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Prediabetes occurs when normal blood sugar elevates above normal levels. Without intervention the condition often develops into Type 2 diabetes. Prediabetes may go undetected as symptoms are often subtle. It's important to have regular checkups with blood work, particularly if you are at risk.

Last Modified: January 29, 2024
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What Is Prediabetes?

Prediabetes is a condition in which your blood sugar is consistently higher than the normal range, but not high enough to qualify for a diagnosis of diabetes type 2. Generally, blood glucose levels below 5.7% are considered normal and levels between 5.7% and 6.4% are diagnosed as prediabetes. A diabetes diagnosis is typically made when glucose levels surpass 6.4%.

According to current diabetes statistics, approximately 96 million U.S. adults (38% of the U.S. population age 18 and older) have prediabetes. Of those, 26.4 million people are at least 65 years old (48.8% of those with prediabetes in the U.S.).

While Type 1 diabetes is a genetic autoimmune condition that causes the immune system to attack insulin-producing cells in the pancreas, Type 2 diabetes often develops when unmanaged prediabetes progresses.

What Are the Symptoms of Prediabetes?

Prediabetes does not usually produce obvious symptoms. Many people have it for years without noticing that anything is wrong. People who do have symptoms report effects that are similar to diabetes symptoms that patients with other types of diabetes may experience.

Possible symptoms of prediabetes:
  • Increased appetite
  • Unexplained weight changes
  • Fatigue
  • Weakness
  • Sweating
  • Blurry vision
  • Slow healing and recurrent infections

Many people with prediabetes are unaware of their condition until a blood test that measures blood sugar levels shows elevated levels within the prediabetes range. Regular checkups are critical, particularly for those at high risk.

Prediabetes Complications

Prediabetes can be a dangerous disease even if it never progresses to Type 2 diabetes. Having prediabetes puts people at significantly higher risk of experiencing cardiovascular problems like heart disease and stroke. It can also cause irreversible damage to blood vessels and kidneys.

When prediabetes progresses to Type 2 diabetes, the consequences of not treating it are even more severe. You could experience:
  • Eye damage and disease
  • Vision loss
  • High blood pressure
  • High cholesterol
  • Nerve damage (neuropathy)
  • Foot damage and possible amputation
  • Erectile dysfunction
  • Gum disease and dental problems

Reversing prediabetes is possible with a treatment plan tailored to your medical needs. It’s important to follow your health care team’s prescribed plan closely to help avoid serious complications.

Prediabetes Causes

Prediabetes stems from an abnormal response to insulin. Normally the glucose in the food you eat causes cells in your pancreas to secrete insulin, which then prompts the cells to absorb the glucose in your body and use it for fuel.

People with prediabetes develop a resistance to the effects of insulin. Your body produces the same amount as it always did, but the amount is no longer enough to absorb all the glucose in your blood. As a result, glucose builds up in your blood and causes your blood sugar to remain consistently high.

Studies show that genetics play a significant role in the development of prediabetes even in people without other common risk factors. If you have a family history of diabetes or prediabetes, it is important to schedule annual checkups with blood work to monitor your blood sugar. Your doctor can also answer questions and share important health information on prediabetes.

Prediabetes Risk Factors

Medical history, genetics, sugar intake and smoking are all significant risk factors for prediabetes. Managing overall health can help mitigate some of these risk factors.

  • Genetics: People with parents who have diabetes or prediabetes are more likely to also develop prediabetes. People of African American, Hispanic, Native American, Pacific Islander and Asian descent also have an elevated risk.
  • Smoking: People who smoke are at greater risk of developing prediabetes and other types of diabetes. Smokers are as much as 30-40% more likely than nonsmokers to develop Type 2 diabetes, for example.
  • Age: More than 50% of adults older than 65 years of age meet the criteria for prediabetes.
  • Medical History: People who have been previously diagnosed with gestational diabetes, polycystic ovary syndrome, high blood pressure, high triglycerides, low HDL (good cholesterol) levels and a body mass index above 25 or are more likely to develop prediabetes.
  • Diet and Infrequent Exercise: Diets high in sugar or simple carbohydrates increase risks. A routine that includes fewer than three physical activities that provide a safe and healthy workout is also a risk factor for prediabetes.

While not all risk factors can be eliminated, some can be managed or mitigated with a customized plan from your medical team. If you are concerned about your risk of developing prediabetes, consult your doctor, who can share important health information with you and may also refer you to other specialists.

Diagnosing Prediabetes

When it comes to diabetes testing, physicians use two main exams to diagnose prediabetes: the fasting plasma glucose test and the A1C test (also called the hemoglobin A1C or HbA1c test).

The fasting plasma glucose test is the most common test, given after you have fasted for at least eight hours. If your blood sugar reading is between 100 and 125 mg/dL, you will likely be diagnosed with prediabetes.

When doctors want a better look at your long-term blood sugar trends, they may use the A1C test. It records your average blood sugar level for the past two to three months. If your reading is between 5.7% and 6.4%, you will typically be diagnosed with prediabetes.

Doctors also diagnose some people with prediabetes using a glucose tolerance test.

Prediabetes & Preventing Type 2 Diabetes

Preventing diabetes is one of the essential goals of prediabetes treatment. It is important to diagnose and begin treatment as early as possible to keep it from developing into Type 2 diabetes. There are several ways to work toward this goal, some of which are similar to other diabetes treatment plans for other types.

Regular exercise has proven to be effective in lowering blood sugar. Aiming to get some moderate aerobic exercise for at least 30 minutes a day, multiple days a week can help. Some activities might include swimming, cycling and brisk walking. But it’s essential to speak with your doctor about starting any new exercise program to ensure it’s safe for you.

While weight loss has shown to be effective, it’s essential to approach any meal plan with care to ensure that you’re meeting all of your nutritional needs. Speaking with a licensed and registered dietitian can help you tailor a diabetes diet that meets your specific health needs best.

Reversing prediabetes is possible. Support can help boost success. Many organizations around the country offer diabetes prevention classes on behalf of the National Diabetes Prevention Program. The CDC, for example, offers classes around the U.S.

Please seek the advice of a medical professional before making health care decisions.