Guide To Understanding Pre-Diabetes





What Is Prediabetes?
What Are The Signs?
What Causes It?
How Can I Test For Prediabetes?
How Often Should I Be Tested?
How A Diagnosis Can Delay Type 2 Diabetes
What Is The Treatment For It?
Diabetes Prevention Study
What Are My Chances Of Developing Type 2 Diabetes?

Return To Main Guide:
Diabetic Guide

What Is Prediabetes?

Prediabetes is also written as pre-diabetes.

Prediabetes is a condition in which a person's blood sugar (glucose) levels are higher than normal but not yet high enough to qualify as full-blown diabetes. Before most people develop type 2 diabetes they almost always have prediabetes for maybe up to 10 years beforehand. At least 79 million Americans have prediabetes, but because it is often a silent disorder, many are unaware of it. While a person with prediabetes does not usually develop diabetes complications such as eye disease or kidney damage, research shows that they are still at much greater risk of developing heart attacks and strokes than people with normal blood sugar levels.

What Are The Signs?

Most people show no obvious signs of prediabetes. If there are any indications, they are likely to be milder versions of symptoms of diabetes such as:

• Increased thirst
• Frequent urination
• Fatigue and feeling generally exhausted
• Increased hunger
• Recurrent yeast infections or gum infections
• Cuts or bruises that are slow to heal
• Tingling or numbness in your hands or feet

Doctors now recommend that everyone aged over 45 be screened for prediabetes. Testing is also recommended for people under 45 (including children) if they are overweight and have one or more of the following risk factors:

High blood pressure (hypertension).
• Low HDL cholesterol (the good stuff).
• High triglycerides.
• A family history of diabetes.
• Belong to a high risk ethnic group: African American, Asian, Hispanic or Native American. For example, 20 percent of American Indians aged 15 years or older have prediabetes.
• If they developed gestational diabetes during pregnancy or gave birth to a child weighing more than 9 pounds. For some statistics see diabetes facts.

What Causes It?

The exact cause of prediabetes is unknown but it is closely associated with obesity and Metabolic Syndrome. It may be that excess body fat interferes with the way the body processes sugar in the blood. If everything works properly, insulin (a natural hormone) is produced by the pancreas and instructs the cells in the body when to open up and allow sugar from the blood into them. The sugar (glucose) is then immediately used as energy or stored as fat for later use. If this system is not working properly - either because the pancreas is not producing enough insulin, or because the cells stop responding to the insulin made - sugar builds up in the blood causing prediabetes and eventually diabetes. See, also causes of diabetes.

How Can I Test For Prediabetes?

Testing for prediabetes means finding out your blood glucose level. There are 3 different types of tests your doctor can use to achieve this:
1. The A1C test.
2. The fasting plasma glucose test (FPG).
3. The oral glucose tolerance test (OGTT).
These are discussed in more detail under our article diabetes diagnosis. Also, check our answer to are there any home tests for diabetes?

Blood Sugar Levels: What's Normal, What's Prediabetes

Diagnosis Glucose Level Before Eating Glucose Level After Eating
Normal Less than 100 mg/dl (5.5 mmol/L) Less than 140 mg/dl (7.8 mmol/L)
Prediabetes 100-125 mg/dl (5.5-7 mmol/L) 140-199 mg/dl (7.8-11 mmol/L)

How Often Should I Be Tested?

If your test results come back normal, aim to be checked every 3 years thereafter, unless your doctor says otherwise. If you are diagnosed with prediabetes, you should be tested every year or two in case your blood sugar rises to the level of full-blown diabetes. If this happens you will need to discuss diabetes treatment with your doctor.

How A Diagnosis Can Delay Type 2 Diabetes

If you know you have prediabetes, this allows you to take preventative action to reduce your chance of developing type 2 diabetes. Studies show that people with prediabetes who actively follow diabetes prevention advice can prevent or delay the onset of type 2 diabetes by up to 58 percent. This primarily means making lifestyle changes such as losing 7 percent of your body weight and exercising 30 minutes a day, 5 times a week. For some people, this is enough to bring their blood sugar levels back down to normal levels.

What Is The Treatment For Prediabetes?

Treatment consists of lifestyle changes: losing 7 percent of your total body weight by following a healthy calorie controlled diet plan and taking moderate exercise like walking for 30 minutes a day, 5 days a week. If 7 percent of your total body weight seems a tall order, even losing 10 to 15 pounds will make a significant difference to your blood sugar levels. As prediabetes also increases your risk of heart disease and stroke, do be sure to read the following articles:
Heart disease in women
Coronary heart disease in women
Heart attack prevention and learn to recognize heart attack symptoms.
Stroke prevention and recognizing the symptoms of stroke.

Diabetes Prevention Study

The Diabetes Prevention Program was a major clinical trial which took 3 years to complete. It investigated whether either exercise and diet or the oral diabetes drug metformin (Glucophage) could delay or prevent the onset of type 2 diabetes in people with prediabetes. Patients from 27 clinics from around America where randomly divided into 3 groups. All participants had major risk factors for type 2 diabetes (overweight with impaired glucose tolerance) and 45 percent were from high risk ethnic groups.
Group 1: Received intensive diet and exercise training as well as behavior modification. They ate fewer calories, reduced their fat intake and exercised for a total of 150 minutes a week. The aim was to lose 7 percent of their body weight.
Group 2: Took 850mg of metformin twice a day. They received information on diet and exercise but were not intensively counseled like group 1.
Group 3: Unknowingly received placebo pills (no active ingredients) instead of metformin. They received the same information on diet and exercise, without counseling as group 2.
The Result?
Group 1 sharply reduced their risk of developing diabetes. While group 2 who were taking metformin also reduced their risk, it was far less dramatic. See also, our Q&A on can prediabetes be reversed?

Is Prediabetes Different To Impaired Glucose Tolerance or Impaired Fasting Glucose?

No, it's the same thing. Doctors just refer prediabetes differently sometimes, depending on which test was used to diagnose it.

What Are My Chances Of Developing Type 2 Diabetes?

According to the results from the Diabetes Prevention Program, every year after diagnosis you have an 11 percent chance of developing type 2 diabetes. See books on diabetes, the section specifically on prediabetes and how to prevent full-blown diabetes.

  Related Articles on Prediabetes

For more about blood sugar conditions, see the following:

Type 1 Diabetes
Diabetes Resources - List of recommended websites with expert advice.

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