Prediabetes: Signs, Tests & Treatment Options

What is prediabetes?

A condition where your blood sugar level is higher than normal but not yet high enough to be classified as type 2 diabetes. Without any proper intervention, prediabetes is likely to become type 2 diabetes in 10 years or less. If you have prediabetes, the long-term damage of diabetes — especially to your heart and circulatory system — may already be starting.

However, the good news is that the progression from prediabetes to type 2 diabetes isn’t inevitable. With healthy lifestyle changes like eating healthy foods, including physical activity in your daily routine and maintaining a healthy weight,  you can bring your blood sugar level back to normal.

Signs of prediabetes:

Often, prediabetes has no signs or symptoms.

One possible sign that you may be at risk of type 2 diabetes is darkened skin on certain parts of the body. This is called acanthosis nigricans. Common areas that may be affected include the neck, armpits, elbows, knees and knuckles.

The exact cause of prediabetes is unknown, although family history and genetics appear to play an important role. Excess fat — especially abdominal fat — and inactivity also seem to be important factors in the development of prediabetes.

People who have prediabetes aren’t quite processing sugar (glucose) properly anymore. This causes sugar to build up in the bloodstream instead of doing its normal job of fueling the cells that make up muscles and other tissues.

Most of the glucose in your body comes from the foods you eat, specifically foods that contain carbohydrates. Any food that contains carbohydrates can affect your blood sugar levels, not just sweet foods.

During digestion, sugar enters your bloodstream, and with the help of insulin, it enters the body’s cells where it is utilized as a source of energy.

Insulin is a hormone that comes from a gland located just behind the stomach (pancreas). When you eat, your pancreas secretes insulin into your bloodstream. As insulin circulates, it acts like a key that unlocks microscopic doors that allow sugar to enter your cells.

Insulin lowers the amount of sugar in your bloodstream. As your blood sugar level drops, so does the secretion of insulin from your pancreas.

When you have prediabetes, this process begins to work improperly. Instead of fueling your cells, sugar builds up in your bloodstream. This occurs when your pancreas doesn’t make enough insulin or your cells become resistant to the action of insulin or both.


Factors that increase the risk of developing prediabetes, including:

  • Being overweight is a primary risk factor for prediabetes. The more fatty tissue you have — especially inside and between the muscle and skin around your abdomen — the more resistant your cells become to insulin.
  • A large waist circumference can indicate insulin resistance. The risk goes up for men with waists larger than 40 inches around and for women with waists larger than 35 inches.
  • The less active you are, the greater your risk of prediabetes.
  • Risk of prediabetes increases as you get older, especially after age 45.
  • The risk of prediabetes increases if a parent or sibling has type 2 diabetes.
  • Although it’s unclear why, people of certain races — including African-Americans, Hispanics, Asian-Americans and Pacific Islanders — are more likely to develop prediabetes.
  • If you developed gestational diabetes when you were pregnant, your risk of later developing diabetes increases.
  • A common condition in women characterized by irregular menstrual periods, excess hair growth and obesity — increases the risk of diabetes.
  • Obstructive sleep apnea is a sleep disorder that causes breathing to be interrupted numerous times during sleep, leading to poor sleep quality.

Progression to type 2 diabetes is the most serious consequence of untreated prediabetes because type 2 diabetes can lead to other complications, such as:

  • High blood pressure
  • High cholesterol
  • Heart disease
  • Stroke
  • Kidney disease
  • Blindness
  • Amputations

How to test Prediabetes?

Who should be tested?

The American Diabetes Association recommends that blood glucose screening begin at age 45, or sooner if you have a body mass index above 25  and if you:

  • are less active
  • Have a family history of type 2 diabetes
  • Have a history of gestational diabetes or have given birth to a baby who weighed more than 9 pounds (4.1 kilograms)
  • Have a history of polycystic ovary syndrome
  • Have high blood pressure
  • Have abnormal cholesterol levels, including high-density lipoprotein (HDL) cholesterol levels below 35 mg/dL (0.9 mmol/L) or a triglyceride level above 250 mg/dL (2.83 mmol/L)


  • Glycated haemoglobin (A1C) test: This blood test indicates your average blood sugar level for the past two to three months. It works by measuring the percentage of blood sugar attached to haemoglobin, the oxygen-carrying protein in red blood cells. The higher your blood sugar levels, the more haemoglobin you’ll have with sugar attached. A normal A1C should be below 5.7 per cent. An A1C level between 5.7 and 6.4 per cent is considered prediabetes. A level of 6.5 per cent or higher on two separate tests indicates you have diabetes.

Certain conditions can make the A1C test inaccurate — such as if you are pregnant or have an uncommon form of haemoglobin (known as a haemoglobin variant).

Following are other tests that your doctor may use to diagnose prediabetes:

  • Fasting blood sugar test. A blood sample will be taken after you fast for at least eight hours or overnight. Under these conditions, a blood sugar level lower than 100 milligrams per deciliter (mg/dL) — 5.6 millimoles per litre (mmol/L) — is normal.

A blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes.

If you have prediabetes, further testing may be needed like A1C, total cholesterol, HDL cholesterol, low-density lipoprotein (LDL) cholesterol and triglycerides at least once a year, possibly more frequently if you have additional risk factors for diabetes.


Healthy lifestyle choices can help you prevent prediabetes and its progression to type 2 diabetes – even if diabetes runs in your family.

  • Eat healthy foods.
  • Get more physical activity.
  • Lose excess pounds.

The same lifestyle changes that can treat or even reverse prediabetes help prevent the condition, too.

(Content Courtesy: DiaSem )   


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