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What is Prediabetes?

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What is Prediabetes?


Prediabetes describes a health condition where one’s blood sugar (glucose) is elevated but has not yet reached the threshold of a type 2 diabetes diagnosis. Healthcare professionals advise people to consider prediabetes a warning sign.

If a loved one has been diagnosed with prediabetes, it’s time to take their health more seriously to avoid potentially serious health problems. Important lifestyle changes to reduce the risk of type 2 diabetes may include healthy eating habits, more physical exercise, and weight loss.

People diagnosed with prediabetes have up to a 50% chance of developing diabetes within five to 10 years. Because prediabetes often doesn't present with symptoms, once diagnosed it is important to have your blood sugar levels tested, especially if you are at high risk for diabetes.

Unmanaged prediabetes can lead to type 2 diabetes, but there are steps you can take to reverse the condition to reduce the risk of developing diabetes.


What are the risk factors for prediabetes?


According to the CDC, prediabetes is a very common health condition, occurring in 1 of every 3 American adults. More than 80% of those who have prediabetes are unaware.

Your risk for prediabetes may be higher if you:

  • Are over the age of 45

  • Have a parent or sibling diagnosed with Type 2 diabetes

  • Are overweight or obese

  • Are of African-American, Hispanic/Latino, Asian-American, Native American, or Pacific Islander ethnicity

  • Live a mostly sedentary lifestyle, exercising less than three times per week

  • Are a woman who was diagnosed with gestational diabetes

  • Have high blood pressure or high cholesterol

  • Have polycystic ovary syndrome (PCOS)

  • Take medications, including certain HIV medications, antipsychotics, or steroids

  • Have hormonal conditions, including Cushing’s syndrome and acromegaly

  • Experience sleep disorders, such as sleep apnea

  • Are a smoker


What are the complications of prediabetes?


Being diagnosed with prediabetes puts you at a higher risk of developing type 2 diabetes, a disease that correlates with a greater risk of developing heart disease or stroke.

Prediabetes can be reversed, and average blood sugar maintained, by adopting a lifestyle change program, as suggested by your healthcare provider.


What causes prediabetes and type 2 diabetes?


Prediabetes occurs when the body’s insulin has a lower than normal response. Insulin typically allows glucose (blood sugar) to enter your cells and be used as energy to fuel your body. 

This sluggish response, known as insulin resistance, causes the pancreas to increase insulin production, resulting in excess glucose in the bloodstream. High blood glucose levels indicate prediabetes, and at a certain threshold, type 2 diabetes.

There are many factors involved in the cause of prediabetes, which include lifestyle and genetics. Research shows that a sedentary lifestyle increases the risk for prediabetes, and adopting a more active lifestyle can lower the risk of developing type 2 diabetes.


What causes insulin resistance?


According to researchers, it isn’t entirely clear why a person becomes insulin resistant. However, some studies find being overweight and sedentary appear to contribute.

Excess abdominal fat can cause increased inflammation, which may be a factor leading to insulin resistance. Lack of regular exercise has also been found to cause imbalances that cause blood sugar levels to increase.


What are the symptoms of prediabetes?


Prediabetes often has no symptoms, even in those who have had the condition for many years, and it can sometimes be undetectable until the condition develops into diabetes.

In some cases, people with prediabetes may notice:

  • Darkened skin around the neck, armpit, or knuckles

  • Small skin growths or skin tags

  • Eye changes that can lead to diabetes-related retinopathy


If your loved one is diagnosed with prediabetes and notice these symptoms of diabetes, be sure to contact your health provider:

  • Excessive thirst

  • Increased urination

  • Blurred vision

  • Fatigue

  • Cuts or sores that do not heal


Can prediabetes be prevented?

Avoiding or reversing obesity can be an important step, and even a small amount of weight loss can be beneficial.

Regular check-ups with your healthcare provider and providing a thorough family history, including mention of any metabolic conditions, makes early detection possible, reducing the risk of developing diabetes.

Taking steps to reverse Metabolic syndrome, which is a combination of high blood pressure, high cholesterol level, and large waist measurement, with diet and exercise, can effectively prevent prediabetes or reduce the risk of developing diabetes.


How is prediabetes diagnosed?


Prediabetes is often diagnosed through routine screening tests administered by your healthcare provider. The earlier prediabetes is diagnosed, the lower the chances of developing type 2 diabetes and requiring a lifetime of diabetes care.

A typical blood test may be a fasting glucose test and a hemoglobin A1C test to test your blood glucose level. Another test used is the oral glucose tolerance test, which assesses how your body responds to sugar.

There is a complex test used to test for insulin resistance by researchers, but not usually by healthcare providers.


Can prediabetes be reversed?


Though prediabetes is very common and has a high chance of progressing into diabetes, the good news is that it’s possible to reverse prediabetes.

Many people with prediabetes can prevent or delay Type 2 diabetes with weight loss, more regular physical activity, and changing to a more healthful diet.

Speak with your healthcare provider about programs to reverse prediabetes and search through the National Diabetes Prevention Program and the American Diabetes Association for more programs and other resources.


What are the treatment options for prediabetes?


The best treatment plan for prediabetes requires lifestyle changes, including regular exercise and adjustment to a healthier diet.

These relatively simple changes can help prevent the development of type 2 diabetes, a serious health condition.

The Centers for Disease Control and Prevention recommends:

  • Weight loss of even 5% of your body weight can be beneficial in improving your health

  • Regular exercise, such as walking 30 minutes per day, five days a week, can bring improvements in many areas of your health

Get started with these suggested actions to begin reducing your risk of diabetes and getting your blood sugar levels back to healthy levels:

  • Develop a healthy diet plan with the help of a nutritionist or dietitian

  • Take steps to manage stress levels

  • Follow your doctor’s plan to manage your high blood pressure or high cholesterol

  • Get support to stop smoking and limit your alcohol intake

  • Speak with a healthcare provider about treatment for sleep disorders

  • Take metformin, a diabetes medication your healthcare provider may prescribe to delay the onset of diabetes

  • Connect with other people embarking on a similar healthy lifestyle program


What is the prognosis for people with prediabetes?


When blood tests indicate prediabetes, you are at greater risk of developing diabetes and the complications of heart disease and stroke. However, there are many ways to reduce your risk.

Get support and talk to your healthcare provider to put together a plan for a healthier lifestyle. Be sure to schedule regular screening tests for blood sugar levels


Can prediabetes cause problems with vision?

Prediabetes and diabetes may result in vision loss. If you notice blurred vision, contact your eye doctor, and they can check for retinopathy, a change in the structure of your eye, and other vision problems related to diabetes.

Prediabetes often occurs without symptoms, so it is advisable to have a dilated eye exam annually. Talk with your healthcare provider about scheduling other regular screenings, especially if you are over 45 with a high BMI (body mass indicator). 

Rob Fisher

A Nurse Director at a large medical center in Boston, MA, who holds a Master’s in Nursing Leadership and Administration and an MBA in Healthcare Management.

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