Prediabetes: A Guide

If you have prediabetes, your blood sugar levels are above the normal range but not high enough for a diagnosis of type 2 diabetes. It is a serious health condition that can lead to heart disease, type 2 diabetes, or stroke.   Prediabetes happens when your cells do not respond properly to the hormone insulin. In many cases, there are no symptoms.

Prediabetes has several risk factors, including having excess body weight, a family history of diabetes, and a sedentary lifestyle. A blood test can check for prediabetes.

This article discusses the symptoms and causes of prediabetes and the risk factors. It also lists the potential complications, shares some natural remedies, and explains how you can prevent prediabetes from progressing.

In the United States, 1 in 3 adults have prediabetes, and many of them do not know it. Prediabetes typically does not cause symptoms, which makes health screenings very important. You can make changes to lifestyle factors, such as diet and exercise, to help prevent complications. 

If you do experience symptoms of prediabetes, they may include:

• increased appetite
• unexplained weight loss or gain
• weakness
• fatigue
• sweating
• blurred vision
• slow healing wounds
• recurring skin infections
• bleeding gums

Prediabetes happens when your cells do not respond correctly to insulin. Insulin is a hormone that your pancreas makes. It allows sugar into your cells, which they use as energy. 

A healthy blood sugar cycle looks like this:

1. You eat a meal or snack, and your stomach digests the food.
2. As the digested food travels through your intestines, it breaks down even more.
3. Sugar from the digested food travels through the walls of your intestines and enters your bloodstream.
4. The amount of sugar in your blood, known as your blood glucose level, increases.
5. The pancreas releases insulin to start unlocking your cells so that they can absorb the sugar.
6. As the cells absorb sugar, your blood glucose level decreases until it reaches the healthy range.

The blood sugar level in a person with prediabetes is constantly higher than usual — either because the cells do not respond to insulin or because the pancreas is not making enough insulin. 

Researchers do not entirely understand what causes the cells to start resisting insulin. However, they believe that excess weight and a sedentary lifestyle are likely significant factors. 

Learn about the types of diabetes.

Various genetic and lifestyle factors can increase your risk of developing prediabetes.

The risk factors include:

• excess weight or obesity
• being aged 45 years or older
• having a parent or sibling with diabetes
• physical inactivity
• high blood pressure
• abnormal cholesterol levels
• a history of gestational diabetes
• a history of heart disease or stroke
• polycystic ovary syndrome (PCOS)
• metabolic syndrome, which is a combination of high blood pressure, large waist size, and abnormal cholesterol levels

People from certain ethnic groups may also have an increased risk of developing prediabetes.

If you have several risk factors for prediabetes, it is a good idea to talk with a doctor about testing. They can order a simple blood test called A1C, which reflects your blood sugar levels over the last 3 months. 

Lifestyle changes can help reduce your risk of prediabetes turning into type 2 diabetes. These changes may reverse prediabetes altogether.

The Diabetes Prevention Program (DPP) evaluated people at high risk for developing diabetes. The DPP showed that people who lost up to 7% of their starting weight reduced their risk of developing diabetes. As an example, for a person whose starting weight is 200 pounds (lb), this is up to 14 lb of weight loss. 

The people in the study lost weight by changing their diet and becoming more physically active. 

Planning meals is often helpful in preventing or reversing prediabetes. The meal plan should focus on eating foods that keep your blood sugar levels within a target range. 

A good meal plan includes:

• plenty of nonstarchy vegetables, such as spinach, green beans, and broccoli
• a low intake of added sugars and refined grains, such as white rice, white bread, and white pasta
• whole foods rather than processed foods

The plate method is a simple system you can use to help ensure that you eat all the right foods in the correct serving size. 

1. Start with a 9-inch dinner plate.
2. Fill half your plate with nonstarchy vegetables, such as:
   • salad
   • cabbage
   • green beans
   • broccoli
   • carrots
   • cauliflower
3. Fill one-quarter of the plate with lean protein, such as chicken, turkey, beans, or tofu. 
4. Fill the last quarter of your plate with carbohydrates, such as starchy vegetables or grains.
5. For your beverage, drink water or unsweetened tea. 

Learn more about a prediabetes diet.

Being active has multiple benefits. It helps with reaching or maintaining a moderate weight and allows your cells to be more sensitive to insulin. 

Other benefits of being active include:

• feeling happier
• sleeping better
• controlling your blood pressure 
• improving your memory
• lowering your levels of bad cholesterol
• decreasing your risk of heart disease

You can make it a goal to get a minimum of 150 minutes of moderate intensity exercise each week and to perform exercises that work all major muscle groups on 2 days of the week. 

If you have not previously been physically active, start with 20–25 minutes of activity a few days a week.

Moderate intensity activities include:

• brisk walking
• mowing the lawn
• doing house chores
• swimming
• dancing
• playing team sports, such as soccer or basketball
• bicycling

People who have prediabetes and make no lifestyle changes can develop type 2 diabetes within 5 years. 

Prediabetes puts people at higher risk of:

• type 2 diabetes
• heart attack
• stroke
• blindness
• kidney failure
• amputation of the toes, feet, or legs

In the U.S., diabetes is the seventh leading cause of death. 

If your doctor has diagnosed you with prediabetes, you can still make changes and prevent it from developing into type 2 diabetes. 

The most important step is to try to reach or maintain a moderate weight by doing some physical activity every day and eating a well-balanced diet. If it helps, find someone to get involved with you who will encourage you in the process. 

Learn which foods keep your blood sugar in your target range and which foods you should avoid. 

The Centers for Disease Control and Prevention (CDC) have a National Diabetes Prevention Program that works with public and private organizations to help people learn the lifestyle changes that can prevent or delay type 2 diabetes. 

You might wish to consider working with a lifestyle coach, who can help you with:

• taking small steps toward health that fit into your life and schedule
• eating a more healthy diet and adding more exercise into your day
• managing stress, solving problems that may slow you down, and staying motivated

Prediabetes is when your blood sugar levels are higher than is healthy for your body but not sufficiently high for a type 2 diabetes diagnosis. Your blood sugar is high because your cells are not reacting to insulin the way they should. 

Without treatment, prediabetes can lead to many other health conditions. 

Although researchers do not know the exact cause of diabetes, they believe that carrying excess body weight and being inactive play a role. As prediabetes usually produces no symptoms, people with risk factors should talk with a doctor about getting a test. 

Prediabetes is a serious condition. However, it is treatable by following lifestyle changes such as maintaining a moderate weight and eating a healthy and balanced diet.