A person holding a blood glucose meter with a test strip inserted. A small drop of blood is visible on their fingertip, indicating they are checking their blood sugar level. They are wearing a light pink shirt.

Prediabetes 101: What It Is and Why It Matters

Prediabetes is a condition where blood sugar levels are higher than normal but not yet high enough to be classified as type 2 diabetes. It can be a warning sign that your body is struggling to regulate blood sugar effectively.

Prediabetes suggests a decrease in insulin sensitivity and an increase in insulin resistance, potentially elevating the risk for health complications if not managed. The condition is often silent, meaning most people who have it are unaware of it.

A diagram showing Hemoglobin A1C levels. Green for normal (5.6), yellow for prediabetes (5.7 to 6.4) with "risk" noted, and red for diabetes (6.5 and above). An arrow points upward, indicating risk progression.
Hemoglobin A1C

How Is Prediabetes Diagnosed?

Prediabetes is diagnosed through simple blood tests that measure glucose levels. The most common tests include fasting blood glucose, an oral glucose tolerance test, and hemoglobin A1C. Fasting blood glucose levels between 100 and 125 mg/dL indicate prediabetes. An oral glucose tolerance test result between 140 and 199 mg/dL after two hours also falls into the prediabetes range.

For the A1C test, a reading between 5.7% and 6.4% is considered prediabetes. These thresholds are important because, according to the ADA, they highlight when intervention is needed to prevent the progression of diabetes. Having said that, there are problems with this diagnostic approach as it is reactive rather than proactive. But this is a topic for another time.

What Causes Prediabetes?

Prediabetes develops when your body begins to lose its sensitivity to insulin. Insulin resistance, which occurs when cells stop responding effectively to insulin, is a major contributor. This resistance forces the pancreas to produce more insulin to keep blood sugar stable, but over time, the system becomes overwhelmed.

Key factors that can contribute to prediabetes include a diet high in refined carbohydrates and sugars, lack of physical activity, and excess body weight. Genetics can also play a role, but lifestyle factors are often the main drivers.

A person holding a blood glucose meter with a test strip inserted. A small drop of blood is visible on their fingertip, indicating they are checking their blood sugar level. They are wearing a light pink shirt.
Photo credit: Depositphotos.

Why Does Prediabetes Matter?

Prediabetes is a critical warning sign because it often occurs years before type 2 diabetes develops. During this stage, experts suggest damage to the body may already be occurring, including to blood vessels and nerves.

Studies also suggest that prediabetes can increase the risk of cardiovascular disease, as high blood sugar and insulin resistance contribute to inflammation and damage in arteries. Identifying and addressing prediabetes early can help to prevent these complications and significantly reduce the likelihood of developing type 2 diabetes.

Who Is at Risk for Prediabetes?

Certain groups of people are more likely to develop prediabetes due to lifestyle, genetics, or other factors. Risk factors include being overweight, particularly if excess fat is stored around the abdomen. A sedentary lifestyle with little physical activity is another major risk factor. Age also plays a role, as the risk of prediabetes increases after age 45.

A family history of diabetes, a personal history of gestational diabetes, and conditions such as polycystic ovary syndrome (PCOS) can also increase the likelihood of prediabetes. Knowing these risks can help you take proactive steps to protect your health.

What Are the Symptoms of Prediabetes?

One of the challenges with prediabetes is that it often has no noticeable symptoms. However, there are subtle warning signs that may indicate your blood sugar is higher than normal. These include increased thirst, frequent urination, and fatigue.

Some individuals may experience darkened patches of skin around the neck or armpits, known as acanthosis nigricans. If you notice these symptoms, it is important to consult a healthcare provider for testing.

Can Prediabetes Be Reversed?

The good news is that prediabetes can often be reversed with lifestyle changes. Losing even a small amount of weight, such as 5-10% of your body weight, can significantly improve insulin sensitivity. Regular physical activity, including both aerobic exercise and strength training, can help your cells respond better to insulin.

Adopting a balanced diet rich in whole foods, vegetables, organic proteins, and healthy fats can be another effective strategy. Reducing refined carbohydrates, sugary foods and processed foods can ease the strain on your insulin system. These changes may not only reverse prediabetes but may also improve overall health.

Close-up of a hand holding a blue glucose meter showing a reading of 105 mg/dL. Another hand pricks a fingertip for a blood sample. Text at the bottom reads "Prediabetes 101" and "AddressingDiabetes.com".
Photo credit: Addressing Diabetes.

What Steps Can You Take Today?

If you have been diagnosed with prediabetes or are concerned about your risk, there are actionable steps you can take. Start by prioritizing movement in your daily routine, even if it’s a short walk after meals. Make gradual dietary changes, such as swapping packaged foods for whole foods.

Stay consistent with these habits, as long-term commitment is key to reversing prediabetes. Regular check-ups with your healthcare provider can also help you monitor progress and adjust your approach as needed.

Why Awareness Is Key

Prediabetes often goes undetected because it develops gradually and without obvious symptoms. However, awareness is a powerful tool. By understanding your risk factors and recognizing the importance of early intervention, you can take control of your health.

Small, consistent changes in diet, exercise, and stress management can make a significant difference. Prediabetes does not have to progress to type 2 diabetes, and taking steps today can set the foundation for a healthier tomorrow.

Conclusion

Prediabetes is not a diagnosis to fear but a call to action. It’s an opportunity to address your health before more serious complications arise. By focusing on lifestyle changes, staying informed, and seeking support when needed, you can reverse prediabetes and reclaim your health.

References:

https://www.cdc.gov/diabetes/prevention-type-2/truth-about-prediabetes.html

https://pmc.ncbi.nlm.nih.gov/articles/PMC10420389

https://pmc.ncbi.nlm.nih.gov/articles/PMC8026645

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