Recognizing prediabetes symptoms and prevention tips

1 in 3 Americans – about 96 million – have prediabetes.¹ Of the people with prediabetes, 80% don’t know they have it, according to the Centers for Disease Control and Prevention (CDC).²

A person with prediabetes has a higher blood sugar level than normal, but not high enough for a diabetes diagnosis.³ Prediabetes is a serious health condition because patients have an increased risk of developing type 2 diabetes, heart disease and stroke.⁴

Symptoms of prediabetes

What are the warning signs of prediabetes? Because the disease has no clear symptoms, prediabetes can go undetected for years. Patients may not be aware of the disease until they develop type 2 diabetes.⁵

Patients with these risk factors are advised to contact a physician if they are:⁶

• Overweight.
• Aged 45 years or older.
• Have a parent or sibling with type 2 diabetes.
• Physically active less than 3 times a week.
• Have gestational diabetes (during pregnancy) or gave birth to a baby who weighed more than 9 pounds.
• Have polycystic ovary syndrome (PCOS).
   

Some people may experience a condition called acanthosis nigricans, which is a sign of insulin resistance. The condition causes dark, thick and often velvety patches of skin that can be associated with PCOS.⁷ Skin discoloration usually occurs around knuckles, elbows, knees, the neck and armpits.⁸

Here are symptoms that may indicate that prediabetes has progressed to type 2 diabetes:⁹

• Feeling thirsty.
• Needing to urinate more frequently, especially at night.
• Experiencing fatigue and tiredness.
• Seeing less clearly due to blurry vision.
• Getting sores or cuts that won’t heal.

Prediabetes testing

The pancreas produces a hormone called insulin, which allows blood sugar (glucose) into the body’s cells to use as energy. In prediabetes, the cells don’t respond to insulin as they should, causing insulin resistance.¹⁰

Screening for prediabetes includes 3 blood testing methods. They are the same tests currently recommended for undiagnosed type 2 diabetes, as well.

Blood sugar tests are simple, and results are provided fairly quickly:¹¹

• A1C test measures average blood sugar level over the past 2 or 3 months. An A1C below 5.7% is normal, between 5.7% and 6.4% is an indication of prediabetes, while 6.5% or higher is an indication of diabetes.
  
  
• Fasting blood sugar test measures blood sugar after the patient fasts (doesn’t eat) overnight.  A fasting blood sugar level of 99 mg/dL or lower is normal, 100 to 125 mg/dL is an indication of prediabetes, and 126 mg/dL or higher is an indication of diabetes.
  
  
• Glucose tolerance test measures blood sugar before and after the patient drinks a liquid that contains glucose. The patient fasts overnight before the test, then blood is drawn to determine fasting blood sugar level. Then the patient drinks the liquid and has their blood sugar level checked 1, 2, and/or possibly 3 hours afterward. At 2 hours, a blood sugar level of 140 mg/dL or lower is considered normal, 140 to 199 mg/dL is an indication of prediabetes, and 200 mg/dL or higher is an indication of diabetes.

Preventing prediabetes

While a prediabetes diagnosis increases the risk of developing type 2 diabetes, the patient can make lifestyle changes to avoid the disease, including:¹²

• Losing weight – A modest weight loss of 5% to 7% of body weight is about 10 to 14 pounds for a person weighing 200 pounds.
• Exercising regularly – At least 150 minutes of physical activity, such as an up-tempo walk, climbing stairs, mowing the lawn, vacuuming or similar activity. That’s equal to 30 minutes a day, 5 days a week.
   

The CDC offers the National Diabetes and Prevention Program. The program supports patients in making lifestyle changes that have been shown to lower the risk of developing type 2 diabetes by as much as 58%.¹³ For patients over age 60, the success rate increases to 71%.¹⁴

Program highlights:¹⁵

• Get guidance from a trained coach to make lifestyle changes that stick.
• Identify healthy foods and ways to become more physically active every day.
• Uncover stress management and motivation techniques to solve problems and keep positive momentum.
• Find people with similar goals and challenges to help each other stay on track.
   

Learn more about the National Diabetes and Prevention Program by visiting https://www.cdc.gov/diabetes/prevention/index.html.

Prediabetes diet tips

In prediabetes, sugar from food builds up in the bloodstream. A diet containing a large amount of refined and processed carbohydrates (carbs) that digest quickly may cause higher spikes in blood sugar. Since the body has difficulty lowering blood sugar levels after meals, monitoring carb intake may help patients to reduce blood sugar spikes.¹⁶

The key is early intervention to get blood sugar levels out of prediabetes range. Eating certain foods may balance blood sugar levels and help patients maintain a moderate weight range.¹⁷

• Choose foods high in fiber
  Fiber helps patients feel full longer. Examples of high fiber foods are beans and legumes, fruits and vegetables with edible skin, whole wheat pasta, whole grains, whole grain bread and cereals.
  
  
• Cut down on carbs
  The glycemic index (GI) is a rating system that measures how food could affect blood sugar, helping patients to maintain their health and well-being. Foods that have a high GI will raise blood sugar faster, while foods with a lower GI have less impact on blood sugar.
  
  Different people may process these foods differently. Cooking certain foods or combining it with protein or fat may change its GI. Eating a large amount of food with carbohydrates may cause blood sugar levels to rise.
  
  Low GI foods include steel cut oats (as opposed to instant oatmeal), non-starchy vegetables such as carrots and leafy greens, beans, sweet potatoes, nuts and seeds.
  
  High GI foods are refined, processed foods, which lack fiber and other nutrients. Foods to avoid by prediabetics are white bread, russet potatoes, sugar-sweetened soda and juice.
  
  
• Manage portion sizes
  In the United States, food portion sizes are regularly much larger than serving sizes recommended by the U.S. Food and Drug Administration. Patients are advised to check food labels to determine nutritional value, carbohydrates and calories being consumed.
  
  
• Eat lean meats
  Meat is often a source of fat. Eating an excess amount of unhealthy fats may lead to prediabetes, high cholesterol and heart disease. Choose lean meats such as eggs, chicken, turkey, fish, shellfish and lean beef cuts.
  
  
• Consume alcohol in moderation
  Since alcohol is a diuretic, drinking alcoholic beverages may cause dehydration. Some cocktails contain high amounts of sugar, which may cause blood sugar spikes.
  
  
• Drink more water
  As part of a healthy diet, drinking water helps the body eliminate toxins. For patients with prediabetes, water is a healthier option than sugary sodas, juices or energy drinks. Those beverages typically contain calories and quick-digesting carbohydrates.
  
  
• Combine diet with exercise
  A lack of physical activity has been linked to insulin resistance, according to the National Institute of Diabetes and Digestive and Kidney Diseases.¹⁸ Exercise causes muscles to use glucose (sugar) for energy and makes the cells work more effectively with insulin.¹⁹

Reversing prediabetes

People with prediabetes may ask, does prediabetes go away? According to the CDC, prediabetes is reversible.²⁰ With simple proven lifestyle changes, people may prevent or delay prediabetes from turning into type 2 diabetes.²¹

In addition to the above diet tips, weight management and exercise, patients are advised to quit smoking because smoking may worsen insulin resistance.²²

Controlling high blood pressure and high cholesterol may ease the risk of prediabetes and future disease.²³

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Sources:

¹“The Surprising Truth About Prediabetes,” Centers for Disease Control and Prevention, last accessed August 10, 2023, https://www.cdc.gov/diabetes/library/features/truth-about-prediabetes.html.

²“The Surprising Truth About Prediabetes.”

³“The Surprising Truth About Prediabetes.”

⁴“The Surprising Truth About Prediabetes.”

⁵“Prediabetes – Your Chance to Prevent Type 2 Diabetes,” Centers for Disease Control and Prevention, last accessed August 10, 2023, https://www.cdc.gov/diabetes/basics/prediabetes.html.

⁶“Prediabetes – Your Chance to Prevent Type 2 Diabetes.”

⁷Valencia Higurea and Brett Huffman, “What Is Prediabetes?” Healthline, last accessed August 10, 2023, https://www.healthline.com/health/type-2-diabetes/what-is-prediabetes.

⁸Higurea and Huffman, “What Is Prediabetes?”

⁹Higurea and Huffman, “What Is Prediabetes?”

¹⁰“Prediabetes,” Cleveland Clinic, last accessed August 10, 2023, https://my.clevelandclinic.org/health/diseases/21498-prediabetes.

¹¹“Diabetes Tests,” Centers for Disease Control and Prevention, last accessed August 10, 2023, https://www.cdc.gov/diabetes/basics/getting-tested.html.

¹²“Prediabetes – Your Chance to Prevent Type 2 Diabetes.”

¹³“Prediabetes – Your Chance to Prevent Type 2 Diabetes.”

¹⁴“Prediabetes – Your Chance to Prevent Type 2 Diabetes.”

¹⁵“Prediabetes – Your Chance to Prevent Type 2 Diabetes.”

¹⁶Kristen Cherney, “The Right Diet for Prediabetes,” Healthline, last accessed August 10, 2023, https://www.healthline.com/health/diabetes/prediabetes-diet.

¹⁷Cherney, “The Right Diet for Prediabetes.”

¹⁸“Insulin Resistance & Prediabetes,” National Institute of Diabetes and Digestive and Kidney Diseases, last accessed August 10, 2023, https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance.

¹⁹Cherney, “The Right Diet for Prediabetes.”

²⁰“The Surprising Truth About Prediabetes.”

²¹“The Surprising Truth About Prediabetes.”

²²Cynthia Weiss, “Mayo Clinic Q and A: How to reverse prediabetes,” Mayo Clinic, last accessed August 10, 2023, https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-how-to-reverse-prediabetes/.

²³Weiss, “Mayo Clinic Q and A: How to reverse prediabetes.”

This information is provided for educational purposes only. It is not to be used for medical advice, diagnosis or treatment. Consult your healthcare provider if you have questions or concerns.

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