Prediabetes

Prediabetes is the condition of having a blood sugar (blood glucose) level that is higher than it should be, but not high enough for you to be diagnosed with type 2 diabetes.

Having prediabetes puts you at risk for developing type 2 diabetes (type 2 diabetes mellitus). Prediabetes may be called impaired glucose tolerance or impaired fasting glucose.

Prediabetes usually does not cause symptoms. Your health care provider can diagnose this condition with blood tests. You may be tested for prediabetes if you are overweight and if you have at least one other risk factor for prediabetes.

What is blood glucose, and how is it measured?

Blood glucose refers to the amount of glucose in your bloodstream. Glucose comes from eating foods that contain sugars and starches (carbohydrates), which the body breaks down into glucose. Your blood glucose level may be measured in mg/dL (milligrams per deciliter) or mmol/L (millimoles per liter). Your blood glucose may be checked with one or more of the following blood tests:

• A fasting blood glucose (FBG) test. You will not be allowed to eat (you will fast) for 8 hours or longer before a blood sample is taken.
  • A normal range for FBG is 70–100 mg/dl (3.9–5.6 mmol/L).
• An A1c (hemoglobin A1c) blood test. This test provides information about blood glucose control over the previous 2‒3 months.
• An oral glucose tolerance test (OGTT). This test measures your blood glucose at two times:
  • After fasting. This is your baseline level.
  • Two hours after you drink a beverage that contains glucose.

You may be diagnosed with prediabetes:

• If your FBG is 100‒125 mg/dL (5.6–6.9 mmol/L).
• If your A1c level is 5.7‒6.4%.
• If your OGTT result is 140‒199 mg/dL (7.8–11 mmol/L).

These blood tests may be repeated to confirm your diagnosis.

How can this condition affect me?

The pancreas produces a hormone (insulin) that helps to move glucose from the bloodstream into cells. When cells in the body do not respond properly to insulin that the body makes (insulin resistance), excess glucose builds up in the blood instead of going into cells. As a result, high blood glucose (hyperglycemia) can develop, which can cause many complications. Hyperglycemia is a symptom of prediabetes.

Having high blood glucose for a long time is dangerous. Too much glucose in your blood can damage your nerves and blood vessels. Long-term damage can lead to complications from diabetes, which may include:

• Heart disease.
• Stroke.
• Blindness.
• Kidney disease.
• Depression.
• Poor circulation in the feet and legs, which could lead to surgical removal (amputation) in severe cases.

What can increase my risk?

Risk factors for prediabetes include:

• Having a family member with type 2 diabetes.
• Being overweight or obese.
• Being older than age 45.
• Being of American Indian, African-American, Hispanic/Latino, or Asian/Pacific Islander descent.
• Having an inactive (sedentary) lifestyle.
• Having a history of heart disease.
• History of gestational diabetes or polycystic ovary syndrome (PCOS), in women.
• Having low levels of good cholesterol (HDL-C) or high levels of blood fats (triglycerides).
• Having high blood pressure.

What actions can I take to prevent diabetes?

• Be physically active.
  • Do moderate-intensity physical activity for 30 or more minutes on 5 or more days of the week, or as much as told by your health care provider. This could be brisk walking, biking, or water aerobics.
  • Ask your health care provider what activities are safe for you. A mix of physical activities may be best, such as walking, swimming, cycling, and strength training.
• Lose weight as told by your health care provider.
  • Losing 5–7% of your body weight can reverse insulin resistance.
  • Your health care provider can determine how much weight loss is best for you and can help you lose weight safely.
• Follow a healthy meal plan. This includes eating lean proteins, complex carbohydrates, fresh fruits and vegetables, low-fat dairy products, and healthy fats.
  • Follow instructions from your health care provider about eating or drinking restrictions.
  • Make an appointment to see a diet and nutrition specialist (registered dietitian) to help you create a healthy eating plan that is right for you.
• Do not smoke or use any tobacco products, such as cigarettes, chewing tobacco, and e-cigarettes. If you need help quitting, ask your health care provider.
• Take over-the-counter and prescription medicines as told by your health care provider. You may be prescribed medicines that help lower the risk of type 2 diabetes.
• Keep all follow-up visits as told by your health care provider. This is important.

Summary

• Prediabetes is the condition of having a blood sugar (blood glucose) level that is higher than it should be, but not high enough for you to be diagnosed with type 2 diabetes.
• Having prediabetes puts you at risk for developing type 2 diabetes (type 2 diabetes mellitus).
• To help prevent type 2 diabetes, make lifestyle changes such as being physically active and eating a healthy diet. Lose weight as told by your health care provider.