Prediabetes affects more than 1 in 3 Americans (about 100 million adults), and affects more than half of people over age 65!
This article will describe exactly what prediabetes is, who is at the highest risk for it, and how often you should be tested for it in order to prevent or delay the development of diabetes in your life.
What is prediabetes?
Prediabetes means that while your body is still producing insulin, you have higher blood sugar levels than normal, but not yet quite high enough to constitute a diabetes diagnosis.
Your body is experiencing insulin resistance, where your pancreas is pumping out insulin, but your body is not utilizing that insulin effectively. Without intervention, about 70% of people with prediabetes will go on to develop type 2 diabetes later in life.
It’s important to note that prediabetes never turns into type 1 diabetes, which is an autoimmune disease that does not develop from insulin resistance.
Someone who has prediabetes has a fasting blood sugar level of between 100-125 mg/dL. Normal fasting blood sugar levels are below 99 mg/dL, and someone with type 1 or type 2 diabetes would normally see a fasting blood sugar level of above 125 mg/dL.
Prediabetes may sometimes not have any symptoms, so it’s important to get checked regularly at your doctor’s office for the condition if you are at heightened risk for the condition.
More than 84% of people with prediabetes don’t even know they have it!
Who is at risk for prediabetes?
You may be at risk for prediabetes if you fall into any of the following categories (and you’re more likely to develop prediabetes if you fall into multiple categories). The first list is factors that you cannot control:
- You have a direct relative who has type 2 diabetes (sibling or parent)
- You are 45 years or older
- You are African-American, Hispanic, Native-American, Pacific Islander, or Asian-American
- You suffer from Polycystic Ovary Syndrome (PCOS)
- You have Cushing’s Syndrome or Acromegaly
- You suffer from sleep apnea
- You previously had gestational diabetes while pregnant
- You take steroids for a health condition, are on certain antipsychotic or HIV medications
Additionally, the following risk factors you can control, and are able to modify to lower your risk of prediabetes:
- You are overweight or obese
- You eat a poor diet, full of saturated fats and added sugars
- You live a sedentary lifestyle and get no regular exercise
- You suffer from high blood pressure or high cholesterol, and they’re not well-controlled
- You suffer from metabolic syndrome, which is a combination of hypertension, high cholesterol levels, and a large waist measurement
- You smoke cigarettes
- You drink alcohol in excess
Quitting smoking, increasing your physical activity levels, losing excess weight, and improving your diet can help lower your risk for prediabetes.
Talk with your doctor to make a plan to improve your health, if you’re at heightened risk for prediabetes.
What are the symptoms of prediabetes?
More often than not, there are no symptoms of prediabetes, which is why it’s so important to have your blood sugar regularly checked for the onset of the condition.
Sometimes, however, the following symptoms of prediabetes may appear:
- Blurrier than normal vision
- Feeling fatigued
- Stubborn weight gain (or difficulty losing weight)
- Slowly healing wounds or infections
- Acanthosis Nigricans (darkened skin in the armpit, back, or sides of the neck)
- Skin tags
What are the complications of prediabetes?
Prediabetes puts you at heightened risk for developing type 2 diabetes.
Type 2 diabetes is a main risk factor for both heart disease and stroke. If you are at heightened risk for prediabetes, make sure to get tested at your doctor’s office!
How do you test for prediabetes?
If you fear you’re at risk for prediabetes, take the risk test, which was created by the American Diabetes Association, in conjunction with the American Medical Association, the AD Council, and the Centers for Disease Control and Prevention (CDC).
Once you have your results (and if you’re high risk!), contact your doctor, who will do a fasting blood test (at least 12 hours without any food or beverage) on you to check your blood sugar.
Any fasting blood sugar level between 100-125 mg/dL indicates prediabetes. If your number is on the lower end, your doctor may order an Hba1c test to measure your average blood sugar over the previous three months.
The prediabetes range is between 5.7%-6.4% and anything above 6.4% indicates diabetes.
You can also measure your Hba1c at home with an inexpensive and reliable self-test.
How often should you test for prediabetes?
Depending on your risk factors and fasting blood sugar level, your doctor may want to test you more or less frequently.
Some doctors may even opt to have your blood sugar checked during every annual physical. Other doctors may encourage you to buy an at-home glucometer, so you can periodically check your blood sugar on your own.
Ask your doctor which glucometers they recommend for at-home testing.
An hba1c test is usually measured every 3 months, so if your number is creeping up, your doctor may want to check that level again in a few months to see if there’s a trend headed up or down.
If you’re struggling with insulin resistance, but do not yet have prediabetes blood sugar levels, your doctor will encourage you to adopt healthy lifestyle habits such as regular exercise, healthier eating, and quitting smoking to reduce the likelihood of developing prediabetes.
Unfortunately, there is no clinical test for insulin resistance available for patients.
How do you treat prediabetes?
If you receive a prediabetes diagnosis, it’s important to take charge of your health right away, in order to prevent or delay the onset of type 2 diabetes, which can bring a whole host of additional health issues your way.
Even small lifestyle changes can drastically reduce the likelihood of developing type 2 diabetes. The Centers for Disease Control and Prevention (CDC) recommends two things:
- Weight loss of between 5%-7% of your body weight. Even losing 10 pounds can make a big difference!
- Physical activity of about 30 minutes per day, most days of the week (aim for 5)
The National Diabetes Prevention Program (NDPP) is an accredited program recognized by the CDC that helps people who have prediabetes prevent the onset of type 2 diabetes. This research-based program focuses on healthy eating and physical activity.
In a pivotal study, participants cut their risk of developing type 2 diabetes by 58% when completing the program (and 71% for people over 60 years old!).
There are accredited programs in every state, and most insurance plans cover the cost of participating.
How can you lower your risk factors for prediabetes?
Work with your doctor if you fall into any high-risk category for prediabetes and you’re worried about your blood sugar levels and/or insulin resistance.
Some tactics your doctor may recommend include:
- Working with a dietician to improve your diet
- Manage stress levels with meditation and/or yoga
- Test for prediabetes regularly at your doctor’s office (or if they recommend, buy an at-home glucometer to test more often)
- Work to get 7-9 hours of sleep per night
- Maintain a healthy weight
- Properly manage any health conditions you have, like hypertension or high cholesterol
- Stay physically active for at least 150 minutes per week (around 30 minutes per day, 5 days a week)
- Quit smoking, if you smoke
- Limit your alcohol consumption
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