What is prediabetes and what can be done?
Blood sugar is higher than normal but not yet in the diabetes range. This article explains how prediabetes is identified, why it should not be ignored, and what reliable sources say about slowing its course.
If your test report says “prediabetes”, or your fasting blood sugar was 100 to 125, you may be worried. This article explains what prediabetes is, what it is not, and what to do next.
What is prediabetes?
It means blood sugar is higher than normal but not yet high enough for a diagnosis of diabetes. According to NIDDK, this state raises the risk of type 2 diabetes and heart disease. The CDC says prediabetes is a stage that many people pass through before type 2 diabetes.
How is it identified?
By blood test. The CDC cut-offs for prediabetes:
- HbA1c (average blood sugar over the past two to three months): 5.7% to 6.4% (normal is below 5.7% and diabetes is 6.5% or higher)
- Fasting blood sugar: 100 to 125 mg/dL (normal is 99 or lower and diabetes is 126 or higher)
- Glucose tolerance test (value at two hours): 140 to 199 mg/dL (normal is below 140 and diabetes is 200 or higher)
A single borderline number is not a diagnosis without the doctor’s review. The CDC says that if you had the test at a pharmacy or health fair, follow-up with a doctor is needed and the test may be repeated.
It has no symptoms
According to the CDC there are usually no symptoms, and many people who have it do not know. So if you have risk factors (family history, excess weight, low physical activity, high blood pressure, earlier gestational diabetes), have the test regularly. The NHS also says not everyone has symptoms, and screening is important.
What can be done?
The sources say:
- Activity. NIDDK gives at least 30 minutes of physical activity, 5 days a week. If you have been inactive for a long time, start slowly.
- Weight. NIDDK says losing 5 to 7 percent of starting weight may delay or prevent diabetes. For a person weighing 90 kg, that is about 4.5 to 6.3 kg. This figure is not the same for everyone, and the doctor sets the goal with you.
- Food. Smaller portions, less fat, and water instead of sweet drinks, according to the same source.
- A prevention programme. The CDC suggests structured lifestyle change programmes (with a coach and a group). If there is one near you, ask the doctor.
- Follow-up. Repeat the test according to the doctor’s plan. The doctor also decides the interval.
On medicine, NIDDK says to ask the doctor whether it is needed for you. This is an individual decision, and you should not make it yourself or start a medicine without the doctor.
Being realistic
The CDC page speaks of “reversing” prediabetes with lifestyle change, and NIDDK speaks of delaying or preventing type 2 diabetes and says even a few years of delay is good for health. These are possibilities, not promises; the result differs from person to person. After gestational diabetes too, the risk of type 2 diabetes stays higher for 5 to 10 years (NIDDK).
When should you tell the doctor?
If you develop heavy thirst, passing a lot of urine, unusual tiredness, unexplained weight loss or blurred vision, do not wait for the next test. These are signs of diabetes (NHS).
Every patient’s treatment plan is different; ask the doctor about your own situation.