What Is Prediabetes and What Does It Mean for Your Health?

The U.S. Centers for Disease Control and Prevention estimate that 86 million people age 20 years and older have prediabetes – that’s one in every three adults, and for those 65 years-of-age and older, likely one in every two people have prediabetes. Like diabetes itself, many people don’t know they have prediabetes, but finding out early is important because there are lifestyle changes that can be made to prevent the onset of Type 2 diabetes.

What Is Prediabetes?

Prediabetes, often referred to as borderline diabetes, occurs when your blood glucose levels (blood sugar levels) are above the normal range but still slightly lower than that of what is considered to be diabetes.

While each blood testing laboratory may have slightly different ranges of normal for the various blood sugar levels, a general rule of a fasting blood sugar level for someone without diabetes (taken upon arising and before eating or drinking) is 70 to 99 mg/dl. The range of a normal fasting blood sugar for someone with diabetes is 80 to 130 mg/dl.

The hemoglobin A1C test, or HbA1c test, is a measurement of of how much glucose (sugar) has bound to the hemoglobin in your blood, providing an average measurement of your blood glucose levels over the previous two to three months. A normal A1C results for someone without diabetes is 5.7 percent or less. A healthy A1C level for someone with diabetes is 7 percent or less.

These are not the only blood glucose test available, but they are the ones most commonly used. As you can see from the numbers here, there is not much leeway in the numbers for a healthy person without diabetes and a person with diabetes. People with prediabetes fall within that leeway.

Who Is at Risk for Prediabetes?

That old saw about if there are three people in a group and the other two don’t have borderline diabetes, then it’s probably you, could come into play here. With one in three people between the ages of 20 and 64 having prediabetes, and one in every two people for those 65 and older, the possibility that you are that one is great.

When you consider that more than 80 percent of the people with borderline diabetes don’t know they have it, you begin to see the value of learning whether you are prediabetic, and if so, what you can do about it. Even though prediabetes is not yet diabetes, it is still representative of blood glucose levels that are higher than normal, meaning that there may be damage being done to your heart, blood vessels, eyes and kidneys from those abnormal levels.

The risk factors for prediabetes are the same as for diabetes and fall into two categories – those over which you have no control and those that you can control.

Risk Factors for Prediabetes Outside Personal Control

  • Family history of diabetes
  • Older age
  • Having a parent or sibling who has diabetes
  • Having had gestational diabetes during pregnancy or having delivered a baby who weighed 9 pounds or more
  • Family background that is African American, American Indian, American Asian, Hispanic/Latino or Pacific Islander
  • Polycystic Ovary Syndrome (PCOS)

Risk Factors for Prediabetes Within Personal Control

  • Being overweight or obese
  • High blood pressure
  • History of cardiovascular disease
  • Elevated total cholesterol
  • Low HDL cholesterol
  • Low levels of physical activity
  • Diet of red and processed meats, drinking sugar-sweetened beverages
  • Obstructive sleep apnea

What Are the Signs and Symptoms of Prediabetes?

There are often no noticeable signs or symptoms of prediabetes.

There is a condition called Acanthosis nigricans where darkened patches of velvety-textured skin may be noticed in areas of skin folds such as in the groin, armpits, neck, knees, elbows and knuckles. Sometimes this discolored skin becomes thicker than the skin surrounding it. This condition may be an indication of prediabetes. If you notice this, make an appointment with your health care provider who can determine what steps to take.

If you begin to notice symptoms such as fatigue, increased thirst, frequent urination or blurred vision, you may have Type 2 diabetes. Your health care provider can determine this through blood tests and other diagnostic tools.

What Should You Do If You Have Prediabetes?

A visit to your health care provider reveals that you do in fact have prediabetes – now what? Your health care provider can help you learn to manage those risk factors within your control, from obesity to high blood pressure to elevated cholesterol levels.

Positive lifestyle changes such as changing dietary habits to reduce your consumption of red and processed meats to one that includes more poultry and/or fish, includes nuts and whole grains is a start.

Ask your health care provider about participating in the National Diabetes Prevention Program, a program based on research that concluded that a loss of 7 percent of your body weight (14 pounds for someone weighing 200 pounds, etc.) and increasing physical activity to a total of 150 minutes per week were even more effective at preventing prediabetes from becoming Type 2 diabetes than medication.

The most important thing is not to take prediabetes lightly. It may not be full blown diabetes – yet – but it’s your opportunity to make the changes necessary to prevent Type 2 diabetes from developing.


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