Reduce Your Chance of Developing Type 2 Diabetes

By Gretchen Shull, MD
Mercy Clinic Endocrinology
Mercy Diabetes Education

Prediabetes is not a term that is familiar to a lot of people, but you likely know someone (maybe it’s you) who is prediabetic.

About 1 in 4 people have prediabetes, but many don’t know it because prediabetic symptoms can be hard to spot or are non-existent. A third of people with prediabetes will progress to diabetes in five years.

Prediabetes is a warning sign that you are at risk for progressing to type 2 diabetes. It means your blood sugar is higher than it should be, but not high enough to be labeled as diabetes. However, many symptoms and complications of diabetes, such as cardiovascular disease and neuropathy, can begin during the prediabetes stage. Prediabetes is nothing to ignore or take lightly.

Prediabetes also is called impaired glucose tolerance or impaired fasting glucose. Most people who get type 2 diabetes have prediabetes first.

Many cases of type 2 diabetes are preventable, so screening is important. If you are diagnosed with prediabetes, you may be able to prevent or prolong the formal diagnosis of diabetes.

What causes prediabetes?

The food you eat turns into sugar, which your body uses for energy. Normally, the pancreas makes insulin, which allows the sugar in your blood to get into your body's cells.

When your body can't use insulin the right way, sugar doesn't move into cells and stays in your blood. This is called insulin resistance. The buildup of sugar in the blood causes prediabetes.

People who are overweight, aren't physically active and have a family history of diabetes are more likely to have prediabetes. Women who have had diabetes during pregnancy also are more likely to be at risk for prediabetes.

What are the symptoms?

Most people with prediabetes don't have any symptoms, but if you have prediabetes, watch for:

• Feeling very hungry
• Having blurred vision
• Fatigue
• Numbness or tingling of feet

How is prediabetes diagnosed?

A blood test can tell if you have prediabetes. You have prediabetes if:

• The results of your hemoglobin A1c test are 5.7 percent to 6.4 percent
• The results of your fasting blood glucose test are between 100 and 125 milligrams per deciliter
• The results of your oral glucose tolerance test are 140 to 199 mg/dL (two hours after the beginning of the test)

How is it treated?

The key to treating prediabetes and preventing type 2 diabetes is getting your blood sugar levels back to a normal range. You can do this by making some lifestyle changes:

Watch your weight. If you are overweight, losing just a small amount of weight may help. Reducing fat around your waist is particularly important.
Make healthy food choices. Limit the amount of unhealthy fat you eat, such as saturated fat and trans fat. Limit sweets. Make food choices count.

Be active. Increase the amount you do every day. Do not go more than two days without activity.
Choose a type of exercise that you like and that fits easily into your daily schedule. If you choose something you like, you will be more likely to continue the program.

Before starting an exercise program, talk to your doctor about how and when to exercise. You may need to have a medical exam and special tests (such as a treadmill test) before you begin.

Consider medication. You may need to take a diabetes medicine called metformin. It reduces the amount of sugar made by the liver in people who are insulin-resistant. It has been shown to further prevent diabetes when used in conjunction with proper nutrition and exercise.

Can prediabetes be prevented?

Making the above changes may help delay or prevent diabetes. You also may avoid or delay some of the serious problems that you can get when you have diabetes, such as heart attack, stroke, and eye, nerve and kidney disease.

Staying at a healthy weight, eating healthy foods and getting regular exercise can help prevent prediabetes.