What Is Prediabetes?

1. systemic self-care Aug 04, 2021
a blog explaining prediabetes

Prediabetes acts as an early warning light for diabetes. And the good news is, it's reversible. In this article, you'll learn what prediabetes is, how to recognize it, and what to do if you're concerned you might have it. 

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As a registered dietitian who has helped thousands of people prevent or manage diabetes over the past 20 years, what I've learned is that the earlier you invest in self-care, the better.

What is Prediabetes? 

Prediabetes is a clinical precursor to diabetes, meaning that it isn’t a diagnosis as much as it is a cluster of symptoms that act as a red flag to alert you that things may be headed toward diabetes.

People with prediabetes experience high blood sugars, but the levels aren't high enough to be officially diagnosed as diabetes. So, if you've been told that you have prediabetes, what it means is that you're at a higher risk for developing diabetes.

The term prediabetes emerged in the 70s to describe the period of time between the initial onset of impaired glucose metabolism and the onset of diabetes. 

As of 2020, it’s been estimated that 88 million Americans have prediabetes -- roughly 34.5% of the adult population in the US. It's worth noting that a 2012 research paper estimated there will be over 470 million people with prediabetes by 2030, and the International Diabetes Federation projects that number will reach 548 million by 2045.

Of those diagnosed with prediabetes, approximately 70% are expected to eventually develop diabetes. 

But what's perhaps most alarming is that it's believed that 84% of people who have prediabetes don't even know they have it. 

If you’re wondering how it’s possible to measure this, here’s how it works: The estimated cases of undiagnosed diabetes is based on fasting plasma glucose and A1C levels among people people who did not self-report they had diabetes. Essentially, these people would never have known they had diabetes if they hadn't been tested during the study.

What Are the Criteria for Prediabetes?

The American Diabetes Association uses the following criteria to identify individuals with prediabetes:

  • Fasting Plasma Glucose (FPG) 100–125 mg/dL (5.6–6.9 mmol/L) (blood sample is taken when you haven't eaten for at least __ hours)
  • 2-h Plasma glucose 140–199 mg/dL (7.8–11.0 mmol/L) (blood sample taken 2 hours after eating)
  • HbA1c 5.7–6.4% (39–46 mmol/mol) (your average blood sugar reading over the past 3 months)

One challenge for researchers is that there are several different definitions of prediabetes. This makes it difficult to compare findings and interpret data, but it also helps illustrate just how elusive and difficult it can be to classify prediabetes and diabetes.

What Are the Risk Factors for Prediabetes?

Certain risk factors can increase your risks for developing prediabetes and diabetes.

For example, you may be at an increased risk of developing prediabetes and diabetes if:

  • A first degree relative has prediabetes or diabetes. There is a strong correlation between developing prediabetes and having a parent or sibling with prediabetes or diabetes.
  • You have a high waist circumference. A high waist circumference is defined as 35 or more inches for women and 40 inches for men.
  • You have high blood pressure. Blood pressure above the normal range of 120/80 is considered early high blood pressure, and anything above 140/90 is considered high blood pressure.
  • You have high triglycerides. A triglyceride level above 150 mg/dL is considered high, although lower levels can also be concerning when other heart-related disease risks are present. Factors that can raise triglycerides include excessive alcohol use, high consumption of sugar and simple carbohydrates, certain medications, obesity, smoking, thyroid disease, and uncontrolled diabetes.
  • You have low high-density lipoprotein (HDL). HDL cholesterol is known as “good” cholesterol because it removes the "bad" LDL cholesterol as it travels through bloodstream. The best way to increase HDL cholesterol is to increase your level of physical activity.
  • You drink a lot of sugary beverages. While there is little evidence that drinking sugar-sweetened beverages causes diabetes directly, it has been associated with increased risk for prediabetes and diabetes.
  • You’re inactive. A sedentary lifestyle is a risk factor for prediabetes and diabetes. The Physical Activity Guidelines for Americans recommends that adults aim for 150 to 300 minutes of moderate-intensity physical activity every week. And if your health goals involve weight loss, this level needs to be closer to  an hour each day.
  • You’re over 45. Beginning at age 45, the risks of developing prediabetes and diabetes increase.
  • You’re Black, Hispanic/Latino, American Indian, Asian American, or of Pacific Island descent. Certain ethnicities have been linked to a higher incidence of developing prediabetes and diabetes.
  • You’ve bene diagnosed with gestational diabetes in the past. If you were diagnosed with gestational diabetes when you were pregnant, you have a 50% chance of developing diabetes at some point in the future, so it's a good idea to stay up to date with screenings.
  • Your baby weighed less than 5.5 pounds or more than 8.5 pounds. Low birth weight and high birth weight have both been associated with a higher risk of prediabetes and diabetes.
  • You have polycystic ovarian syndrome (PCOS). PCOS is associated with insulin resistance and a greater risk of developing prediabetes and diabetes.
  • You have obstructive sleep apnea. Sleep apnea has been associated with impaired glucose metabolism and insulin resistance, which increases the risks for prediabetes and diabetes.
  • You’re a smoker. Smoking has been identified as a independent risk factor for diabetes.

While certain lifestyle-related risk factors for prediabetes and diabetes are still somewhat elusive, the strongest risk factors appear to be age and BMI.

Fortunately, many of the risk factors are modifiable -- meaning they can be reversed through behavior changes. That means there's a significant opportunity to prevent prediabetes from progressing into diabetes.

What Are the Signs of Prediabetes?

Unlike diabetes, which typically has distinctly recognizable signs and symptoms, prediabetes can go undetected for years.

That's why it's so important to have regular screenings and preventive visits. Catching metabolic changes early is the key to maintaining good health. 

If you’re concerned that you may be at high risk for prediabetes, stop reading article and schedule an appointment with your primary care physician. They can assess your risk factors and order the necessary tests to determine how to best treat your condition to prevent further progression.

Reducing Your Risk for Prediabetes

While prediabetes is an early indicator for diabetes, it is reversible. The earlier you can make lifestyle adjustments, the better your chances will be to prevent the condition from progressing further. 

To reduce your risk for prediabetes, prioritize self-care.

Which self-care activities will you commit to right now? Share in the comments below.

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