What is Pre-Diabetes?

Diagnosis, Treatment, and Prevention

-- By Liza Barnes & Nicole Nichols, Health Educators

SparkPeople advertisers help keep the site free! Learn more

Before developing the serious health condition of type 2 diabetes, a person will almost always have pre-diabetes beforehand. But pre-diabetes is a condition without symptoms, meaning that many people can have it without even knowing it. Left unchecked, pre-diabetes can lead to full-blown type 2 diabetes, heart disease and stroke. Luckily, pre-diabetes can be diagnosed with a simple test, and treatment can prevent many health problems and complications. Here's what you need to know to control pre-diabetes before it gets control of you.

Diabetes Basics
Under normal circumstances, the glucose (sugar) levels in your blood rise after you eat a meal or snack. In response, your body produces a hormone called insulin, which is needed for the body to convert the glucose in your bloodstream into usable energy. But if insulin isn’t available, or if the body isn’t using it correctly, your blood glucose will remain elevated, and that can be harmful to your body. This is a condition known as diabetes. People who have higher-than-normal blood glucose levels that aren’t quite high enough to be diagnosed as type 2 diabetes have pre-diabetes. In the past, individuals with pre-diabetes would have been considered "borderline diabetic."

Who's at Risk?
Over 50 million Americans over the age of 20 have pre-diabetes, according to the American Diabetes Association. If you have any of the risk factors for type 2 diabetes, including uncontrollable factors like age and race, and/or controllable risk factors like obesity and physical inactivity, then you are also at risk for pre-diabetes.

Most of the time, pre-diabetes is asymptomatic (shows no symptoms), but some people will experience some general diabetes symptoms like extreme thirst, frequent urination, fatigue and/or blurred vision.

If you fall into any high-risk categories or experience any of the symptoms above, then visit your health care provider for a blood glucose test as soon as you can. Early diagnosis and treatment are crucial steps, as they can prevent the development of type 2 diabetes and its serious health consequences.

Testing & Diagnosis
There are two tests commonly used to diagnose diabetes and pre-diabetes: a fasting plasma glucose (FPG test) and an oral glucose tolerance test (OGTT).

The FPG test will measure your blood glucose level after an eight-hour (overnight) fast. A result less than 100 mg/dL is considered normal, but anything above that level is diagnosed as "impaired fasting glucose" (IFG). Between 100 mg/dL and 125 mg/dL is considered pre-diabetes, while 126 mg/dL or higher indicates diabetes.
The OGTT will measure your blood sugar after a fast and then again after drinking a glucose-rich beverage. Two hours after the beverage, a result less than 140 mg/dL is considered normal, but anything above that level is diagnosed as "impaired glucose tolerance (IGT). Between 140 mg/dL and 199 mg/dL is considered pre-diabetes, while 200 mg/dL or higher indicates diabetes.
Some people have both IFG and IGT.

Treatment & Prevention
While pre-diabetes in itself isn’t necessarily dangerous, the fact is that many people with pre-diabetes will develop type 2 diabetes within 10 years.

If you have pre-diabetes, realize that you’re fortunate to have found out while there is still a lot you can do to prevent or delay the development of type 2 diabetes. Here are some preventative measures:

Lose weight. In a study of more that 3,000 people with pre-diabetes, a five to seven percent weight loss (about 10 pounds for a 200-pound person) lowered the incidence of type 2 diabetes by nearly 60 percent. Follow the SparkDiet to reach your weight loss goal.
Get active. Physical activity (and its accompanying weight loss) will lower your risk of developing type 2 diabetes and boost you health in other ways too. Try walking 30 minutes a day, five days a week. Read about Exercising with Diabetes for more tips.
Eat sensibly. Cut excess calories, sugar, saturated fat and trans fat from your diet and you will cut your risk of diabetes. Include more healthy fats, fiber, whole grains, fruits and veggies, using the Nutrition Resource Center as a guide.
Quit smoking. Smokers are 50% to 90% more likely to develop diabetes than nonsmokers. If you smoke, taking steps to quit today can reduce your risk of serious health problems, including type 2 diabetes.
Drink moderately. Moderate drinking (no more than one drink daily for women or two drinks daily for men) has a protective effect against diabetes, but avoid heavy drinking.

If you have pre-diabetes, work closely with your doctor to create a plan of sensible lifestyle changes that will work for you. The complications of diabetes—heart disease, stroke, blindness, and more—can be avoided by taking these proactive steps today.

For more specific information or help, talk to your health care provider. The American Diabetes Association's National Call Center also offers live advice from 8:30 a.m. to 8 p.m. EST, Monday through Friday at 1-800-DIABETES or 1-800-342-2383.

Read More:
Prediabetes: What You Need to Know (RealAge.com)

This article has been reviewed and approved by Amy Poetker, Registered Dietitian and Certified Diabetes Educator.

Click here to to redeem your SparkPoints

You will earn 3 SparkPoints

Page 1 of 1 Return to main nutrition page »

Stay in Touch With SparkPeople

About The Author

Liza Barnes
Liza has two bachelor's degrees: one in health promotion and education and a second in nursing. A registered nurse and mother, regular exercise and cooking are top priorities for her. See all of Liza's articles.

View All Comments (53) Leave a Comment ›

Member Comments

MARYELLEN1235

hi my name is maryellen and i just find out that i'm a prediabete and in 2010 of march 30th i drop from 355 to 274 pounds which i am very pound of my self . and now my ac1 is high so my drs is watch it and i have to watch what i eat.. but i am lucky cuz i have lose total of 81 pound since 2010. but prediabetes - 5/11/2013 8:26:26 PM
Report Inappropriate Comment
AMBAGANJ

My A1C was high at one time, it was up to 6.7 I watched what I ate and lost weight and the last time it was checked it was 5.2, but what I don't understand is that my glucose is still over a 100 most of the time unless I eat cheerios for breakfast and they bring it down below 65 then I have to eat something because I get the shakes and feel week. - 12/29/2012 2:05:29 PM
Report Inappropriate Comment
BOJODO

A little bit about Hemoglobin A1C: This is a helpful screening test for pre-diabetes as well as the tool of choice for monitoring glucose control in diagnosed diabetics. It's not standard of care everywhere to use it as a diagnostic lab for Pre-DM, but is being adopted increasingly as such and is recommended by the ADA. The reason it catches pre-diabetes earlier than a fasting glucose is because typically the blood sugar will be abnormally elevated after a meal (either higher than should be or high for too long) before the fasting sugar is affected in the course of insulin resistance. The glucose tolerance test will also catch these, but it is a one-time shot versus an average of 3-4 months.

For diagnosis:
5.6% and below: normal glucose metabolism
5.7-6.4% Pre-Diabetes. 15-30% of people with Pre-DM will develop diabetes within 5 years without lifestyle change.
6.5% and above: Diabetes - 11/24/2012 9:26:00 AM
Report Inappropriate Comment
KIARARAMIREZ

I am pre diabetic, I was diagnosed about 5 years ago but just 3 monts ago my ACI wa high and scared me to death! I was working out 3 times a week already so I started working out 5 times a week and eating healty, I cut almost all carbs from my diet except those from fruits and vegetables, well... I don't eat potatoes, bananas, peas or corn. I was 193 lbs and now 3 months later weight 172, I'm still working hard to lose another 20. I have to go back to my doctor next week, hopefully my numbers dropped and I don't have to take any medicine. All my other number were already good, no high cholesterol or high blood pressure. My mother died of complication with diabetes and my brother who is younger that me is diabetic, I am determined to beat this beast! - 10/24/2012 11:47:58 AM
Report Inappropriate Comment
SVIPETERSON

As harmful as sugar is, it always goes along with flour, white rice, pasta, white grains - harmful for diabetics. They do me as bad as the sugar does. If your pre-diabetc, take control now before you become diabetic - it is no fun. - 10/1/2012 1:06:58 PM
Report Inappropriate Comment
TLTFAAS

I think there is a lot of information available on how to manage pre-diabetes but it requires hours and hours of research and weeding through inaccurate information. There are several really good books on Amazon.com about pre-diabetes but my favorite is at http://www.nutrit
ionxpert.com/
pre-diabetes-ebook - 8/16/2012 8:55:20 PM
Report Inappropriate Comment
OLIVE_LOAF

One of my spark trivia questions today was "Which of these does not help prevent diabetes" and I forget what all of the answers were but one was "Cut excess sugar from your diet" or something to that effect. I chose "All of the above help prevent diabetes" and it said that was wrong, that there was no proof that eating excess sugar causes Type 2 diabetes! And then had a link to this article. I'm disappointed Spark is spreading misinformation, especially on something this important. - 7/8/2012 1:07:07 PM
Report Inappropriate Comment
PERIWINKLEBLUE

All I can say to pre diabetics is TAKE IT SERIOUSLY - I didn't understand what it meant and am now a diabetic. Research it and change your habits. Don't become a diabetic. - 7/2/2012 1:19:15 PM
Report Inappropriate Comment
VINSAKE

"Eat sensibly. Cut excess calories, sugar, saturated fat and trans fat from your diet and you will cut your risk of diabetes. Include more healthy fats, fiber, whole grains, fruits and veggies, using the Nutrition Resource Center as a guide."

The only thing I see right here is the "cut excess calories & sugar". Why they didnt put "cut excess carbs" here, beats me. Sugar is found in carbs as well ie. Fruits, veges, bread, starchy veges. This advice is similar to what would come from the ADA in which I find saddening.

Lowering your carb intake significantly can help prevent type 2 diabetes. I already have type 2 diabetes and have had it for 3yrs now. Only recently, after being told to lose 20kgs in 6 months, I looked up "weight loss for diabetes". I came across Dr. Jay Wortman's interview on Youtube, and from there it lead me to Dr. Bernstein's Diabetes revolution. I have followed Dr. Bernstein's radical carb decrease in my diet just to see if it would work for me. I had to lower my diabetes medication significantly (going from 6 - 3 tablets per day after 2 weeks of monitoring my glucose levels. I havent felt this good in years. Physically and mentally. Never hungry either. My glucose levels have been stable at non-diabetic's glucose levels for 1 week now.

Anyone wanting to avoid diabetes, should try this approach. There are a lot of people for and against low carb diets, but if you want to know if it would work for you to lower your risk of type 2 diabetes, read the book, try the diet yourself and get your tests done again in 3 months. I was my own guinea pig and ended up convincing myself that this is the way to go, just by obtaining my own results that reflected what the book promised. I wish I knew this earlier, but Im glad I found out eventually :) - 7/2/2012 8:50:22 AM
Report Inappropriate Comment
WALL-E2

Jennkfi

I agree with your comment 100%.
There is enough information out there to make informed healthy choices but peope think it won't happen to me.
It is easier to keep the weight off the to take it off.
My diabetic numbers are completely within range. Very rare do I go above 10 or 11 (Canadian numbers). I won't allow it to happen.
Oh, sure, last night at work on my break, I had a real treat, a small sliver of cheesecake but that's not an everyday item for me either. - 7/2/2012 8:03:50 AM
Report Inappropriate Comment
JENNKFIT

Ever notice in America, all of our major health problems are caused by our disgusting lazy lifestyle and aren't actual "Health" problems, but American problems? We have to STOP reading these articles and get our bodies moving, not for some 20 or 30 minute fix but we need to be up and moving for hours every day. It's natural for our bodies to be in motion. Get up and get moving! And don't eat so 'American'! - 7/2/2012 7:13:54 AM
Report Inappropriate Comment
BIKEBALTIMORE

Lose 5-10% of body weight - #1 priority. All of the prevention tips are good, but I've read a few articles about studies done in England and Europe. The most important thing is to bring your weight down. Even if you're not too overweight - if people in the higher range of healthy can lose weight - they are able to avoid diabetes. - 6/28/2012 1:51:15 PM
Report Inappropriate Comment
SHOSH770

Something not mentioned here is that if you have PCOS you might be considered pre-diabetic. Insulin resistance tends to come along with it, and it can be harder to lose weight. - 6/6/2012 9:35:07 AM
Report Inappropriate Comment
SLOAN128

I HAVE BEEN DIAGNOSED AS BORDERLINE DIABETIC. I AM A HEALTHY, SLIGHTLY OVERWEIGHT 57 YEAR OLD. I WORK OUT ATLEAST 4 TIMES A WEEK, I CUT OUT MOST CARBS, GOOD CHOLESTEROL LEVELS, PRETTY HEALTHY AND WITHIN 6 MONTHS MY HbA1c WENT FROM 6.0-6.3. I ENDED UP GOING ON METFORMIN WHICH I WAS NOT CRAZY ABOUT BECAUSE I JUST DON'T TAKE MEDS. YOU CAN'T WAIT UNTIL YOU HAVE TYPE 2 TO START TAKING MEDS, IT COULD BE OUT OF CONTROL BY THEN. I THINK SOMETIMES DOCTORS DON'T KNOW AS MUCH AS THE DRUG REPS THAT ARE TRAINED ON THE DIFFERENT MEDICATIONS. NOTHING ELSE WORKED FOR ME. I GO BACK FOR ANOTHER TEST NEXT WEEK AFTER 1 MONTH OF TAKING METFORMIN. WE SHALL SEE.
- 5/31/2012 7:51:12 PM
Report Inappropriate Comment
TWEITZY

Artificial sweetners CAN also raise insulin levels and they present a host of other issues. AVOID THEM!
Saturated fats from organic free-range stock is HEALTHY. Coconut oil is a saturated fat - it is HEALTHY!!! Real butter from organic free-range animals is HEALTHY! Organic free-range eggs are HEALTHY. As surprising as it might be to hear, the fact that animal fats pose this same risk is not supported by science.

Even a single can of diet or regular soda per day will raise risk of diabetes by as mush as 60%. substitute with water, tea or fresh ground organic coffee (w/o the crap added).

Join the renaissance and take charge of your health and avoid as much of the man-made or modified crap as possible. - 5/31/2012 11:50:29 AM
Report Inappropriate Comment