Prediabetes

What Is Prediabetes?

Prediabetes is a serious health condition where blood sugar levels are higher than normal, but not high enough yet to be diagnosed as type 2 diabetes.Prediabetes puts you at increased risk of developing type 2 diabetes, heart disease, and stroke.

Symptoms and Causes

What are the symptoms of prediabetes?

Most people with prediabetes don’t have any symptoms. This is why it’s important to see your primary care provider regularly so they can do screenings, like a basic metabolic panel, to check on your blood sugar levels. This is the only way to know if you have prediabetes.

For the few people who do experience symptoms of prediabetes, they may include:
  • Darkened skin in your armpit or back and sides of your neck (acanthosis nigricans).
  • Eye changes that can lead to diabetes-related retinopathy.
  • Skin tags

What causes prediabetes?

The cause of prediabetes is the same as the cause of Type 2 diabetes — mainly, insulin resistance. Insulin resistance happens when cells in your muscles, fat and liver don’t respond as they should to insulin. Insulin is a hormone your pancreas makes that’s essential for life and regulating blood sugar levels. When you don’t have enough insulin or your body doesn’t respond properly to it, you experience elevated blood sugar levels. Several factors can contribute to insulin resistance, including:

  • Genetics.
  • Excess body fat, especially in your belly and around your organs (visceral fat).
  • Physical inactivity.
  • Eating highly processed, high-carbohydrate foods and saturated fats frequently.
  • Certain medications, like long-term steroid use.
  • Hormonal disorders, like hypothyroidism and Cushing syndrome.
  • Chronic stress and a lack of quality sleep.

Risk Factors

What are the risk factors for prediabetes?

Risk factors for prediabetes include:

  • Family history of Type 2 diabetes (parent or sibling).
  • Having overweight or obesity (a BMI greater than 25).
  • Being physically active fewer than three times a week.
  • Being 45 or older.
  • Smoking
  • Obstructive sleep apnea.
  • Having had gestational diabetes.
  • Polycystic ovarian syndrome (PCOS).

Race and ethnicity are also factors. You’re at increased risk if you are:

  • Black.
  • Hispanic/Latino American.
  • Native American.
  • Pacific Islander.
  • Asian American.

Some of these risk factors you can’t change, like your age and family history (genetics). But others, like physical inactivity and smoking, you can help improve. The more of these risk factors you have, the more likely prediabetes is around the corner — or you already have it. It’s important to talk to your primary care provider about screening for prediabetes. While it might be mentally easier to avoid finding out, knowing and taking action are very valuable to your long-term health.

Complication & Prevention

What are the possible complications of prediabetes?

The main complication of prediabetes is it developing into Type 2 diabetes. Undiagnosed or undermanaged Type 2 diabetes increases your risk of several complications, like:

  • Heart attack and stroke.
  • Eye issues (diabetes-related retinopathy).
  • Kidney issues (diabetes-related nephropathy).
  • Nerve damage (diabetes-related neuropathy).

While it’s possible to reverse prediabetes, it’s typically not possible to reverse diabetes complications. This is why prevention and/or proper management are key.

How can I reverse prediabetes?

The best way to treat — and potentially reverse — prediabetes is through healthy lifestyle changes. Regularly eating nutritious foods and getting regular exercise can help return your blood sugar to healthy levels and prevent or delay Type 2 diabetes. Even small changes can significantly lower your risk for developing Type 2 diabetes, like:

  • Weight loss : Your healthcare provider may recommend trying to lose excess weight to combat insulin resistance and prediabetes. One study revealed that losing 7% of weight can reduce the onset of Type 2 diabetes by 58%.
  • Regular activity: : Getting regular amounts of moderate-intensity physical activity helps increase glucose usage and improve muscle insulin sensitivity. A single session of moderate-intensity exercise can increase glucose uptake from your blood and into your muscles by at least 40%. This helps lower blood sugar levels. Aim for 30 minutes a day, five days a week, for a total of 150 minutes a week. Try walking or another activity you enjoy.
  • Eating changes: Cutting out added sugars, swapping simple carbohydrates for complex carbohydrates and eating more veggies can help your blood sugar return to healthy levels. Your provider will help you find which long-term diet for prediabetes is best for you.
Lowering your risk factors for prediabetes can often get your blood sugar levels back to healthy levels. You might:
  • Work with a nutritionist or dietitian to plan healthy eating patterns you can stick with long-term, like the Mediterranean diet.
  • Find ways to reduce or manage stress.
  • Quit smoking
  • Get a diagnosis for and/or treat any sleep disorders.
  • Manage related conditions, like high cholesterol and high blood pressure.
  • Find support groups where you can meet other people going through the same challenges.

Can you take medication for prediabetes?

In some cases, your healthcare provider may recommend taking certain oral diabetes medications. This is more likely if lifestyle changes haven’t helped improve your blood sugar levels and/or you have multiple risk factors for Type 2 diabetes. The most common medications providers prescribe for prediabetes are metformin and acarbose.

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