Prediabetes usually doesn't have symptoms or warning signs. So, it can be shocking to receive a diagnosis. But one in three people has prediabetes, and most people with prediabetes don't know it.
A prediabetes diagnosis means that your blood sugar (glucose) levels are higher than normal, though they are not high enough to signify Type 2 diabetes. But don't be fooled — prediabetes is a serious diagnosis. If you don't take action to change your lifestyle, you could develop full-blown diabetes.
The good news is that prediabetes is reversible. The first step is realizing what's happening in your body. Then, you can create a plan to prevent the progression to diabetes.
Here's what you need to know:
What does it mean to have prediabetes?
To understand prediabetes, you first need to understand how a healthy body manages blood sugar.
Blood glucose is your body's main source of energy. The food you eat gets broken down into glucose (sugar), which is released into your bloodstream. When your blood glucose level increases, your pancreas releases insulin — a hormone that helps move sugar from your blood to the cells that will convert it into energy.
A diagnosis of Type 2 diabetes means your body isn't using insulin correctly, your cells aren't responding well to insulin, or both. As a result, glucose builds up in the bloodstream. Over time, high blood sugar levels can lead to health complications including eye disease, heart disease and kidney disease.
Prediabetes is a warning sign for Type 2 diabetes. Lifestyle changes that include a healthy diet and exercise can help reduce blood sugar and improve insulin sensitivity — how well your cells respond to insulin.
Blood glucose tests
There are several ways to measure the sugar in your blood. Most likely, a blood sugar test led to your prediabetes diagnosis.
The most common blood sugar tests include:
- Fasting plasma glucose (FPG) test: This test measures the sugar in your blood after an overnight fast — only having water for at least eight hours before testing. The American Diabetes Association (ADA) sets the FPG prediabetes range as 100 to 125 milligrams per deciliter (mg/dL).
- Oral glucose tolerance test (OGTT): This test shows how well your body processes glucose by measuring blood sugar before and two hours after drinking a glucose solution. OGTT suggests prediabetes if the score is 140 to 199 mg/dL when measured at the two-hour mark.
- A1C test: This blood test measures your blood glucose over a longer period — typically two to three months. Scores falling in the range of 5.7% to 6.4% suggest prediabetes.
Health care providers rarely rely on just one test to determine whether someone has prediabetes or diabetes. They consider multiple test results and look at your health trends over time.
Questions to ask about your prediabetes diagnosis
The steps you take to prevent progression to Type 2 diabetes are based on your test scores, current health and lifestyle. The more information you have about your condition and how it will affect your health, the better equipped you'll be to make the necessary changes.
Consider asking your physician:
- Are there local programs or resources that can help me make lifestyle changes and manage prediabetes?
- Are there signs or symptoms I should watch for that may indicate progression to Type 2 diabetes?
- Do I have any health conditions that increase my risk of developing Type 2 diabetes?
- Is medication an option to help me manage prediabetes?
- What are my blood sugar test results and what should they be?
- What are my target blood glucose levels before and after eating, and should I be checking them?
- What is the best thing I can do right now to prevent progression to Type 2 diabetes?
Next steps for people with prediabetes
Your primary care physician will guide you in the best way to monitor prediabetes. You can expect follow-up appointments and yearly blood glucose testing to measure your progress. Your physician will also help you create a plan for managing lifestyle changes.
Lifestyle choices that help prevent Type 2 diabetes include:
- Eat a balanced diet: You don't have to eliminate entire food groups. Choose whole foods and eat a plant-forward diet whenever possible. Avoid ultra-processed foods and added sugar.
- Exercise regularly: Physical activity uses the sugar in your blood as fuel. Make sure to get 150 minutes weekly of moderate exercise, such as brisk walking.
- Reach a healthy weight: If you are not at a healthy weight, losing just 5% to 7% of your body weight can reduce your risk of developing Type 2 diabetes.
- Find support: Consider enlisting a dietitian or trainer to guide your diet and exercise choices and help you stay on track. You can also join the National Diabetes Prevention Program, which is a year-long lifestyle change program focused on preventing diabetes.
Remember, the lifestyle choices you make are critical to managing prediabetes. Even small changes can add up and help put prediabetes in reverse.
