Key takeaways

Approximately one in three Americans have prediabetes, with the majority of cases going undiagnosed and untreated, which can lead to more serious health problems such as heart disease, stroke, and type 2 diabetes.
Prediabetes is primarily caused by lifestyle factors, including being overweight, a sedentary lifestyle, poor diet, and also has a genetic component, affecting those with a family history of diabetes or specific ethnic backgrounds more severely.
Symptoms of prediabetes are often subtle and go unnoticed, but include increased thirst, frequent urination, dry mouth, and blurred vision, highlighting the importance of regular blood sugar testing for those at risk.
Prediabetes can be reversed through lifestyle changes such as losing weight, increasing physical activity, and eating a healthy diet, with medication like metformin prescribed in high-risk cases, emphasizing early detection and management to prevent the progression to type 2 diabetes.

Approximately one in three Americans have prediabetes, according to the CDC. However, the majority of cases go undiagnosed and untreated. Prediabetes is when your blood sugar (blood glucose) levels are higher than normal, but not yet high enough to be classified as diabetes. Prediabetes symptoms often go undetected, and without prediabetes treatment, blood vessels and nerves can be damaged. This can lead to heart disease and stroke, and eventually, develop into type 2 diabetes.

Type 2 diabetes, the next stage after prediabetes, is when your body cannot regulate blood sugar levels correctly because you can no longer produce or properly use the hormone insulin. When your body cannot properly use insulin, it’s known as insulin resistance. Without the proper use of insulin, blood glucose levels can get dangerously high. This is because insulin is a hormone that helps your cells use and process glucose.

Prediabetes causes

There are a number of factors that contribute to prediabetes, many of which are related to lifestyle. Risk factors for developing prediabetes and insulin resistance include:

Being overweight or obese
Lack of exercise/sedentary lifestyle
Poor diet
Immediate family members have diabetes
You experience gestational diabetes (diabetes during pregnancy)
You are a female with polycystic ovary syndrome (PCOS)
High blood pressure
Low levels of “good” (HDL) cholesterol
You are African American, Native American, Latin American or Asian/Pacific Islander
Over 45 years old
Sleep apnea

Is diabetes genetic?

Given that diabetes is so complex, several factors usually contribute to developing the disease. Lifestyle factors can significantly increase risk, however, genetics and family history play a strong role in both type 1 and type 2 diabetes. It’s well researched that if a family member has diabetes, you’re more likely to develop the condition.

Is diabetes more common in men or women?

Studies show that type 1 diabetes is more common in men, and they’re more likely to pass it on to their offspring. However, although women previously showed more indication of type 2 diabetes, it is now equally prevalent between men and women.

Type 1 diabetes is an autoimmune condition that usually starts in childhood. With type 1 diabetes, your body attacks its own pancreas so it cannot produce insulin. Type 2 diabetes is far more common in adults, and although often milder than type 1, can still cause major health implications, including kidney disease or damage, heart disease, or stroke. Unlike type 1, with type 2 diabetes some insulin can be produced, but the body is either resistant to it or there is not enough. This insulin resistance develops in fat, liver, and muscle cells, hence the extensively researched correlation between obesity and type 2 diabetes.

Prediabetes symptoms

One of the main reasons so many people have undiagnosed prediabetes is because you can go for years without experiencing any obvious symptoms. This means it is often left undetected until it develops into more serious health problems.

For this reason, it is always important to regularly ask your doctor for a simple blood sugar test to check if you have prediabetes. This is especially important if you have any of the higher risk factors, such as being obese, 45 years or older, or being physically active less than three times a week.

That said, some warning signs and symptoms of prediabetes to look out for are:

Feeling very thirsty
Frequent urination
Dry mouth
Hunger after eating
Unexplained weight loss or gain
Headaches
Blurred vision

An increase in these symptoms can be an indication that you’ve transitioned from prediabetes into type 2 diabetes.

If you’re experiencing any prediabetes symptoms, speak with your primary care doctor and request a blood test.

Prediabetes tests

There are a number of different blood tests that your doctor can use to determine if you’re prediabetic. The following three are the most common and effective:

1. Fasting glucose test

As the name suggests, this test is taken after you have fasted for at least eight hours. For convenience, many doctors will suggest you fast overnight and come in first thing in the morning to have your test.

A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 7.0 mmol/L) is considered prediabetes, however, a fasting blood sugar level of 126 mg/dL (7.0 mmol/L) or higher indicates type 2 diabetes.

2. Oral glucose tolerance test

Doctors generally only perform this prediabetes blood test during pregnancy. Like the fasting blood sugar test, the doctor will take a blood sample after the patient has been fasting for at least eight hours. Then, the patient will consume a sugary liquid and have their blood sugar levels tested again in two hours.

In this test, a blood sugar level from 140 to 199 mg/dL (7.8 to 11.0 mmol/L) is considered prediabetes. Any higher indicates diabetes.

3. Glycated hemoglobin (A1C) test

Another test for blood sugar levels, the A1C test measures your average blood sugar level over the last sixty to ninety days. It’s generally not used in pregnant women and patients with rare forms of hemoglobin as it can cause inaccurate test results.

An A1C level between 5.7 and 6.4 percent is considered prediabetes. Consistent tests above 6.5 percent indicate type 2 diabetes.

Prediabetes treatments

In very good news, although prediabetes is common, it can be reversed and go away. With some healthy lifestyle changes, a patient with prediabetes can prevent or delay the development of type 2 diabetes.

The three most effective prediabetes treatments are:

1. Lose body weight

Usually, just 10 to 14 pounds for a 200-pound person is enough to have a significant benefit.

2. Increase physical activity

According to the Centers for Disease Control and Prevention, just 30 minutes a day, 5 days a week, is enough to impact and reduce prediabetes. Try brisk walking in the morning or afternoon, taking the stairs every day, or parking one to two blocks away from the office.

3. Eat healthy foods

Start by reducing the amount of refined and processed carbohydrates, and focus on non-starchy vegetables and lean meats. Switch to plant-based proteins such as beans, lentils, and nuts. The key is to make a healthy, balanced diet part of your everyday lifestyle. A registered dietitian can help you create a meal plan specific to your weight, allergies, and other factors specific to your health and condition.

It’s also helpful to reduce the amount of alcohol you’re consuming, as this can be high in sugar and be dehydrating. Drinking more water can also help weight loss, and is the best option when switching away from sugary drinks like soda and fruit juice.

Smoking may also to increase the likelihood of developing diabetes, so your doctor may suggest cutting the habit. The period directly following quitting smoking can make a person more likely to develop diabetes, so your doctor will need to monitor your progress and response to the lifestyle change.

Only when a person is considered a very high risk of developing type 2 diabetes will a doctor prescribe medication for prediabetes. An example would be a patient with a body mass index (BMI) greater than or equal to 35 kg/m2. Metformin is the only medication that the American Diabetes Association advises fir use in prediabetes treatment. It keeps your blood glucose level in a safe range by preventing the liver from producing too much unneeded glucose.

What should you do if you are prediabetic?

If you’ve been to see your doctor, and a blood test confirms you are prediabetic, there are many simple steps you can take to reverse the condition and prevent it from developing into diabetes.

Your healthcare providers will suggest help and guidance, like the best lifestyle changes considering your medical history and circumstances. Steps they may recommend include cutting out processed sugar, consuming more vegetables and whole grains, and taking a walk every morning.

A valuable resource for many prediabetic patients in the United States is the National Diabetes Prevention Program (DPP). Through private and public partnerships, it aims to prevent or delay type 2 diabetes by making it easier for Americans to make the lifestyle changes they need.

In some cases, they may even recommend medication. Whatever your doctor suggests, remember prediabetes can be reversed and it’s great you caught it early.

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