Prediabetes - Risk Factors, Diagnosis, and Management

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According to the U.S. Centers for Disease Control and Prevention, more than 1 in 3 American adults have prediabetes. While the “pre” in its name might suggest it isn’t that serious, prediabetes puts you at serious risk for type 2 diabetes, high blood pressure, heart disease, and stroke.

What is Prediabetes?

Prediabetes is a condition in which blood sugar, or glucose, levels are higher than normal but not high enough to be diagnosed as type 2 diabetes.

Elevated levels can occur when the pancreas fails to produce enough insulin, or when the body does not use the insulin produced effectively. Prediabetes is a clear warning sign that a person is at an increased risk of developing type 2 diabetes in the future. However, due to a lack of symptoms, an estimated 80% of adults with prediabetes don't know they have it. Untreated it can lead to type 2 diabetes, which can damage blood vessels, nerves, tissue, and organs.

The good news is there are steps you can take to reduce your risk of developing type 2 diabetes and improve your health.

Symptoms & Risk Factors

Prediabetes often has very few or no symptoms. Many people live with it for years, only learning of it when more serious health conditions, such as type 2 diabetes, are diagnosed.

Factors that put you at greater risk for prediabetes include:

Being overweight
Being 45 years or older
Having a parent, brother, or sister with type 2 diabetes
Being physically active less than 3 times a week
Ever having gestational diabetes (diabetes during pregnancy)
Giving birth to a baby who weighed more than 9 pounds
Having polycystic ovary syndrome
Being of African American, Hispanic/Latino American, American Indian, Alaska Native, or Pacific Islander descent

If you have any one of these risk factors, ask your doctor to test your blood sugar annually. Diagnosing prediabetes early can help prevent or delay the onset of type 2 diabetes as well as other serious health complications.

Could You Have Prediabetes?

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Diagnosis

Prediabetes is diagnosed using the same blood tests used to diagnose type 2 diabetes. The most common test is the Hemoglobin A1C (HbA1C) test , which measures your average blood sugar level over the past two to three months. A normal HbA1C level is below 5.7%, while a level between 5.7% and 6.4% indicates prediabetes. A level of 6.5% or higher on two separate tests or in combination with a glucose level above 126 in the fasting state or 200 in the non-fasting state indicates diabetes.

Other blood tests that can be used to diagnose prediabetes include:

Fasting blood sugar test to measure your blood sugar levels after not eating overnight
Random blood sugar test to check glucose levels at a random or nonfasting time
Oral glucose tolerance test to measure the body’s response to glucose intake. Commonly used to check for diabetes during pregnancy

Management & Treatment

Not everyone with prediabetes develops type 2 diabetes. Moderate lifestyle changes can reverse high glucose levels and delay or prevent the onset of type 2 diabetes entirely.

Treatment plans often include:

Losing weight - your doctor will help you establish a weight-loss goal
Being physically active (at least 150 minutes of moderate to vigorous aerobic activity a week)
Choosing foods and timing meals to keep glucose levels in check by moderating carbohydrates

Complications

The primary complication of prediabetes is the development of type 2 diabetes.

Complications from type 2 diabetes include: