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Prediabetes

Prediabetes is a serious medical condition that affects roughly 98 million American adults. Unmanaged, it can develop into Type 2 diabetes, which increases the risk of other medical complications including heart disease and nerve damage. Strategies for prevention and management include lifestyle modifications and drugs like Ozempic.

Last Modified: March 26, 2024
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What Is Prediabetes?

Prediabetes is a health condition marked by higher-than-normal blood sugar levels that are not high enough to warrant a Type 2 diabetes diagnosis. This serious condition affects nearly one-third of American adults, many of whom are unaware of the risk. Doctors often consider prediabetes a warning sign of developing Type 2 diabetes because it indicates the pancreas’ inability to produce sufficient insulin to manage blood glucose levels.

Diagnosing Prediabetes

Doctors use blood tests that establish blood sugar levels to screen for prediabetes. Prediabetes blood glucose range is between 100 to 125 mg/dL. Doctors consider fasting blood glucose levels between 70 mg/dL and 100 mg/dL normal, and levels above 126 mg/dL diabetes. Many patients exhibit no prediabetes symptoms, so preventative monitoring can help identify the disease early.

Doctors may use the following tests to screen for and monitor prediabetes:
  • A1C test results of 5.7% to 6.4%
  • Fasting plasma glucose test levels of 100-125 mg/dL
  • Oral glucose tolerance test levels of 140 to 199 mg/dL

Adhering to a routine screening program can help people identify changes in blood glucose levels, monitor the progress of prevention strategies and receive appropriate medical care for their condition. The American Diabetes Association recommends patients with prediabetes receive regular blood screening at least every two years.

Causes of Prediabetes

An abnormal insulin response that reduces the body’s ability to regulate blood sugar causes prediabetes. When people eat food, the pancreas releases insulin to process and metabolize the glucose released into the bloodstream. Patients with prediabetes produce normal amounts of insulin, but their bodies no longer use it efficiently. This insulin resistance results in excess glucose remaining in the blood, causing elevated blood sugar levels.

Research shows that genetics play a role in prediabetes developing in patients with no other risk factors. Therefore, patients with a family history of diabetes should schedule regular checkups and blood tests to screen for the condition. Doctors are an excellent resource for answering questions and providing health information about prediabetes.

Risk Factors

Both environmental and genetic risk factors for prediabetes exist. New research shows a strong genetic component to developing the condition, and patients with a family history of diabetes or prediabetes are more likely to develop it than others. It is also more prevalent in people from certain ethnic backgrounds. However, many patients with insulin resistance have more than one risk factor.

Environmental Risk Factors for Prediabetes
Age
Many people develop insulin resistance with age, and more than 50% of adults older than 65 years of age have prediabetes.
Diet
Eating a diet high in sugar or simple carbohydrates increases the risk of developing insulin resistance.
Infrequent Exercise
A sedentary lifestyle that includes minimal physical activities that provide a safe and healthy workout increases the risk of developing prediabetes.
Smoking
Smokers are at greater risk of developing prediabetes Type 2 diabetes.

Medical history can also play a role in the development of prediabetes. People with a previous diagnosis of gestational diabetes, high blood pressure, high triglycerides, low HDL, obesity and polycystic ovary syndrome are more likely than others to develop insulin resistance. Patients cannot eliminate all risk factors for prediabetes, but they can manage many of them by implementing a comprehensive prevention strategy with their medical providers.



Common Symptoms of Prediabetes

Prediabetes symptoms are very subtle and many patients never exhibit them. Those who do often report symptoms similar to those associated with Type 2 diabetes. Symptoms are often an indicator of the progression from prediabetes to Type 2 diabetes.

Common Prediabetes Symptoms
  • Blurry vision
  • Darkened skin on the groin, neck and underarm areas
  • Fatigue
  • Increase appetite and thirst
  • Recurrent infections
  • Sweating
  • Weakness

Because symptoms are typically mild or nonexistent, regular blood sugar testing is the most effective way to monitor prediabetes. It is especially important in high-risk populations, such as individuals with a family history of diabetes.

Health Consequences of Untreated Prediabetes

Untreated prediabetes can have serious health consequences. Patients are at increased risk of developing Type 2 diabetes, heart disease and stroke. Untreated prediabetes may also contribute to irreversible kidney and blood vessel damage.

Patients should seek medical care for the condition to limit these consequences. Prediabetes treatments can help counter insulin resistance and reduce the incidence of diabetes.

Preventing Type 2 Diabetes

Patients can often prevent Type 2 diabetes with lifestyle modifications and carefully monitored medical interventions. Implementing these strategies may help patients with prediabetes symptoms or an increased risk of prediabetes to maintain proper blood glucose levels.

Lifestyle Modifications

Lifestyle modifications are effective prediabetes treatments that can significantly reduce individual risk of developing Type 2 diabetes. When implemented, they can mitigate many of the environmental factors that contribute to increasing insulin resistance.

Dietary changes that include reduced sugar and refined carbohydrate intake are crucial to reducing blood sugar levels and slowing insulin resistance. They may also help patients maintain a healthy weight, which further reduces the risk of developing diabetes.

Regular exercise is another important lifestyle behavior for preventing Type 2 diabetes. The American Heart Association recommends adults get at least 150 minutes of exercise each week. Walking, cycling, swimming and other cardiovascular activities all contribute to this threshold and improve blood sugar management.

Managing stress may also help improve overall health and keep blood glucose levels in check. Hormones released during high-stress events can increase blood sugar levels and may contribute to insulin resistance. Patients should speak to their health care providers about how to use stress management techniques as effective prediabetes treatments.

The Role of Medication in Prediabetes Treatment

Certain drugs can play an important role in prediabetes treatments. This is especially true for patients with obesity which contributes to their insulin resistance.

For example, patients taking GLP-1 agonists Wegovy and Ozempic report significant weight loss and lower, more consistent blood sugar levels. Both drugs use the active ingredient semaglutide and should be used in conjunction with a balanced, reduced-calorie diet and increased exercise.

Wegovy is FDA-approved for weight loss in adults with obesity or overweight with other health factors. Ozempic is an FDA-approved Type 2 diabetes treatment that helps the pancreas produce increased amounts of insulin, reduces the amount of glucose released by the liver and slows gastric emptying. Studies show that it effectively helps trial participants reduce their body weight by 15%. Additional studies support prediabetes treatments that include GLP-1 drugs such as Ozempic.

Only a medical provider can provide a diagnosis of prediabetes or Type 2 diabetes. Therefore, individuals at high risk for the condition or who suspect they have prediabetes should consult their health care provider for regular blood sugar level screenings.



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