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Understand how prediabetes leads to type 2 diabetes

Prediabetes is characterized by blood glucose levels that are higher than normal but not yet high enough to be considered diabetes. It serves as a warning sign that an individual is at an increased risk of developing type 2 diabetes, which is a chronic and serious health condition. People with prediabetes have elevated blood sugar levels, typically measured through a test called the Hemoglobin A1c test or fasting blood sugar test.

Prediabetes is a critical stage because it provides an opportunity for individuals to take proactive steps to prevent or delay the onset of full-blown diabetes. Lifestyle changes, including dietary modifications, increased physical activity, and weight management, can often be effective in preventing the progression to diabetes. Regular monitoring, healthy eating, and exercise are essential components of managing prediabetes and reducing the associated health risks.

Determining a normal blood sugar level

A normal blood sugar level, when measured in a fasting state (usually before consuming any food or beverages), is typically:

Between 70 and 100 milligrams per deciliter (mg/dL) for adults without diabetes.

However, blood sugar levels can vary throughout the day, and what's considered normal can differ between individuals. It's essential to keep in mind that normal values may also depend on factors like age, overall health, and specific circumstances.

Prediabetes causes

  • Excess body weight: Being overweight or obese is one of the most significant risk factors for prediabetes. Extra body fat, particularly around the abdomen, can lead to insulin resistance, making it harder for the body to control blood sugar levels.

  • Lack of physical activity: A sedentary lifestyle with minimal physical activity increases the risk of prediabetes. Regular exercise helps the body use insulin effectively and maintain healthy blood sugar levels.

  • Unhealthy diet: Consuming a diet high in sugary and processed foods, as well as a low intake of fruits, vegetables, and whole grains, can contribute to prediabetes.

  • Family history: Having a family history of diabetes, especially in first-degree relatives (parents, siblings), can increase the risk of prediabetes.

  • Age: The risk of prediabetes tends to increase with age, particularly after the age of 45.

  • Gestational diabetes: Women who have experienced gestational diabetes during pregnancy are at a higher risk of developing prediabetes later in life.

  • Polycystic ovary syndrome (PCOS): Women with PCOS have a higher risk of prediabetes due to hormonal imbalances and insulin resistance.

  • High blood pressure: Hypertension, or high blood pressure, is often linked to prediabetes and type 2 diabetes.

  • High cholesterol levels: High levels of LDL ("bad") cholesterol and low levels of HDL ("good") cholesterol can be associated with an increased risk of prediabetes.

  • Sleep apnea: Sleep apnea, a condition characterized by disrupted breathing during sleep, has been connected to insulin resistance and a higher risk of prediabetes.

  • Ethnicity: Some ethnic groups, such as African Americans, Hispanics, Native Americans, and Asian Americans, have a higher prevalence of prediabetes.

  • Stress: Chronic stress can affect blood sugar levels and contribute to insulin resistance.


Prediabetes symptoms

  • Increased thirst

  • Frequent urination

  • Fatigue

  • Blurry vision

  • Slow wound healing


How do you diagnose prediabetes?

  • In a fasting blood sugar test (FBS), you'll be asked to fast (not eat or drink anything except water) for at least 8 hours before the blood sample is taken. This test measures the blood sugar level after the fasting period. A fasting blood sugar level between 100 and 125 milligrams per deciliter (mg/dL) is indicative of prediabetes.

  • The Hemoglobin A1c test, often referred to as the A1c test, measures the average blood sugar levels over the past two to three months. An A1c level between 5.7% and 6.4% indicates prediabetes.


If either of these tests indicates that you have prediabetes, your endocrinologist or diabetes provider may recommend further evaluation or additional tests to confirm the diagnosis.

What you can do to reverse prediabetes

Yes, prediabetes can often be reversed or, at the very least, its progression to full-blown type 2 diabetes can be significantly delayed. Reversing prediabetes typically involves making important lifestyle changes to improve blood sugar control. Here are some effective strategies for reversing prediabetes:

  • Healthy eating: Adopt a balanced and nutritious diet. Focus on whole grains, lean proteins, plenty of vegetables, and fruits. Limit the intake of sugary and processed foods. Managing portion sizes and monitoring carbohydrate intake can also be beneficial.

  • Regular physical activity: Engage in regular physical activity, such as brisk walking, cycling, or other aerobic exercises. Exercise helps the body use insulin more effectively and can lower blood sugar levels.

  • Weight management: If you're overweight, even modest weight loss (5-10% of your current weight) can have a significant impact on blood sugar control. Maintaining a healthy weight is crucial for reversing prediabetes.

  • Monitoring blood sugar: Keep a close eye on your blood sugar levels as recommended by your healthcare provider. This can help you track your progress and make necessary adjustments to your lifestyle.

  • Medication (if prescribed): In some cases, healthcare providers may prescribe medications, such as metformin, to help manage blood sugar levels in people with prediabetes. These medications are often used in combination with lifestyle changes.

  • Stress management: Reducing stress through relaxation techniques, mindfulness, or stress management activities can also contribute to better blood sugar control.

  • Regular medical check-ups: It's important to attend regular check-ups with your healthcare provider to monitor your progress, adjust your treatment plan if needed, and assess your risk of developing type 2 diabetes.

Reversing prediabetes is not guaranteed for everyone, and individual results can vary. However, by following a healthy lifestyle and consistently practicing these strategies, many people with prediabetes are able to return their blood sugar levels to within the normal range and reduce their risk of developing type 2 diabetes. It's essential to work closely with your endocrinology team to create a personalized plan that addresses your specific needs and circumstances.

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