Last updated on April 27, 2022
Content By: Dr. Nikita Toshi BDS, Assistant Manager (Medical Review) & Dr. Ritu Budania MBBS, MD (Pharmacology) Head, Medical Affairs
Last updated on April 27, 2022
Diabetes is a condition that affects many people across the world. It is all too common for us and all of us have grown up knowing someone who had high blood sugar levels. Chronic illnesses such as diabetes, high blood pressure, cholesterol and other disorders are growing more common as the world develops and progresses. But, sadly, it is also a condition that presents very few symptoms in its early stage leaving most people unaware about their increasing sugar levels. Prediabetes is a condition where your blood sugar levels are higher than normal but not high enough for it to be termed as diabetes.. Prediabetes symptoms are almost like a warning call. It is like your friend asking you not to make that bad decision, not to skip exercising today. If you do not pay heed to these symptoms, unfortunately, you risk the chance of developing type 2 diabetes in the near future.
Diabetes is a condition that affects many people across the world. It is all too common for us and all of us have grown up knowing someone who had high blood sugar levels. Chronic illnesses such as diabetes, high blood pressure, cholesterol and other disorders are growing more common as the world develops and progresses. But, sadly, it is also a condition that presents very few symptoms in its early stage leaving most people unaware about their increasing sugar levels. Prediabetes is a condition where your blood sugar levels are higher than normal but not high enough for it to be termed as diabetes.. Prediabetes symptoms are almost like a warning call. It is like your friend asking you not to make that bad decision, not to skip exercising today. If you do not pay heed to these symptoms, unfortunately, you risk the chance of developing type 2 diabetes in the near future.
Written by:
BDS, Assistant Manager (Medical Review)
Reviewed by:
MBBS, MD (Pharmacology) Head, Medical Affairs
Prediabetes is a prevalent health condition in which blood sugar levels are more than usual but not high enough to be classified as Type 2 diabetes.
Prediabetes affects around 88 million individuals in the United States or almost one-third of the population. And as per the National Urban Diabetes Survey, around 14% of India’s population currently suffers from prediabetes. The major concern that needs to be addressed is identifying these persons so that early therapeutic intervention may be made.
The sad reality is that over 80% of people with prediabetes symptoms are unaware of their condition. Therefore, you need to be careful if you have prediabetes. As a prediabetic, you’re more likely to develop Type 2 diabetes, or even heart disease and stroke if left unchecked.
If you have prediabetes, your pancreas still generates adequate insulin in response to consumed carbohydrates. However, because the cells of your body do not respond to insulin well, your blood sugar level remains high. Insulin resistance is the medical term for this disorder.
According to the National Institutes of Health (NIH), prediabetes is a condition that can be managed and potentially reversed. Lifestyle changes, such as diet and exercise and medication, may be used to treat the condition. According to the Mayo Clinic, if you recognize prediabetes symptoms and don’t make lifestyle adjustments, you might develop Type 2 diabetes within ten years.
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Prediabetes does not imply that you will develop diabetes. But it’s almost like a warning of what’s to come. Prediabetes increases the risk of Type 2 diabetes by 5 to 15 times compared to people with normal blood sugar levels.
Unfortunately, those odds will only grow higher if you don’t make any healthy adjustments to your diet or activity habits. Adults with prediabetes usually have no symptoms at all or the signs are so subtle that they go undiagnosed for years. There are, however, warning signs from time to time.
Prediabetes can lead to skin disorders, usually dark, thick and frequently velvety patches of skin. This discolouration is most common around the elbows, neck, knees, knuckles and armpits.
If you’ve got a family history of diabetes, you should see your doctor if you’ve any of the following symptoms:
Excessive thirst
Increased urination, particularly at night
Excessive fatigue
Wounds or sores that won't heal
Unexplained weight loss
These are Type 2 diabetes symptoms and they may signal that your prediabetes has escalated to Type 2 diabetes. A doctor can help you confirm if you’ve got prediabetes by conducting a series of tests.
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Prediabetes is associated with certain causes and risk factors that increase your chances of developing prediabetes and eventually Type 2 diabetes if left undetected. Some of these factors include:
Weight – Being overweight or obese is a significant risk factor for developing prediabetes. The fattier tissue you’ve around your belly, especially inside and between the muscle and skin, the more insulin resistant your cells become.
Waist size – Insulin resistance might be indicated by big waist size. Prediabetes is more likely to occur in males with waists greater than 40 inches and females with waists greater than 35 inches.
Age – Even though diabetes can strike at any age, the risk of prediabetes rises after the age of 45.
Diet – The consumption of red and processed meat and sugar-sweetened drinks is linked to a greater risk of prediabetes. A diet rich in fruits, vegetables, nuts, whole grains and olive oil has been linked to a reduced risk of developing prediabetes.
Inactivity – The more inactive someone is, the higher the chances of developing prediabetes. Physical activity helps you maintain a healthy weight, burns sugar for energy and improves insulin sensitivity.
Polycystic ovarian syndrome (PCOS) – Prediabetes is more likely among women who have PCOS, which is characterized by a hormonal imbalance which may cause irregular menstrual cycles, excessive hair growth and obesity.
Ethnicity or race – Although the reason for this is unknown, some ethnic groups, such as Black, Hispanic, American Indian and Asian Americans, are more susceptible to prediabetes.
Gestational diabetes – You and your kid are more likely to develop prediabetes if you had diabetes while pregnant (gestational diabetes). Your doctor will most likely check your blood sugar at least once in three years if you’ve had gestational diabetes.
Stress – Studies have shown that stress is also a risk factor associated with prediabetes. Perceived stress and anxiety has shown to negatively impact one’s blood sugar levels and so caring for your mental health becomes equally important in reducing your risk of prediabetes.
Here are some other health conditions that are linked to prediabetes:
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These conditions are linked to insulin resistance when they occur along with obesity.
But don’t worry, it’s not as grim a picture as it seems. There are ways to manage and control prediabetes, as we’ll see in the following sections. Prediabetes does not signal a life sentence and it’s very possible to live happy, fulfilling lives with prediabetes.
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In order to make an accurate diagnosis, your doctor will ask you to get a simple blood sugar test done to check for prediabetes. This entails taking a blood sample and sending it to a lab for analysis.
Depending on the type of test, the results may differ. According to the National Institutes of Diabetes and Digestive and Kidney Diseases, you should repeat the test to confirm the diagnosis. Glucose-monitoring devices, such as the finger-stick test, aren’t utilized for diagnosis. Instead, your doctor may do one or more of the following tests:
Fasting plasma glucose test
Your doctor will ask you to fast for eight hours or overnight before the fasting plasma glucose test. A healthcare professional will collect a blood sample for testing before you eat.
Normal fasting blood sugar levels are less than 100 milligrams per deciliter (mg/dL) – 5.6 millimoles per litre (mmol/L).
Prediabetes is defined as a fasting blood sugar level of 100 mg/dL to 125 mg/dL (5.6 to 7.0 mmol/L). Impaired fasting glucose is a term used to describe this outcome.
Type 2 diabetes is diagnosed by a fasting blood sugar level of 126 mg/dL (7.0 mmol/L) or greater.
Oral glucose tolerance test (OGTT)
Fasting is also required for an OGTT. Your doctor will check your blood glucose levels twice – first at the start of the visit and again two hours later after you’ve consumed a sugary drink.
After two hours:
Normal blood sugar levels are considered as levels lower than 140 mg/dL (7.8 mmol/L).
A blood sugar level of 140 mg/dL to 199 mg/dL (7.8 to 11.0 mmol/L) is considered prediabetic. Impaired glucose tolerance is the term used to describe this condition.
Type 2 diabetes is defined as a blood sugar level of 200 mg/dL (11.1 mmol/L) or greater.
If you’ve been diagnosed with prediabetes, your doctor will examine your blood sugar levels at least once a year.
Haemoglobin A1c test
The haemoglobin A1c test, commonly known as the A1c test, is a blood sugar test that evaluates your average blood sugar level over the past two to three months. This test requires no fasting and can be performed at any time.
Prediabetes is diagnosed by an HbA1c score of 5.7% to 6.4%. However, to validate the results, a second HbA1c test is recommended. The higher your HbA1c value is, the more likely your prediabetes will develop into Type 2 diabetes.
Generally speaking:
A1c levels of less than 5.7% are considered normal.
Prediabetes is defined as an A1c level of 5.7% to 6.4%.
Type 2 diabetes is diagnosed when the A1c result is 6.5% or above in two independent examinations.
If you’re pregnant or have an unusual type of haemoglobin, the A1c test may be incorrect.
Prediabetes normal range: What is my safe zone?
In the United States, over 29 million individuals have diabetes but many more are at risk and suffer from prediabetes. Patients in the danger zone have blood glucose levels that are too high to be normal yet are not diabetic. The tests mentioned above can help you detect whether or not you’ve got prediabetes.
But here’s the good part, say you have symptoms of prediabetes; it doesn’t have to develop to Type 2 diabetes if you take the necessary steps on time. You can regulate your blood sugar levels by making lifestyle adjustments. Emphasize reducing high-carbohydrate foods, which quickly break down into glucose and raise blood sugar levels quicker than the body’s ability to create enough insulin. The body can dispose of glucose more effectively and maintain an average blood sugar level if you restrict the amount of carbohydrates you consume.
When to take a test for prediabetes?
The National Institute of Diabetes and Digestive and Kidney Diseases recommends that persons with the following risk factors get a prediabetes screening:
A waist circumference of more than 40 inches in males or more than 35 inches in females.
Age limit of 45 years or more.
Being overweight, obese or having a BMI above 25.
PCOS (Polycystic ovary syndrome), dark velvety patches on the skin of neck, armpits, elbows, etc. and liver disease are all conditions that exacerbate insulin resistance.
A history of gestational diabetes is diabetes that was first diagnosed during pregnancy and tends to go away after childbirth.
An ethnic background that puts an individual at high risk of diabetes, including people who are African-American, Asian-American, Latino, Native American or Pacific Islander.
Having recently received long term or high doses of medicines containing steroids or some medicines that may be given for a mental illness. Having given birth to a child that weighed over 4.1 kg.
If your doctor detects any of these risk factors, he or she may suggest that you undergo a blood glucose test. Doctors recommend conducting screening tests every 1 to 3 years.
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While prediabetes is a condition that can be managed effectively if you identify the symptoms and diagnose them on time, complications can arise if left undiagnosed. Fear of the disease is one reason that many people don’t get tested for prediabetes. However, late diagnosis or leaving the disease undiagnosed will only exacerbate the condition in the future. So, it’s recommended that you get your screening test done as soon as possible. By diagnosing prediabetes, you can considerably delay the onset of Type 2 diabetes.
Consider prediabetes to be a fork in the road – ignore it and your chances of developing Type 2 diabetes increase. On the other hand, if you lose a little weight or fat to be precise and engage in regular physical activity, your risk of developing Type 2 diabetes decreases. For a 90 kg person, modest weight reduction is losing 5% to 7% of their body weight or 4.5 kgs to 6 kgs. Regular physical exercise is defined as at least 150 minutes of brisk walking or other comparable activities each week. That’s all you need to do to control your prediabetes.
The National Diabetes Prevention Program has been shown to assist patients in making the lifestyle adjustments necessary to prevent or delay Type 2 diabetes. Participants in the program will be able to:
Create long-term lifestyle changes and work with a qualified coach.
Learn how to eat healthier and include more physical activity into their daily routine.
Learn how to deal with stress, stay motivated and resolve issues.
Likewise, you can either join a diabetes intervention program in your city or ask your doctor or dietician what to do to delay or prevent the onset of Type 2 diabetes.
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Managing prediabetes can also be viewed as an attempt to prevent Type 2 diabetes. If you’ve got prediabetes, your doctor will advise you to make certain lifestyle adjustments. People who meticulously followed these modifications for the long term saw a 58% reduction in their risk of diabetes, according to the Diabetes Prevention Program.
The following are the most frequent strategies to control prediabetes:
Eating healthy – When it comes to your diet, vegetables, fruits, healthy grains, lean meats like fish or poultry and low-fat dairy are all good choices. Limit your intake of processed, fried and sugary foods. Reduce the number of calories you consume each day by eating smaller meals.
Exercising frequently – Exercising is a crucial component of diabetes prevention. At least 5 times a week, you should engage in 30 minutes of moderate physical activity. This may involve going for a quick walk, riding a bike or going for a swim. Consult your doctor to determine the appropriate level of exercise for you.
Losing weight – If you’re overweight, reducing only 7% of your initial weight might help you avoid or delay diabetes. If you weigh 90 kg, dropping 6 – 7 kg may make a significant impact. Weight loss also aids in the reduction of blood pressure and cholesterol.
Taking medication – If you’re at a high risk of diabetes, your doctor may advise you to take medication to control its progression. Medications to treat high blood pressure and cholesterol may also be recommended.
Quit smoking – If you smoke, you may increase your chances of getting Type 2 diabetes.
Some people with diabetes choose to opt for complementary and alternative medicine therapies to help them control their condition. Supplements, meditation and acupuncture are examples of complementary and alternative medicine therapies. However, always consult with your doctor before beginning any complementary and alternative medical therapies since they may interfere with your medications.
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Is prediabetes reversible?
Yes. Though it’s a common disease, it’s reversible in many cases. If you’ve got prediabetes, with the help of simple, proven lifestyle modifications, you can avoid or delay the onset of Type 2 diabetes.
What are the warning signs of prediabetes?
Though it might be difficult to know if you’ve got prediabetes, there are some subtle signs to watch for. It is not necessary to experience one of these symptoms to have prediabetes. However, if you experience any of these symptoms, you must discuss them with your doctor.
Vision is blurry
Hands and feet feel cold often
Urinary tract infections become more common
Dry mouth
Excessive thirst
Frequent urination
Irritability, anxiousness or worry have increased
Itchy skin
Strange feelings in your extremities, such as tingling, numbness, pain or burning
Infections that recur
Sudden weight loss
Extreme fatigue
Wounds that don’t heal quickly
How long does it take for prediabetes to become diabetes?
Three to six years is the window of opportunity to prevent or delay the progression of prediabetes to Type 2 diabetes. However, this duration may vary from person to person depending on the individual’s risk factors, dietary habits and lifestyle.
Make sure you follow the diet and lifestyle modifications as advised by your doctor to stay on track in your fight against prediabetes and reduce your blood sugar levels.
How often should I check my blood sugar if I'm prediabetic?
When you’re trying to reverse prediabetes, your doctor will tell you how often you should have blood tests done, generally every three months. But this could vary from one patient to the next, so make sure you consult with your doctor as well.
What foods should you avoid if you’re prediabetic?
The body has a hard time decreasing blood sugar levels after meals for people with prediabetes. Keeping a close eye on your carbohydrate and fat consumption might help you avoid blood sugar rises.
When you consume more calories than your body requires, the excess calories are stored as fat. You may gain weight as a result of this. Insulin resistance is connected to body fat, particularly around the abdomen. So, avoid fatty and carbohydrate-rich foods.
What exercise is good for prediabetes?
If you get out and burn more calories, you’ll lose weight faster and feel better. You don’t need to prepare for a marathon to become in shape: a brisk 30-minute stroll, five times a week should be enough. An exercise companion may sometimes make it easier to adhere to a program, so contact a friend or join a gym to meet new people. Strength training (weight lifting, pushups, pull-ups) and aerobic exercise (walking, swimming, dancing) are beneficial. However, it’s better to combine the two.
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