Prediabetes 101

Medically Reviewed by Brunilda Nazario, MD on March 04, 2020

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Misconceptions abound about prediabetes. Elizabeth Halprin, MD, an endocrinologist at Joslin Diabetes Center in Boston, explains some basics about this condition.

How is prediabetes different from diabetes?

Prediabetes is a condition that happens when your blood sugar levels are above normal but not high enough to be considered type 2 diabetes. A fasting blood sugar between 110 and 125 would be considered in the “prediabetes” range. Less than 110 is normal and greater than 126 is diabetes. These abnormal blood sugar levels usually happen when a person’s tissues don’t respond well to a hormone [insulin] signal to take up sugar from the blood. Also, the body doesn’t make enough insulin to help overcome the weak tissue response to insulin.

Does prediabetes always progress to type 2 diabetes?

No, not always. People who eat a health-conscious diet, exercise regularly, and keep a healthy weight can lower their blood sugar levels and even bring them back to normal. In fact, learning you have prediabetes gives you a chance to make the lifestyle changes you need to avoid getting type 2 diabetes.

What puts me at risk of having prediabetes?

The biggest risk factor for prediabetes in the general adult population is being overweight or obese, particularly when the extra weight is due to excess fat in your abdomen. Also, the older you get, the higher your risk goes. Black, Hispanic, and Asian people are at higher risk than other races, as well as women who have had gestational diabetes, and people with a family history of diabetes.

How can a doctor tell if I have prediabetes? Are there symptoms?

There’s no way to know you have prediabetes without a doctor diagnosing with a blood test. Typically, people with prediabetes don’t have any symptoms. Symptoms of high blood sugar levels -- like frequent urination, increased thirst, blurry vision, and fatigue -- usually become noticeable once a person develops diabetes. Some people with prediabetes may have signs of insulin resistance -- darkened skin in the armpit or on the back and sides of the neck or small skin growths or skin tags in these same areas.

What can I do to help prevent prediabetes?

Eat more vegetables, fewer simple carbs [such as those in sugary foods like candy and many processed foods], and increase your activity. Try to get 10,000 steps per day, at least. Exercise gets your body to use its own insulin more efficiently so that the blood sugars come down. It also helps you lose or maintain your weight, which will decrease the risk of prediabetes and diabetes.

Avoid junk food, and sweets, and especially sweet drinks like soda and juice. Get plenty of sleep. Poor sleep hygiene and not getting enough sleep makes it harder to lose weight, and therefore increases the risk of prediabetes.

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CDC: “Prediabetes: Your Chance to Prevent Type 2 Diabetes.”

Elizabeth Halprin, MD, endocrinologist, Boston.

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