People who have prediabetes have high levels of sugar in their blood. The levels are above normal. However, they are not high enough to be called type 2 diabetes.
There are often no warning signs of prediabetes. Many people don’t know they have it. Blood tests can help your doctor figure out whether you have the condition. This is important because people with prediabetes are more likely to develop full-blown diabetes. They're also at higher risk for heart disease and stroke.
Diagnosing Prediabetes
Several types of blood tests can help your doctor decide whether you have prediabetes. They include:- A1c: This test shows your average blood sugar level over the past three months. Doctors also call it the hemoglobin A1c, the HbA1c, or the glycohemoglobin test. The test report gives the results as a percentage. The higher the percentage, the higher your blood sugar level. A normal A1c result is below 5.7%. An A1c level between 5.7% and 6.4% means you may have prediabetes.
- Fasting blood glucose (FPG): This test measures your blood sugar after you haven’t eaten or had anything to drink (except water) for 8 to 12 hours. A normal level is below 100 milligrams per deciliter (mg/dL). A blood sugar level between 100 and 125 mg/dL is prediabetes.
- Oral glucose tolerance test (OGTT): This is a
fasting blood sugar test that adds a “glucose challenge.” You can’t eat
or drink anything (except water) for at least eight hours before the
test. Then, two hours before your blood is drawn, you will have a sugary
drink. This lets your doctor see how your body handles the sugar in the
drink. If your test shows a blood sugar level between 140 and 199
mg/dL, you may have prediabetes.
Prediabetes Warning Signs and Risk Factors
The higher your blood test results, the greater your risk of developing type 2 diabetes. But your doctor will check more than these blood tests. Other factors also matter. You are more likely to develop prediabetes if you:
- Are 45 or older
- Have high blood pressure
- Are overweight or obese
- Have family members with diabetes
- Do not do physical activity at least three times a week
- Are a woman who had gestational diabetes (diabetes during a pregnancy)
- Have low HDL (“good” cholesterol)
- Have a high level of triglycerides (a type of fat in the blood)
- Are African American, Hispanic/Latino, American Indian, Asian American or Pacific Islander
- Are a woman with polycystic ovary syndrome
How to Prevent Prediabetes
Many people with prediabetes develop type 2 diabetes within 5 to 10 years. But that doesn't have to happen. You can take steps to control your blood sugar levels.Lifestyle changes can often prevent or reverse prediabetes. These include:
- Weight loss. Losing even a small amount of weight can help reverse prediabetes. This can prevent or delay type 2 diabetes. Experts suggest you try to lose 5 to 10% of your body weight. For someone who is 200 pounds, that means losing 10 to 20 pounds. To lose weight, cut extra calories from your diet and get regular physical activity. If you are not sure how to begin, your doctor can put you in touch with a dietitian or a certified diabetes educator. These experts can help you make healthy changes to your eating habits and daily routine.
- Regular exercise. Exercise helps your body use insulin more effectively. Try to get at least 150 minutes of physical activity each week. That’s 30 minutes a day, five days a week. You don’t need to join a gym to exercise. Just take walks, garden, swim, rake leaves, and climb stairs. All activity counts. But before you start a new exercise routine, talk with your doctor about what level of activity is safe for you.
- Healthy eating. A healthy diet is important. It
helps you keep your weight in line. It also keeps your blood sugar
levels in check. It’s best to stick to a diet low in salt, sugar and
fat. Especially avoid saturated fats. Instead, add more fruit,
vegetables, fish, beans, and whole grains to your meals. A nutritionist
or certified diabetes educator can give you ideas about foods to eat,
healthy ways to prepare your meals, and portion sizes.
When Medication Might Help
Healthy eating, a healthy weight, and exercise are the best ways to prevent prediabetes. But some people also need medication as part of their prevention strategy.
Your doctor may prescribe a diabetes medication called metformin. It helps control the amount of sugar in your blood. Doctors are likely to prescribe this if:
- You are at high risk for diabetes
- You are obese
- You have high triglycerides
- You have low HDL
What's Next?
If you have prediabetes, talk with your doctor about how often you should be tested.Also, keep in mind that having prediabetes does not mean you will definitely go on to develop type 2 diabetes. Not everyone does. The key is to catch the condition early and take action.