Prediabetes



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Editors
Abbas E. Kitabchi, PhD, MD
Guillermo Umpierrez, MD



Additional Resources
NIDDK (NIH)
Mayo Clinic
American Diabetes Association

What is prediabetes?

Prediabetes occurs when blood glucose levels are higher than normal, but not high enough for a diabetes diagnosis. Over time, this can increase your risk of heart disease and stroke, as well as your risk of developing type 2 diabetes. Unfortunately, prediabetes symptoms are hard to spot, so many people have the condition without a proper diagnosis.

Who is at risk?

The U.S. Centers for Disease Control indicates that about 79 million American adults over the age of 20 have prediabetes. As the population ages, becomes increasingly overweight and increasingly inactive, the number of adults with symptoms of prediabetes continues to grow. The number of young people with this condition is also increasing. Common risk factors include:

  • Being obese or overweight
  • Not getting enough exercise
  • A family history of type 2 diabetes
  • Being 45 or older
  • Having African-American, Latino/Hispanic or American Indian family background
  • Having had gestational diabetes
  • Giving birth to a baby weighing more than 9 pounds

Symptoms of prediabetes

Unfortunately, there are almost no symptoms of prediabetes. The only way to know for sure that you have the condition is with a blood test. Three blood tests can be used to diagnose the condition. These include:

  • Fasting blood glucose test (FBG) — Blood is drawn after a period of fasting for at least 8 hours.
  • Oral glucose tolerance test (OGT) — Requires an 8 hour fast, after which blood is drawn before you drink a sugary solution and again 2 hours later.
  • Hemoglobin A1c test (HbA1C) — A blood test that shows an estimate of average blood glucose levels for a period of three months.

Why should you be concerned about prediabetes?

Every year, one out of ten people with prediabetes will develop type 2 diabetes, and many are not even aware that they are at risk, because they don't have symptoms. If left untreated, diabetes can cause kidney failure, nerve damage, heart disease, stroke and blindness. Even a slight increase in blood glucose levels in prediabetes can increase your risk for heart disease and stroke.

How do you prevent and treat prediabetes?

Preventing prediabetes is done with lifestyle changes, including a healthy diet that is high in vegetables and fruits and low in fat and processed foods. Regular physical activity, averaging 30 minutes five days per week, is also important. Maintaining a healthy weight, or losing 5–10% of your weight if you are overweight, can also help.

In addition to lifestyle changes, a few drugs have been proven to lower the risk of developing diabetes if you have prediabetes. These drugs do have side effects, and their benefits wear off when you stop taking the drug, making lifestyle change the best option for tackling this problem.

Questions to ask your doctor

  • Do I need to be checked for prediabetes?
  • If I have prediabetes, should I be checked for type 2 diabetes? How often?
  • Should I take medicines to treat my prediabetes?
  • What are the benefits and risks of prediabetes medicines?
  • How can I lose weight if I need to?
  • Should I see an endocrinologist for my care?