Prediabetes: What It Is, Why It Happens + What You Can Do About It

If you have prediabetes, it means your blood sugar is higher than it is in someone without any form of diabetes but not high enough to be diagnosed with type 2 diabetes (T2D). Prediabetes is not related to type 1 diabetes (T1D), which is when the body’s immune system mistakenly attacks its insulin-producing cells.

How common is prediabetes?

More people are being diagnosed with prediabetes every year.

The Centers for Disease Control and Prevention (CDC) says:

• Over 115 million American adults have prediabetes: that’s more than 2 in 5 adults.
• About 8 in 10 people with prediabetes do not know they have it.
• Over 40 million Americans have diabetes, and about 11 million of them don’t know it yet.

Prediabetes raises your risk for:

• T2D
• Heart disease
• Heart attack
• Stroke

How to screen for prediabetes

Healthcare providers (HCPs) use three tests to check for prediabetes, and each test has its own range for what counts as prediabetes.

• A1C: This test measures your average blood sugar over the past three months. The prediabetes range for this test is 5.7% to 6.4%. 
• Fasting blood sugar: This test measures your blood sugar after not eating for at least eight hours. The prediabetes range for this test is 100 to 125 mg/dL (5.6 to 6.9 mmol/L). 
• Oral glucose tolerance test (OGTT): This test measures your blood sugar several times during the test. A blood sample is taken after an eight-hour fast, then you drink a sugar solution and your blood sugar is checked two hours later. Special diet instructions are needed with this test. Don’t start or eat a low carbohydrate diet within three days of this test. Most people will need to have at least 150 grams of carbohydrate each day for at least three days before the test. Talk with your HCP about how to prepare ahead of time. Depending on your test results and if you have any signs or symptoms, your HCP may retest you on another day  to confirm your diagnosis.

How to lower your risk of developing T2D after a prediabetes diagnosis

A prediabetes diagnosis is not permanent. Nor does it mean you are destined to live with T2D! Even if you are diagnosed with T2D at some point, rest assured that you can still lead a rich, fulfilling life. They find ways to thrive, lessen symptoms or even go into remission. Getting a prediabetes diagnosis can help you catch it early so you can prevent it from turning into T2D.

Some ways people bring their blood sugar levels back to a stable range and lower the risk of their prediabetes turning into T2D include:

• Implementing healthy lifestyle changes: tracking food, eating nutritiously and increasing daily movement. The CDC says adults should aim for at least 150 minutes of physical activity per week. 
• Weight loss and management: losing 5 to 7% of your body weight can help prevent T2D. The CDC runs the National Diabetes Prevention Program (National DPP), a year-long program that teaches healthy eating and exercise habits in a group format. Research shows it can cut the risk of developing T2D by more than half. For adults over 60, the risk drops by more than 70%. 
• Medication: metformin is the most commonly prescribed medication for T2D. Some HCPs may choose to use it in people with prediabetes as well. Talk to your HCP to see if it makes sense for you, especially if the first two steps aren’t helping you as much as you need. Metformin has many benefits beyond managing the challenges of T2D.

HCPs sometimes use metformin to help prevent T2D in people with prediabetes if they fall into certain groups that you may be in if:

• You are under the age of 60
• You have a body mass index (BMI) of 35 or higher
• You have had gestational diabetes (in the recent or distant past)
• You are taking certain medications to treat cancer or high-dose steroids

What to do if you believe you have prediabetes

Prediabetes often shows no symptoms, so don’t wait until you notice something before taking action. Attending your annual checkups can be helpful if you’re at high risk—just ask your HCP to evaluate you for prediabetes during these visits. This removes the pressure between appointments. 

If you notice any concerns between checkups, don’t wait, especially if you have risk factors like a family history of T2D,  live with a higher weight or a sedentary lifestyle. Talk to your HCP about getting tested. 

Remember: A simple blood test can determine your status. If your results indicate prediabetes, ask whether you’re eligible for the National DPP lifestyle change program  (linked above) or for a similar program that may be offered or covered by your insurance once you receive a formal diagnosis. A single conversation with your HCP can have a huge impact on your health in ways you might not even be able to anticipate.

It’s not a failure if you are diagnosed with prediabetes—it’s just information you can use to take action. Shame helps no one. We can’t change the past, only the future.

How to reduce your risk of prediabetes at home

The small habits we all have make a big impact on our health!

If you are at risk of developing prediabetes, try:

• Taking a walk after meals
• Swapping one processed snack for a higher-fiber option
• Swapping high calorie and sugar beverages for water
• Eating small portions if weight loss is your goal
• Paying attention to how food and movement affect how you feel
• Being mindful of your stress levels and finding ways to reduce stress
• Being mindful of your sleep patterns and finding ways to improve your sleep

These are things most people should be doing, regardless of diabetes. Diabetes often makes you more aware of how your behavior affects your body, whereas people without diabetes may not have to think about it or may already be doing the things that keep them from having to. Everyone must take care of themselves, whatever their illness, circumstances, culture or lifestyle!

A prediabetes diagnosis doesn’t have to stop your life. It might just alter your course a bit. It’s your body waving at you, signaling that something’s up, giving you a chance to respond. And guess what? If the signs are there, it’s time to respond to the gesture!

The sooner you act, the more power you have over what happens next in your health journey. Seek medical treatment whenever you notice something new in your body that wasn’t there before and keeps recurring.

What to do if your prediabetes symptoms change or escalate

If your symptoms progress to any of the following, seek urgent care, as that may be another form of diabetes altogether:

• Excessive thirst
• Frequent urination
• Exhaustion
• Unexplained weight loss

People with T2D more often  have a higher risk of a life-threatening condition called hyperglycemic hyperosmolar state (HHS). If your prediabetes goes unchecked and progresses without your awareness, this is something to be mindful of.

Awareness leads to action! Be aware, and take care.

Diabetes affects millions, but it doesn’t affect millions equally. See how we’re going Beyond Barriers to help the people who need it most, who are often overlooked or unaccounted for within our own communities.