Your Health

Could You Have Prediabetes?

Image for glucose tests Just as pre-cancer may be detected and removed before turning into cancer, discovery of diabetes in its earliest stages can help prevent further development of the condition.

Blood sugar levels that are higher than normal, but not high enough to be called diabetes, are classified as prediabetes. Prediabetes is also called impaired glucose tolerance or impaired fasting glucose. Evidence indicates that people with prediabetes can take steps to return their blood sugar levels to a normal range. This can prevent or delay complications that are linked to diabetes.

How Serious Is the Problem?

If you have prediabetes, then you are at risk for type 2 diabetes and other serious conditions, like heart attack and stroke.

Other long-term health problems can result if you do not have good control over your blood sugar levels. Complications related to type 2 diabetes include but are not limited to:

  • Blindness
  • Impotence
  • Kidney disease
  • Nerve damage
  • Limb amputation
  • Cognitive decline

What Are the Risk Factors?

Being overweight is a risk factor for prediabetes and diabetes. Obesity and type 2 diabetes make your body cells less sensitive to the effects of insulin, a hormone that regulates blood sugar levels. This allows blood sugar levels to rise over time and can result in long-term damage to your body.

This is an especially important risk factor for Americans since many are overweight. African Americans, Hispanics, Native Americans, Asian Americans, and Pacific Islanders may be at an even higher risk.

How Do You Detect Prediabetes?

Prediabetes and diabetes can be diagnosed with a simple blood test. During a routine office visit, your doctor can order tests, such as:

  • Fasting plasma glucose test —You will fast for at least 8 hours and have your blood glucose measured before eating. Your results may be read as follows:
    • Normal: 60-99 milligrams per deciliter (mg/dL)
    • Prediabetes: 100-125 mg/dL
    • Diabetes: 126 mg/dL or above
  • Oral glucose tolerance test —You will fast for at least 8 hours and have your blood glucose measured after the fast. Then you will drink a sugary drink and have your blood glucose measured 2 hours later. Results two hours after the drink are usually as follows:
    • Normal: below 140 mg/dL
    • Prediabetes: 140-199 mg/dL
    • Diabetes: 200 mg/dL or above
  • Hemoglobin A1c (HbA1c) — A blood test that does not require any fasting. The HbA1c is an indicator of your average blood sugar levels over the previous 2 to 3 months. Your results may be read as follows:
    • Normal: below 5.7%
    • Prediabetes: 5.7%-6.4%
    • Diabetes: 6.5% or above

Who Should Get Screened?

The American Diabetes Association (ADA) recommends that the following people get screened for diabetes:

  • Adults of any age who are overweight or obese with one or more of these risk factors:
    • First-degree relative with diabetes
    • Low HDL (good) cholesterol level and high triglycerides levels
    • High blood pressure
    • History of diabetes during pregnancy (gestational diabetes) or having a baby weighing over nine pounds
    • Having polycystic ovary syndrome or other conditions associated with insulin resistance
    • Being inactive
    • History of cardiovascular disease
    • Belonging to an at-risk ethnic group (African American, Hispanic, Native American, Hispanic American, Asian American, or Pacific Islander)
    • Previous blood test results that show HbA1C levels at 5.7% or higher, impaired glucose tolerance, and impaired fasting glucose
  • Adults aged 45 or older without any risk factors
  • Overweight children aged 10 years and older who have two of these risk factors:
    • High body mass index (BMI) based on child's weight and height
    • Family history of any type of diabetes, including during pergnancy
    • Signs of insulin resistance or having a condition associated with insulin resistance
    • At-risk ethnic background
  • Screening should be repeated at least every three years if the results are normal, or every year for those people who are at increased risk for future diabetes.

How Do You Treat Prediabetes?

If your test indicates prediabetes, you should have it repeated for accuracy. If you do have prediabetes, you will need to be retested every year.

Fortunately, we know that people with prediabetes can delay or prevent the onset of diabetes with lifestyle changes. Experts recommend that people with prediabetes reduce their weight by 5-7% and engage in modest physical activity for at least 150 minutes each week. In addition to exercising, you doctor will also recommend that you make changes to your diet. This may include eating more fruits and vegetables and whole grain foods. You should also limit your intake of sugar-sweetened drinks.

If you already drink alcohol, limit your drinking to moderate to amounts of alcohol. This is 2 drinks per day for men, 1 drink per day for women. Some studies have shown a benefit for people who drink moderately.

In some cases, medications commonly used to treat diabetes may be prescribed to prevent people from developing diabetes.

  • American Diabetes Association

    http://www.diabetes.org

  • National Diabetes Education Program

    http://ndep.nih.gov

  • Public Health Agency of Canada

    http://www.phac.aspc.gc.ca

  • Canadian Diabetes Association

    http://www.diabetes.ca

  • All about prediabetes. American Diabetes Association website. Available at: http://professional.diabetes.org/admin/UserFiles/file/Reducing%20Cardiometabolic%20Risk%5F%20Patient%20Education%20Toolkit/English/ADA%20CMR%20Toolkit%5F3Pre.pdf. Accessed September 15, 2014.

  • Complications. American Diabetes Association website. Available at: http://www.diabetes.org/living-with-diabetes/complications/. Accessed September 14, 2014.

  • Diabetes mellitus type 2 in adults. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 25, 2014. Accessed September 15, 2014.

  • Diabetes mellitus type 2 in children and adolescents. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 30, 2014. Accessed September 15, 2014.

  • Diabetes mellitus type 2 prevention. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 31, 2012. Accessed August 20, 2012.

  • Diagnosing diabetes and learning about prediabetes. American Diabetes Association website. Available at: http://www.diabetes.org/diabetes-basics/diagnosis. Updated March 27, 2014. Accessed September 15, 2014.

  • Diagnosis of diabetes and prediabetes. National Diabetes Information Clearinghouse website. Available at: http://diabetes.niddk.nih.gov/dm/pubs/diagnosis/. Updated September 10, 2014. Accessed September 15, 2014.

  • Insulin resistance and prediabetes. National Diabetes Information Clearinghouse website. Available at: http://diabetes.niddk.nih.gov/dm/pubs/insulinresistance/#diagnosed. Accessed September 15, 2014.

  • Making healthy food choices. American Diabetes Association website. Available at: http://www.diabetes.org/food-and-fitness/food/what-can-i-eat/making-healthy-food-choices/. Accessed September 15, 2014.

  • Prediabetes: am I at risk? Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/DIABETES/prevention/prediabetes.htm. Updated May 15, 2014. Accessed September 15, 2014.

  • Risk factors for diabetes mellitus type 2. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 19, 2014. Accessed September 15, 2014.

  • 10/12/2009 DynaMed Systematic Literature Surveillance http://www.ebscohost.com/dynamed : Crandall JP, Polsky S, Howard AA, et al. Alcohol consumption and diabetes risk in the Diabetes Prevention Program. Am J Clin Nutr. 2009;90:595-601.

  • 2/15/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: American Diabetes Association. Standards of medical care in diabetes—2010. Diabetes Care. 2010;33(suppl 1:S11-61).

  • 2/15/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2010;33(suppl 1:S62-69).

  • 4/22/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Phung OJ, Sood NA, Sill BE, Coleman CI. Oral anti-diabetic drugs for the prevention of Type 2 diabetes. Diabet Med. 2011 Mar 23.

  • 12/15/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Rawlings AM, Sharrett AR, et al. Diabetes in midlife and cognitive change over 20 years: A cohort study. Ann Intern Med. 2014;161(11):785-793.