Prediabetes is a serious health condition that doesn’t get the attention it deserves. Even the healthcare community doesn’t recognize the harm this “pre” condition can do. Prediabetes affects millions of Americans, yet it’s a stealth health problem that many people don’t know they have. Here’s a wake-up call. Ninety-six million adults (38% of the adult population) have prediabetes. And would you believe 80% of those affected don’t know it?
When you have prediabetes, your blood sugar levels are higher than normal, yet they’re not elevated enough to meet the criteria for type 2 diabetes. But you’re not off the hook. Without lifestyle changes, you’re a ticking time bomb. Studies show that most people with pre-diabetes will develop full-blown diabetes in five years or less.
But before you get discouraged and throw up your hands, be aware that prediabetes is a reversible condition, and the prescription is lifestyle changes. The earlier you find out you have it, the more quickly you can adopt lifestyle changes and change your health trajectory.
The Silent Threat: What Are the Symptoms of Prediabetes?
Prediabetes is strange in the sense that you’re unlikely to have symptoms. If you do have them, they’re likely to be subtle and easy to miss. If you’re symptomatic, you might experience increased thirst, frequent urination, fatigue, or blurred vision. You might also see darkened skin patches called acanthosis nigricans. But even if you haven’t noticed changes in how you look or feel, you can still experience early organ damage to critical organs like your heart, blood vessels, kidneys, and other organs. Prediabetes can sneak into your life in the stealthiest of modes.
Here’s why you need to be on guard. Research shows that a third of people with prediabetes already have markers for kidney damage, despite not having full-blown type 2 diabetes. These include protein in the urine and reduced kidney function. Plus, prediabetes silently damages blood vessels in a way that boosts the risk of heart attack and stroke. All these changes occur silently and are progressive.
Know Your Risk of Prediabetes
Awareness is key. When you know your risks of prediabetes and diabetes, you’re able to closely monitor and implement lifestyle changes early, so you can prevent early damage and progression to type 2 diabetes. Certain factors can increase your likelihood of developing prediabetes:
- Being overweight or obese, particularly if you have lots of visceral fat, fat storage around your waistline.
- Leading a sedentary lifestyle
- Having a family history of type 2 diabetes
- Being over the age of forty-five
- Have cardiovascular risk factors, like abnormal lipid levels or hypertension. Also, a previous history of cardiovascular disease.
- Having gestational diabetes during pregnancy
- Having polycystic ovary syndrome
- Being of African American, Hispanic/Latino, Native American, Pacific Islander, or Asian American descent
The more risk factors you have, the greater the odds of having prediabetes and progressing to type 2 diabetes. But here’s a word of caution. Don’t assume because you don’t have the above risk factors that you’re out of the woods. You can have prediabetes without having risk factors.
Why You Need to Get Tested
According to the U.S. Preventive Services Task Force, you should get prediabetes screening if you’re overweight or obese and are between the ages of 35 and 70. But you also need to monitor your blood sugar status closely, regardless of age, if you have risk factors for prediabetes or type 2 diabetes. (including the ones above)
If you get tested and your results are within the normal range, you can breathe a sigh of relief and recheck every three years. Talk to your doctor about whether you need more frequent testing based on your results and risks.
There are a few different blood tests used to diagnose prediabetes:
- Fasting plasma glucose (FPG) test: This is the most common test healthcare providers use for screening for prediabetes. This test measures your blood sugar level after fasting overnight. A result of 100-125 mg/dL indicates prediabetes.
- A1C test: This test is a snapshot of your average blood sugar over the past 2-3 months. Prediabetes would fall into the 5.7% to 6.4% range.
- Oral glucose tolerance test (OGTT): This test is more time intensive but measures your blood sugar before and 2 hours after you drink a sweet liquid. A result of 140-199 mg/dL at 2 hours suggests prediabetes. Since it involves multiple blood draws, most healthcare providers don’t routinely perform this test.
Your doctor can determine which test is right for you based on your history and risk factors.
If You Have Prediabetes, It’s Time to Take Charge
If you are diagnosed with prediabetes, don’t panic. Be thankful that you know you’re at elevated risk for type 2 diabetes and blood vessel and kidney damage and can act before you have worse problems. Research shows that lifestyle changes can cut your risk of developing type 2 diabetes in half.
One of the best ways to reduce your risk of developing type 2 diabetes if you have prediabetes is to lose 5-7% of your body weight. (if you’re overweight) Data from the Diabetes Prevention Program (DPP) found that losing this amount of weight lowered the risk of prediabetes by 58% over 3 years in people with blood sugar readings in the prediabetic range.
Other lifestyle changes that will help include:
Meeting the guidelines for physical activity, at least 150 minutes weekly of moderate physical exertion or 75 minutes of more intense exercise.
- Losing 5-7% of your body weight if overweight
- Get at least 150 minutes per week of moderate physical activity like brisk walking. Take breaks from prolonged periods of sitting too.
- Eat a healthy diet rich in fruits, vegetables, whole grains, and lean proteins.
- Quit smoking if you smoke.
- Aim for at least 7 hours of quality sleep each night. (Don’t compromise)
- Make sure you’re managing stress, as stress raises the stress hormone cortisol and causes a jump in blood sugar.
You might wonder if there are medications that can help you reverse prediabetes. The medical community recognizes lifestyle changes, including weight loss, as the main treatment for prediabetes. However, some healthcare professionals prescribe a medication called metformin for blood sugar lowering. There’s also some evidence that metformin lowers the risk of complications of prediabetes and diabetes too. If lifestyle changes don’t work, this may be an option to discuss with your healthcare provider.
Conclusion
Change can be a challenge! Right? So, don’t tackle too much too fast. Even small steps, like sitting less and moving your body more will help you control your blood sugar. Find an accountability partner if you need support in your journey toward a healthier future. It’s in your hands!
References:
- Mayo Clinic. “Prediabetes – Symptoms and Causes.,” 2023. https://www.mayoclinic.org/diseases-conditions/prediabetes/symptoms-causes/syc-20355278.
- National Kidney Foundation. “Prediabetes? What Does It Mean for Your Kidneys?”, August 12, 2014. https://www.kidney.org/news/kidneyCare/Summer10/PreDiabetes.
- “Recommended Tests for Identifying Prediabetes.” National Institute of Diabetes and Digestive and Kidney Diseases. NIDDK – National Institute of Diabetes and Digestive and Kidney Diseases, June 30, 2024. https://www.niddk.nih.gov/health-information/professionals/clinical-tools-patient-management/diabetes/game-plan-preventing-type-2-diabetes/prediabetes-screening-how-why/recommended-tests-identifying-prediabetes.
- Zhang, Jiale, Zhuoya Zhang, Kaiqi Zhang, Xiaolei Ge, Ranran Sun, and Xu Zhai. “Early Detection of Type 2 Diabetes Risk: Limitations of Current Diagnostic Criteria.” Frontiers in Endocrinology 14 (November 9, 2023). https://doi.org/10.3389/fendo.2023.1260623.
- Hsueh WA, Orloski L, Wyne K. Prediabetes: the importance of early identification and intervention. Postgrad Med. 2010 Jul;122(4):129-43. doi: 10.3810/pgm.2010.07.2180. PMID: 20675976.
- and Diabetes. “Diabetes Statistics.” National Institute of Diabetes and Digestive and Kidney Diseases. NIDDK – National Institute of Diabetes and Digestive and Kidney Diseases, June 30, 2024. https://www.niddk.nih.gov/health-information/health-statistics/diabetes-statistics.
- Kucera M, Marchewka T, Craib A. Does Losing 5-7% of Prediabetic Body Weight from a Diabetes Prevention Program decrease Cardiovascular Risks? Spartan Med Res J. 2021 Aug 30;6(2):27627. doi: 10.51894/001c.27627. PMID: 34532627; PMCID: PMC8405285.
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