If your doctor diagnoses you with prediabetes, you may have a range of thoughts swirling through your mind. Is getting diabetes just a matter of time now? Will I need to take insulin? What can I eat? What should I not eat? You might feel stressed or anxious, too. These questions and feelings are normal.
James Speed, MD, an endocrinologist at Banner Health in Colorado, answered some common questions about prediabetes.
What does it means to have prediabetes?
When you have prediabetes, it means your blood sugar, or blood glucose, levels are higher than they should be but not high enough to reach the threshold for a diagnosis of overt diabetes. The high glucose levels come mainly from the foods that you eat.
It’s a common condition. According to the Centers for Disease Control and Prevention (CDC), about one in three adults are prediabetic, although many of them don’t know it. “A prediabetes diagnosis is the first step in making changes that can help you avoid type 2 diabetes,” Dr. Speed said.
How is prediabetes diagnosed?
There are several different ways your doctor can test you to see if you have prediabetes. The most common is a hemoglobin A1c test. This test measures the amount of sugar that’s coating the hemoglobin on your red blood cells. It gives you an average of your blood sugar level over the past three months rather than a snapshot of your levels at a specific time.
“It’s a simple, easy and fairly accurate screening blood test, and you don’t have to fast beforehand,” Dr. Speed said. It’s a good choice for most people. But some health conditions, such as iron deficiency, anemia, kidney disease, recent surgery, abnormal hemoglobin molecules or red blood cell transfusions, could lead to inaccurate A1c levels. In those cases, your doctor may recommend a different test, such as a fasting plasma glucose test. That test measures your blood sugar after an eight-hour fast.
An A1c level of 5.7 to 6.4 percent indicates prediabetes, and a level of 6.5 percent or higher means you have diabetes. According to the CDC, the higher your levels are within the 5.7 to 6.4 percent range, the more likely you are to develop diabetes.
What causes prediabetes?
Prediabetes can develop when the cells in your body don’t respond normally to insulin. Your pancreas makes insulin, a hormone, and the insulin helps glucose get into your cells. There, the cells can use it for energy. Most of your glucose comes from food, although your liver will make glucose if you’re fasting. After you eat, your pancreas releases insulin in response.
When your cells don’t respond appropriately to the insulin, they don’t absorb the glucose from your blood as they should. Your pancreas makes more insulin to compensate, and despite that, they may not make enough to keep up with your body’s demands, leading to higher blood sugar levels.
What can put you at risk for prediabetes?
You most likely won’t notice any symptoms of prediabetes. But according to the CDC and the National Institutes of Health (NIH), certain factors increase your risk:
- Being overweight, especially if you have too much fat in the abdomen
- Being 45 years old or older
- Having a parent, brother or sister who has type 2 diabetes
- Being of African American, Hispanic, American Indian or Pacific Islander descent. Some Asian Americans are also at higher risk
- Getting physical activity less than three times a week
- Having high blood pressure and high cholesterol levels
- Having a history of heart disease or stroke
- Having diabetes during pregnancy (gestational diabetes) or having a baby that weighed more than nine pounds at birth
- Having metabolic syndrome, a group of risk factors for diabetes and other health conditions
- Having polycystic ovary syndrome (PCOS)
- Taking medications such as glucocorticoids, certain antipsychotics or some medicines for HIV (Human Immunodeficiency Virus)
- Having Cushing syndrome or acromegaly
- Having sleep problems such as sleep apnea
What changes should you make if you have prediabetes?
Generally, making changes to your diet and activity levels can help reverse prediabetes or delay the onset of diabetes. Nutritionally, it can help for you to:
- Center your diet around non-starchy vegetables, fruits, nuts, whole grains and olive oil
- Cut back on processed foods or foods with added sugar
- Limit carbohydrate portion sizes
- Avoid sugary drinks
- Limit alcohol
Being physically active—getting at least 150 minutes (about 2 and a half hours) of moderate exercise per week—is also beneficial in controlling prediabetes since it uses some sugar and helps your body use insulin the way it should. “Whether it’s a brisk walk or more intense exercise, doing something to keep yourself moving is better than doing nothing,” Dr. Speed said.
These diet and exercise changes may also lead to weight loss and losing a small amount of weight can lower your risk of developing diabetes. According to the CDC, losing 5 to 7% of your body weight, or 10 to 14 pounds if you weigh 200 pounds, can make a difference.
If you smoke, quitting can help since smoking affects how insulin works.
For people who don’t have prediabetes, these same lifestyle changes can help you avoid developing the condition.
How is prediabetes treated?
Your doctor will typically recommend lifestyle changes as part of your treatment plan to help control prediabetes and keep it from progressing. If lifestyle changes aren’t making enough of an impact, they might prescribe metformin, a medication that can help make your body more sensitive to insulin. You may also need medicine to control high blood pressure and cholesterol.
If I have prediabetes, will I get diabetes?
Your risk of developing diabetes is about 10% per year if you have prediabetes. That means if nothing changes, you’re highly likely to have diabetes within five to ten years. Some experts have found that up to 70% of people with prediabetes will develop diabetes within their lifetimes. But by making healthy changes to your lifestyle, you can prevent or delay a diabetes diagnosis.
The bottom line
A diagnosis of prediabetes can be stressful and worrying. But knowing that you have the condition is the first step toward making changes that can reduce your odds of being diagnosed with diabetes. To connect with a health care provider who can help you modify your lifestyle and reduce your risk, reach out to Banner Health. And to evaluate your risk for diabetes, take this free Diabetes Test.