Prediabetes: The risks, tests and treatments

What is prediabetes?

Prediabetes is a diagnosis nobody wants, but it’s not a life sentence. It occurs when your pancreas doesn't make enough insulin or your cells become resistant to the insulin (or sometimes both). Then the body does not properly process sugar. That causes the sugars to accumulate in the bloodstream, which results in high blood sugar levels.

It’s reported that one in three adults in the U.S. has this condition. According to the Center for Disease Control and Prevention (CDC), it increases your risk for developing type 2 diabetes, heart attack or stroke. Without treatment, nearly 30 percent of people with pre-diabetes will develop type 2 diabetes within five years.

Knowing the facts and living well pays dividends in one’s health. Especially when you consider what you’ll pay out of pocket for diabetes care.

What are the risk factors for prediabetes?

Family history and genetics play a significant role. Living a sedentary lifestyle and carrying excess fat also are important factors. Generally, pre-diabetes has no signs or symptoms. While a prediabetic’s blood sugar is not as high as someone with type 2 diabetes, they do share the same risk factors. These include:

• Weight. This is a primary risk factor. The more fatty tissue you have, the more resistant your cells become to insulin.
• Waist size. A larger waist size can indicate insulin resistance. The risk goes up for men with waists larger than 40 inches and for women with waists larger than 35 inches.
• Diet and nutrition. Eating red, processed meat and drinking sugar-sweetened beverages increase the risk. A diet high in fruits, vegetables, nuts, whole grains and olive oil lowers your risk.
• Inactivity. Physical activity helps you control your weight, uses glucose as energy, and makes your cells more sensitive to insulin. Simply walking more combats this risk factor.
• Age. Although diabetes can develop at any age, the risk of pre-diabetes increases after age 45. This may be because people as they age tend to exercise less, lose muscle mass and gain weight.
• Family history. Your risk of prediabetes increases if you have a parent or sibling with type 2 diabetes.
• Race. Certain races have a higher risk of developing the disease. They include African-Americans, Hispanics, Native Americans, Asian-Americans and Pacific Islanders.
• Gestational diabetes. If your baby weighed more than 9 pounds at birth or you had gestational diabetes while pregnant, you're at increased risk.
• Polycystic ovary syndrome. This common condition increases women's risk of prediabetes.
• Sleep. Certain sleep disorders (such as sleep apnea) increases the risk of insulin resistance. Those who have jobs with changing shifts or night shifts may also have an increased risk of prediabetes or type 2 diabetes.

How is prediabetes diagnosed?

There are several blood tests for prediabetes. The American Diabetes Association (ADA) recommends that screenings for adults begin at age 45. If a person is overweight and has additional risk factors, they should start earlier.

The glycated hemoglobin (A1C) test measures your average blood sugar level for the past two to three months. The test measures the percentage of blood sugar attached to proteins in red blood cells (hemoglobin). The higher your blood sugar levels, the more hemoglobin you'll have with sugar attached. The ranges are:

• An A1C level below 5.7 percent is considered normal.
• An A1C level between 5.7 and 6.4 percent is considered prediabetes.
• An A1C level of 6.5 percent or higher on two separate tests indicates type 2 diabetes.

A fasting blood sugar test is done after not eating for at least eight hours. The ranges for this test are:

• A fasting blood sugar level below 100 milligrams per deciliter (mg/dL) is normal.
• A fasting blood sugar level from 100 to 125 mg/dL indicates prediabetes. Your doctor may call this result is impaired fasting glucose.
• A fasting blood sugar level of 126 mg/dL or higher indicates type 2 diabetes.

How is prediabetes treated?

Lifestyle changes can prevent your prediabetes from becoming type 2 diabetes. Children and adults can find success by spending one hour or more each day in physical activity. Losing weight – if overweight – and eating more fiber (and less sugary, refined carbohydrates and fats) also helps. Medication isn’t generally recommended for children and isn’t always needed when you make diet and lifestyle changes.

Discuss any supplements or alternative therapies with your physician prior to use. Some could be harmful and interfere with other prescribed medications. Learn more about diabetes care.