What is Prediabetes?

Prediabetes is when blood sugar levels are higher than normal, but not high enough to be diagnosed as diabetes. This condition is also referred to as impaired glucose intolerance or impaired fasting glucose. More than 1 in 3 American adults have prediabetes – over 84 million people – but 90% don’t know they have it. Over three to five years, 25% of those with prediabetes develop type 2 diabetes.

What Causes Prediabetes?

Prediabetes is caused when the body’s cells don’t respond normally to insulin, which is created by the pancreas. Insulin helps glucose get into the cells to be used as energy. When cells don’t respond normally to the insulin, the pancreas creates more of it to try and elicit a response. Eventually, the pancreas can’t keep up and blood sugar levels rise, resulting in prediabetes.

Below is a list of factors that increase a patient’s prediabetes risk.

• Weight. The more fatty tissue a body has, the less responsive the cells are to insulin. So being overweight is a major risk factor for prediabetes.
• Diet. A diet dense with red and processed meat and drinks with a high sugar content increases the prediabetes risk. A diet rich in fruits, vegetables, nuts, whole grains and olive oil is associated with a lower prediabetes risk.
• Age. Prediabetes can develop at any age, but the prediabetes risk increases after the age of 45. This can be attributed to people exercising less, losing muscle mass and gaining weight as they get older.
• Inactivity. Sedentary lifestyles are associated with an increased prediabetes risk. Staying physically active helps control weight, uses glucose as energy and makes cells less resistant to insulin.
• Family history. Prediabetes risk increases when a patient’s parent or sibling has type 2 diabetes.
• Waist size. A large waist size can be an indicator of insulin resistance. Men with waists larger than 40 inches are at increased risk, as are women with waists larger than 35 inches.
• Race. While there is no explanation, people of certain races are at an increased prediabetes risk. This includes African-Americans, Asian Americans, Native Americans and Pacific Islanders.
• Gestational diabetes. Women who develop gestational diabetes during pregnancy are at an increased prediabetes risk.
• Polycystic ovary syndrome. Characterized by irregular periods, excess hair growth and obesity, polycystic ovary syndrome is a common condition that puts women at an increased prediabetes risk.
• Disrupted sleep. People with certain sleep disorders or irregular sleep patterns are at an increased prediabetes risk. This includes those with obstructive sleep apnea and those who work night shifts or changing shifts.

Prediabetes Signs and Symptoms

There are usually no signs of prediabetes. This helps explain why the overwhelming majority of people don’t know they have it. One sign that you may be at risk for type 2 diabetes is darkened skin on the neck, knees, knuckles, elbows and armpits.

Signs and Symptoms That May Indicate the Transition of Prediabetes to Type 2 Diabetes

• Frequent urination
• Increased thirst
• Blurred vision
• Fatigue

Prediabetes Diagnosis

A prediabetes diagnosis is made using blood sugar tests. These tests are called the fasting plasma glucose test, the oral glucose tolerance test and the hemoglobin A1c test.

Fasting Plasma Glucose Test

For this test, patients don’t eat for 8 hours, then their blood is tested.

• Results are normal if the blood sugar is less than 100 milligrams per deciliter
• Prediabetes is indicated if the blood sugar is 100 to 125 milligrams per deciliter
• Diabetes is indicated if the blood sugar is 126 milligrams or higher per deciliter

Oral Glucose Tolerance Test

This test is preceded by a fasting plasma glucose test. Then the patient drinks a sugary drink, and at regular increments for two hours later, their blood is tested.

• Results are normal if the blood sugar is less than 140 milligrams per deciliter
• Prediabetes is indicated if the blood sugar is 140 to 199 milligrams per deciliter after the second test
• Diabetes is indicated if the blood sugar level is 200 milligrams per deciliter or higher after the second test

Prediabetes Prevention and Treatment

The best prevention and treatment for prediabetes is making healthy lifestyle choices. Simple changes to manage weight and improve diet can reduce the prediabetes risk and prevent it from developing into type 2 diabetes.

• Eat healthy, natural foods
• Increase physical activity
• Maintain a healthy weight
• Manage blood pressure and cholesterol
• Stop smoking

Prediabetes Treatment at Baptist Health

Patients with a family history of diabetes and/or those who are experiencing excessive thirst, frequent urination, blurred vision, fatigue or dark patches of skin on the neck, knuckles, knees, elbows or armpits, and are overweight should talk to their Baptist Health provider about prediabetes.