What Is Prediabetes?
Before people get diabetes, there is a period of time when blood sugar levels are high but not high enough to be diagnosed as diabetes. This is known as prediabetes. According to the Centers for Disease Control, about 96 million Americans—more than one in three—have prediabetes. Of those with prediabetes, more than 80 percent don’t know they have it.
Prediabetes occurs when the body does not properly process carbohydrates. When you consume carbohydrates, sugar enters your bloodstream. A hormone called insulin moves the sugar from your bloodstream to your body’s cells. The cells use this sugar (“blood glucose”) for energy.
With prediabetes and diabetes, blood sugar gets trapped in your blood. Your body may not make enough insulin or your cells may resist the insulin. So, instead of fueling your cells, sugar builds up in your bloodstream, which can damage your organs, nerves, and blood vessels in the long term.
Prediabetes is a serious health condition. It increases your chances of developing:
- type 2 diabetes,
- heart disease, and
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What Causes Prediabetes?
Experts don’t know the exact cause of prediabetes. But family history and genetics appear to play an important role. Lack of physical activity and being overweight with extra fat around your middle can also contribute.
Prediabetes Risk Factors
The same factors that increase your risk of getting type 2 diabetes increase the risk of prediabetes. These include:
- a diet high in red meat and carbohydrates,
- being older than 45,
- being overweight,
- cardiovascular disease,
- diabetes in your family,
- gestational diabetes (diabetes during pregnancy),
- high blood pressure,
- high cholesterol,
- physical inactivity (not exercising at least three times a week), and
- smoking (smokers seem to carry more weight around their abdomen).
Race and ethnicity also play a role. People who are Black, Hispanic, Latinx, Native American, Pacific Islander, or Asian are at higher risk.
As prediabetes progresses, symptoms can include:
- increased thirst,
- increased hunger,
- frequent urination,
- feeling more tired than usual, and
- blurry vision.
These are symptoms of type 2 diabetes. If you experience them, see your primary care provider or make an appointment with an endocrinologist as soon as possible. An endocrinologist is a doctor who specializes in prediabetes, diabetes, and other disorders of the endocrine system (the glands and organs that make hormones).
What Are the Warning Signs of Prediabetes?
Prediabetes doesn’t have any early warning signs. You can have prediabetes for years without symptoms. That’s why it’s so important to talk to your provider about getting screened if you are at risk. Detecting prediabetes early increases your chances of being able to reverse it.
The American Diabetes Association (ADA) recommends that diabetes screening for most adults begins at age 45. Screening should start before age 45 if you’re overweight and have additional risk factors for prediabetes or type 2 diabetes. The Centers for Disease Control also offers an interactive quiz that can help you assess your risk for prediabetes.
Two simple blood tests can determine whether you have prediabetes. These screening tests include a fasting blood glucose (BG) test and an A1C test, which measures your blood glucose (blood sugar) over the past two to three months.
- Fasting BG Results:
- Normal: less than 100 mg/dl
- Prediabetes: 100 to 125 mg/dl
- Type 2 diabetes: over 125 mg/dl
- A1C Results:
- Normal: 5.6 percent or below
- Prediabetes: 5.7 percent to 6.4 percent
- Type 2 diabetes: over 6.5 percent
Your provider can order these tests for you and help you understand what the results mean.
What to Expect During Your First Appointment
When you come to your first appointment, bring a list of your current medications. Be prepared to answer questions about your family’s medical history, if possible. A family member or friend is welcome to accompany you to this appointment.
During your first appointment, you will meet an endocrinologist, medical assistant, and certified diabetes educator.
The medical assistant will:
- take your blood pressure, weight and height, and pulse;
- check your eyes, mouth, and neck for signs of prediabetes; and
- listen to your heart and lungs with a stethoscope.
You may be asked to give a small blood sample (by finger prick) to test your A1C. You may also be asked to give a urine sample, which can help determine whether you have prediabetes.
The endocrinologist will meet with you and ask the following questions.
- Does anyone in your family have diabetes?
- What do you eat for breakfast, lunch, dinner, and snacks?
- Do you drink juices or sugary soda?
- What do you do for exercise?
- How well do you sleep at night? Do you snore?
Your provider may order blood tests to learn more about your health. These may include cholesterol, kidney, liver, and thyroid tests. If you are having sleep issues, your provider may refer you to a sleep specialist.
The diabetes educator will meet with you one-on-one to provide information about how to reverse prediabetes and prevent diabetes.
How to Reverse Prediabetes
The most powerful action you can take to reverse prediabetes is to make lifelong changes to your diet and exercise. Medication may help, too.
A healthy diet is critical in reversing prediabetes. If you aren’t sure where to start, consider making an appointment with a registered dietitian at U of U Health. You’ll learn how to follow a diet that’s rich in fruit, vegetables, whole grains, nuts, healthy oils, and lean meat. The dietitian can help you set realistic goals and meet them.
Get at least 150 minutes of moderate physical activity a week. Be sure to find an activity you enjoy. Recommended activities include walking, jogging, running, biking, swimming, and exercise classes, such as yoga or spinning. Regular exercise has the added benefit of reducing stress, which is associated with better blood sugar control.
Your doctor may prescribe medication to help treat prediabetes and conditions related to it. These can include:
- metformin for blood sugar control,
- cholesterol-lowering medications, and
- high blood pressure medications.
How Long Does It Take for Prediabetes to Turn into Diabetes?
People with prediabetes have a 3- to 6-year window of opportunity to prevent or slow the progression of prediabetes to type 2 diabetes.
Schedule an Appointment
Endocrinologists at U of U Health provide screening, testing, and personalized treatment plans for people with prediabetes. If you are concerned about your risk for prediabetes or already know you have it, you can find help and support at the Utah Diabetes and Endocrinology Center (UDEC). Call 801-581-7761 to request an appointment today.