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Prediabetes 101

What you need to know about this precursor condition to type 2 diabetes.

prediabetes basics

As you may have guessed from the name, prediabetes is a condition in which blood sugar levels that are higher than normal, but not quite high enough to be diagnosed as type 2 diabetes. This precursor to type 2 diabetes, also known as impaired glucose tolerance (IGT) or impaired fasting glucose (IFG), is diagnosed with a simple blood test.

Prediabetes should be taken seriously. Without any intervention or treatment, people with prediabetes are at risk for developing type 2 diabetes and other conditions and complications such as:

  • heart disease,
  • stroke,
  • blindness,
  • kidney failure,
  • nerve damage and subsequent loss of toes, feet, or legs.

The good news about prediabetes is that lifestyle changes such as maintaining a healthy weight, improving your food choices, and increasing physical activity have been shown to help delay and even prevent getting type 2 diabetes. And they may even reverse prediabetes.

The Simplified Science of Prediabetes
Insulin is a hormone made in the pancreas and released into the bloodstream. When the body breaks down carbohydrates from the food we eat into glucose, also known as blood sugar, insulin helps the body’s cells absorb the glucose and use it for energy.

If the cells that respond to insulin lose sensitivity, a condition known as insulin resistance develops. When people have insulin resistance, although the body still produces insulin, it is not used effectively, causing glucose to build up in the blood instead of being absorbed by cells. This increase in blood glucose leads to prediabetes, and eventually type 2 diabetes, if left untreated.

Who is at Risk?
According to the United States Centers for Disease Control and Prevention (CDC), 86 million adults in America have prediabetes, but many are undiagnosed and unaware of their condition. This is partially because prediabetes usually has no symptoms. Although more than one in three American adults have prediabetes, approximately 90% of these people do not know they have it.1 This is why it’s important to know the risk factors.

You may have prediabetes if you:

  • are overweight,
  • are age 45 or older,
  • have a family history of prediabetes or type 2 diabetes,
  • are African American, Alaska Native, Hispanic/Latino, or Pacific Islander American,
  • have hypertension (high blood pressure) or high cholesterol,
  • participate in physical activity fewer than three times per week,
  • have had gestational diabetes (diabetes while pregnant) or have given birth to a baby weighing more than 9 pounds.

If you are overweight and have one or more of the risk factors listed above, the American Diabetes Association recommends visiting your doctor to get tested for prediabetes.2

Prevention and Treatment
The National Diabetes Prevention Program (DPP), a federally funded study of over 3,000 people at high risk for diabetes, grouped participants into three groups and tested three approaches to preventing diabetes:3

  • Group 1: Lifestyle changes. Participants in this group exercised for 30 minutes a day and lowered their caloric and fat intake.
  • Group 2: Medication. Participants in this group took the diabetes medication metformin and also received information about diet and exercise.
  • Group 3: Diabetes education. The third group received information about diet and exercise and took a placebo—a pill without any active medication in it.

The DPP study found that those in the lifestyle group had the best outcomes, averaging 15 pounds of weight loss and cutting the risk of developing type 2 diabetes by 58 percent over 3 years. Those in the medication group also saw benefits, reducing their risk by 31 percent.3

In addition to lifestyle changes such as achieving and maintaining a healthy weight, increasing physical activity, and eating a healthy diet, talk to your healthcare provider about what prevention methods are right for you.

First published on: September 22, 2015
Updated on: July 15, 2016
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Diagnosing Prediabetes
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