why it often goes undiagnosed for many years. Some people may notice areas of darkened skin in the armpits or on the back and sides of their neck. This is called acanthosis nigricans, a skin condition that can occur in people who are obese and/or who have type 2 diabetes.

Because you can’t rely on having symptoms, it’s important to talk with your health care provider about getting screened for prediabetes or diabetes. The U.S. Preventive Services Task Force issued new guidelines in August 2021 for screening, recommending that adults aged 35 to 70 years of age who have overweight or obesity get screened for prediabetes or type 2 diabetes, and that “clinicians should consider screening at an earlier age in persons from groups with disproportionately high incidence and prevalence (American Indian/Native American, Asian American, Black, Hispanic/Latino, or Native Hawaiian/Pacific Islander persons).” Also, people with a family history of diabetes, a history of gestational diabetes, or a history of polycystic ovary syndrome (PCOS) may need screening at a younger age.

Who is at risk of prediabetes?

While you may not have any symptoms of prediabetes, you might have some risk factors. These include:

  • Being overweight or obese
  • Being 45 years of age or older
  • Being African American, Hispanic/Latino, American Indian, Pacific Islander, or Asian American
  • Having a parent or sibling with type 2 diabetes
  • Not doing enough physical activity
  • Having had gestational diabetes (diabetes during pregnancy) or giving birth to a baby weighing more than 9 pounds
  • Having polycystic ovary syndrome

What if you’re at risk for prediabetes?

If you have any of the above risk factors, make sure you let your health care provider know. You’ll need a blood test to determine if you have prediabetes — or possibly even type 2 diabetes.

How is prediabetes diagnosed?

Prediabetes is diagnosed with a blood test. There are a few different blood tests that your provider may use. These include:

A fasting blood sugar test

You need to fast (not eat or drink) for at least 8 hours before the test

An A1C test

This blood test measures your average blood sugar over the past two to three months.

A glucose tolerance test

This test measures your blood sugar before and after you drink a liquid that contains glucose. You have to fast overnight before the test and have your blood drawn at one hour, two hours, and maybe three hours after drinking the glucose drink.

What do the results of the blood tests mean?

Your provider will determine which test is best for you. Whichever test you have, here is what the results mean:

DIABETES BLOOD TEST RESULTS
Result Fasting Blood Sugar A1C Glucose Tolerance Test
Prediabetes 100-125 mg/dl 5.7-6.4% 140-199 mg/dl
Type 2 diabetes 126 mg/dl or higher 6.5% or higher 200 mg/dl or higher
Normal 99 mg/dl or lower Below 5.7% 140 mg/dl or lower

You have prediabetes — now what?

If your health care provider has told you that you have prediabetes, you might not be sure what that means or what you should do next. Understandably, you might also be worried that you’ll get diabetes. Here’s the good news: You may be able to prevent getting type 2 diabetes, or at least, delay it. Here’s how.

How to prevent type 2 diabetes

In some cases, medicine may be used to treat prediabetes, although the FDA has not approved the use of medication to treat prediabetes. Metformin, a drug commonly used in the treatment of type 2 diabetes, is often the medication of choice.

What else can you do to prevent diabetes?

Consider joining a lifestyle change program that is recognized by the CDC. This is called the National Diabetes Prevention Program. Here’s what you get if you join: A full year of support where you’ll learn how to eat healthy, increase physical activity, manage stress, stay motivated, and solve problems. Not bad! Plus, you’ll be with others in the same boat, and you’ll have an experienced coach who can help you reach your goals.

Many of these programs are offered virtually, and they may be offered through your local YMCA, too. To find a program in your area, visit the website of the CDC.

Can you reverse your prediabetes?

Yes, some people can. But it takes commitment to a healthy lifestyle. The chances of reversal also depend on how early you make these lifestyle changes. That’s why it’s so important to have support — either from your own health care team or from a program such as the National Diabetes Prevention Program.

Want to learn more about prediabetes? Read “Prediabetes: What to Know,” “Prediabetes Treatment” and “Should I Worry About Prediabetes?”

Amy Campbell, MS, RD, LDN, CDCES

Amy Campbell, MS, RD, LDN, CDCES

Amy Campbell, MS, RD, LDN, CDCES on social media

A Registered Dietitian and Certified Diabetes Educator at Good Measures, LLC, where she is a CDE manager for a virtual diabetes program. Campbell is the author of Staying Healthy with Diabetes: Nutrition & Meal Planning, a co-author of 16 Myths of a Diabetic Diet, and has written for  publications including Diabetes Self-Management, Diabetes Spectrum, Clinical Diabetes, the Diabetes Research & Wellness Foundation’s newsletter, DiabeticConnect.com, and CDiabetes.com

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