Prediabetes Symptoms in Indian Patients

Introduction

Chronic illnesses such as diabetes, high blood pressure, cholesterol and other disorders are growing more common as the world develops and progresses. But sadly, diabetes a condition that presents very few symptoms in its early stage, leaving most people unaware of 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 diagnosed as diabetes. Prediabetes symptoms are almost like a warning call. If you do not pay attention to these symptoms, unfortunately, you risk the chance of developing type 2 diabetes in the near future.

What is Prediabetes?

Prediabetes is a prevalent health condition in which blood sugar levels are more than usual but not high enough to be diagnosed as Type 2 diabetes.

 According to a study published in the Lancet, the prevalence of prediabetes in India is estimated to be 15·3% ^[1] . The major concern that needs to be addressed is identifying these people so that early therapeutic intervention may be made.

If you have prediabetes, your pancreas still generates adequate insulin in response to consumed carbohydrates. However, because your body’s cells do not respond to insulin well, your blood sugar level remains high. Insulin resistance is the medical term for this condition.

According to the National Institutes of Health (NIH), prediabetes is a condition that can be managed and potentially reversed^[2]. Lifestyle changes, such as diet, exercise and medication, may be used to treat the condition. If you recognise prediabetes symptoms and don’t make positive lifestyle adjustments, you might develop Type 2 diabetes within the next few years.

To Summarize

• As per the Indian Council of Medical Research–India Diabetes (ICMR-INDIAB) study, the incidence of prediabetes in India is estimated to be 15.3%. 
• Over 80% of people with prediabetes symptoms are unaware of their condition. So, you need to keep a check on blood sugar levels.
• According to the National Institutes of Health (NIH), prediabetes is a condition that can be managed and potentially reversed.

Signs and Symptoms of Prediabetes

Prediabetes is 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.

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
• Blurry vision
• Wounds or sores that won’t heal
• Unexplained weight loss
• Acanthosis nigricans – dark, thick and velvety patches on skin. This discolouration is most common around the elbows, neck, knees, knuckles and armpits.

Monitoring blood sugar levels can help your doctor screen you for prediabetes.

To Summarize

• 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. So keep a lookout for that.
• If you’ve got a family history of diabetes, you should see your doctor if you think you are exhibiting any symptoms of diabetes.

Causes and Risk Factors of Prediabetes

How likely are you to develop prediabetes?

Prediabetes happens due to certain causes and risk factors that raise the chances of developing it. If not detected in time, it can eventually lead to Type 2 diabetes. Some of these factors include:

• Weight: Being overweight or obese is a significant risk factor for developing prediabetes. The fattier the 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 characterised 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 have been shown to negatively impact one’s blood sugar levels, 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:

• Blood pressure that is too high.
• The levels of “good” cholesterol or high-density lipoprotein (HDL) are low.
• Triglycerides – a kind of fat found in the blood — are high.
• These conditions are linked to insulin resistance when they occur along with obesity.
• Certain medications like glucocorticoids

But don’t worry, it’s not as grim a picture as it seems. There are ways to manage 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.

To Summarize

• If you are overweight, there is a higher chance of you being diagnosed with diabetes. So watching your weight is a great way to keep your sugar levels in check.
• The consumption of red and processed meat and sugar-sweetened drinks is linked to a greater risk of prediabetes. So it is better to leave them out of your diet. A little change goes a long way, after all.
• Prediabetes does not signal a life sentence, and it’s very possible to live happy, fulfilling lives with prediabetes.

Do You Have Prediabetes?

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. Consult a doctor for the interpretation of lab tests and diagnosis. 

1. Fasting Plasma Glucose Test

Your doctor will ask you to fast for eight hours or overnight before the fasting plasma glucose test. A phlebotomist 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)^[3]. 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.

2. 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^[3].

Type 2 diabetes is defined as a blood sugar level of 200 mg/dL (11.1 mmol/L) or greater^[3].

If you’ve been diagnosed with prediabetes, your doctor will examine your blood sugar levels at least once a year.

3. 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.

HbA1c score of 5.7% to 6.4% indicates prediabetes (in undiagnosed people) ^[3]. However, to validate the results, a second HbA1c test and other tests like FBS and PPBS are 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 and FBS and PPBS or OGTT are high in two independent examinations.
• If you’re pregnant or have an unusual type of haemoglobin, the A1c test may be incorrect.

Prediabetes: How to Lower Your Blood Sugar to a Safe Level

You can regulate your blood sugar levels by making lifestyle adjustments. Emphasise reducing sugary and processed foods, which quickly break down into glucose and raise blood sugar levels quicker than the body’s ability to create enough insulin. Consult a doctor and understand the dietary and lifestyle changes that are required.

When to Take a Test for Prediabetes?

According to ICMR guidelines^[4], screening should be performed in all individuals >30 years of age and earlier if the person has any of the following risk factors: 

• A waist circumference of more than 90 cm in males or more than 80 cm in females
• Age limit of 30 years or more
• Being overweight, obese or having a BMI above 23 
• PCOS (Polycystic ovary syndrome), dark velvety patches on the skin of the neck, armpits, elbows, etc. and liver disease are all conditions that exacerbate insulin resistance
• A history of gestational diabetes, i.e. 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
• Person with hypertension (high BP), dyslipidemia (deranged lipid profile), cardiovascular disorder (heart disease)
• Family history of type 2 diabetes
• Having recently received long-term or high doses of medicines containing steroids or some medicines that may be given for a mental illness
• During and before planning pregnancy

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 year. 

To Summarize

• For a correct diagnosis, there are some blood tests you need to take to determine if you have prediabetes.
• Type 2 diabetes is diagnosed when the A1c result is 6.5% or above, increased FBS, PPBS/OGTT in two or more independent examinations. But if you’re pregnant or have an unusual type of haemoglobin, the A1c test may be incorrect. Thus, consulting a doctor is important.
• If you are diagnosed with prediabetes, regular exercise and dietary modifications really help. The body can dispose of glucose more effectively and maintain an average blood sugar level if you restrict the amount of refined carbohydrates you consume.
• If you have put on weight suddenly and your BMI is above 25, it is advisable to get tested for diabetes.
• Doctors recommend conducting screening tests every year because early diagnosis and timely intervention can save you from complications later on.

Prediabetes Complications

What happens when prediabetes is left undiagnosed? Prediabetes is a condition that can be managed effectively if you identify the symptoms, get diagnosed early and take the necessary steps. However, if left undiagnosed, complications can arise. 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 worsenthe 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 as a warning sign – 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 kg to 6 kg^[5]. Regular physical exercise is defined as at least 150 minutes of brisk walking or other comparable activities each week^[6]. That’s all you need to do to control your prediabetes – dietary changes + exercise + stress management. Always consult a doctor and do as advised.

To Summarize

• If managed, prediabetes is nothing to worry about at all. But it can be dangerous if we don’t listen to the warnings.
• Fear of the disease is one reason that many people don’t get tested for prediabetes. But ultimately, it just makes matters worse.
• To create long-term lifestyle changes, work with a qualified diabetes educator or nutritionist. Stress is inevitable, but it is better for your health if you can avoid it or learn to manage it in a healthy way. Also, try and eat healthily.

Treatment and Prevention of Prediabetes

Managing prediabetes can also be viewed as an attempt to prevent or delay the onset of 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^[7].

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. Building muscles can be helpful in the effective utilisation of glucose by the body.
• 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. Do not follow crash dieting, lose weight by healthy lifestyle changes gradually.
• 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 if necessary.
• Quit smoking and alcohol: If you smoke or consume alcohol, 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.

To Summarize

• If you’ve got prediabetes, your doctor will advise you to make certain lifestyle adjustments. A few little tweaks will help you lead a healthy life.
• We often confuse eating healthy with just eating salads. It’s not. You eat everything but in moderation. But avoid processed food, fizzy drinks, and alcohol, and quit smoking.
• Some people with diabetes choose to opt for complementary and alternative medicine therapies to help them control their disease. Supplements, meditation and acupuncture are examples of complementary and alternative medicine therapies.

Also Read: Diabetic Retinopathy Treatment in India

Frequently Asked Questions (FAQs)

References:

1. Anjana RM, Unnikrishnan R, Deepa M, Pradeepa R, Tandon N, Das AK, et al. Metabolic non-communicable disease health report of India: the ICMR-INDIAB national cross-sectional study (ICMR-INDIAB-17) [Internet]. The Lancet Diabetes & Endocrinology; 2023 Jun 8 [cited 2025 Feb 4];11(7):474–89. Available from: https://pubmed.ncbi.nlm.nih.gov/37301218/
2. Alvarez S, Coffey R, Mathias PM, Algotar AM. Prediabetes [Internet]. StatPearls – NCBI Bookshelf; 2023 [cited 2025 Feb 4]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459332/
3. Diabetes Diagnosis & Tests | ADA [Internet]. [cited 2025 Feb 4]. Available from: https://diabetes.org/about-diabetes/diagnosis
4. Department of Health Research, Ministry of Health & Family Welfare, Government of India. Standard Treatment Workflow (STW) DIABETES MELLITUS TYPE 2 [Internet]. 2022 Jul [cited 2025 Feb 4]. Available from: https://www.icmr.gov.in/icmrobject/uploads/STWs/1726567245_diabetes_mellitus_type_2.pdf
5. Bramante CT, Lee CJ, Gudzune KA. Treatment of obesity in patients with diabetes. Diabetes Spectrum [Internet]. 2017 Nov 1 [cited 2025 Feb 4];30(4):237–43. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5687113/
6. Physical activity [Internet]. 2025 [cited 2025 Feb 4]. Available from: https://www.who.int/initiatives/behealthy/physical-activity
7. The Diabetes Prevention Program (DPP). Diabetes Care [Internet]. 2002 Dec 1 [cited 2025 Feb 4];25(12):2165–71. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC1282458/

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