What Does a Prediabetes Diagnosis Mean?

Prediabetes can be a warning sign for type 2 diabetes

You may have heard of type 2 diabetes, a chronic condition that arises when blood sugar levels are too high. But are you familiar with prediabetes, which is an early warning sign of type 2 diabetes? Prediabetes often – but not always – progresses to type 2 diabetes. It’s sometimes known as early-onset diabetes, borderline type 2 diabetes or insulin resistance.

If you develop insulin resistance, your body has become less sensitive to the insulin you produce, or your pancreas has stopped making enough insulin to meet your needs. Both conditions cause sugar to build up in your bloodstream. You can be diagnosed with prediabetes when your blood sugar levels are higher than normal, but not high enough to be considered diabetes.

When you’re diagnosed with prediabetes, you may be able to control the condition. Some people can delay the onset of type 2 diabetes. Others prevent their blood sugar levels from ever reaching the diabetic range.

Unfortunately, 80% of people with prediabetes don’t know they have it because it’s a silent condition without symptoms. People are usually diagnosed after routine blood work, which primary care providers order at yearly well visits. If you don’t go for yearly well visits or have blood work done from time to time, you may never know your prediabetes status.

Are you at risk of prediabetes?

Prediabetes is frequently diagnosed in people who are 45 or older. People who are Black, Hispanic and Asian are at greater risk of prediabetes than people who are White.

People are at greater risk if they:

• Are overweight or obese.
• Lead an inactive lifestyle.
• Have a family history of prediabetes or diabetes.
• Have high blood pressure.
• Have high cholesterol levels.
• Have sleep apnea.
• Were diagnosed with gestational diabetes during pregnancy.
• Eat a lot of red meat or foods with refined flour or added sugar.

How is prediabetes diagnosed?

Prediabetes and diabetes can be diagnosed with simple blood tests. The two most common tests are:

• Fasting blood sugar test, which requires you to fast for eight hours before having your blood drawn. This test gives a snapshot of your blood sugar level on the day of the test.
• Hemoglobin A1C test, which isn’t affected by what you eat before the test. It shows your average blood sugar level during the previous three months.

What do fasting blood sugar test results mean?

• Less than 100 mg/dL is within the normal range.
• Between 100 mg/dL and 125 mg/dL is considered prediabetic.
• 126 mg/dL or higher on two occasions is considered diabetic.

What do hemoglobin A1C test results mean?

• Less than 5.7% is normal.
• Between 5.7% and 6.4% is prediabetes.
• 5% or higher on two occasions is diabetes.

How can people manage prediabetes?

You may feel perfectly fine when you are diagnosed with prediabetes, but it’s important to manage the condition. Controlling prediabetes may delay or prevent the onset of type 2 diabetes.

Many people control their prediabetes by making lifestyle changes or by taking medication in addition to adopting lifestyle changes.

Some people are motivated to change their habits because they have relatives with type 2 diabetes, and they want to avoid the health complications that their loved ones have experienced. For others, the diagnosis itself may be motivation enough.

Changing the way that you eat and move may help you lose weight and lower your blood sugar levels, which should help you control your prediabetes. Try these changes:

• Make healthy tweaks to your diet. Avoid simple sugars (soda or juice) and simple carbohydrates (white bread, white rice, white pasta, white flour tortillas or potatoes). They can greatly drive up your blood sugar levels or cause weight gain. Patients with prediabetes should eat complex carbohydrates (whole-grain bread, brown rice, quinoa or beans) as part of the Mediterranean diet, which includes lean protein, healthy fats and plenty of fruits and vegetables.
• Get more exercise. Adults – including those with prediabetes – should aim to get 150 minutes (about two and a half hours) of moderate-intensity exercise each week. This may sound overwhelming if you haven’t done much physical activity lately. If you’ve been sedentary, start walking for 15 minutes after dinner and gradually increase the time for each walk. Research has shown that walking after meals helps lower blood sugar levels from the meal that you’ve just eaten, so it’s an excellent time to get moving.
• Lose weight if you’re overweight or obese. You don’t need to lose very much weight to have a positive influence on your prediabetes. Research has shown that losing as little as 5% of your body weight may have a major effect on your blood sugar levels. If you weigh 180 pounds, that’s a weight loss of only 9 pounds.

It can be hard to adopt habits that are different than those you’ve followed your whole life. Some patients struggle to make meaningful changes to their diet or exercise routine. When you embark upon a new routine, it’s best to do things in moderation. If you try to adopt a completely new lifestyle all at once, it will be too hard to keep up with those changes for the long haul.

If you’re interested in making positive changes through lifestyle habits, your provider may give you three months to try to improve on your own before they prescribe medication. You may never need medication if you can make significant changes on your own, and many people do. Others aren’t successful, despite their best efforts. For these patients, providers may prescribe a drug that helps patients with prediabetes and diabetes lower blood sugar levels and makes it easier for them to lose 5% of their body weight.

Whether you’re able to control your prediabetes on your own or with your doctor’s help, it’s a notable accomplishment. You’ll not only look and feel healthier, but you’ll also reduce your risk of type 2 diabetes and the complications that may arise from this condition.

Shivani Vekaria, MD, is an endocrinologist for ChristianaCare and is accepting new patients in Newark. Call today to schedule an appointment and learn more: 302-661-3070.