What is Prediabetes?
By Kathy Ferguson, RN, Parish Nurse
The Lord nurses them when they are sick and restores them to health. Psalm 41:3
November is American Diabetes Awareness Month®. Chances are that you know someone with diabetes, or you may have it yourself. In previous articles, I have shared information about what diabetes is, the different types of diabetes, and treatments. Today’s article will focus on prediabetes. Did you know that approximately 88 million American adults—more than 1 in 3—have prediabetes? Of those with prediabetes, more than 84% don’t know they have it (CDC). I have a family history of type 2 diabetes—my mother, my uncle, and my grandfather had it. My brother also has it. Because of this, I have been very tuned into my blood sugar level over the last several years. A few years ago, I was diagnosed with prediabetes. I sometimes think that prediabetes should be called “wake-up call diabetes”. At least that is how I felt when I got the news. In other words, time to focus on healthy lifestyle habits so that it does not progress to type 2 diabetes. This month’s article has information about what prediabetes is, why it should be of concern, and what you can do to stop the progression to type 2 diabetes.
What is prediabetes?
Basically, prediabetes is blood sugar levels that are higher than normal but not yet high enough to be diagnosed as diabetes. This is the wake-up call: Before people develop type 2 diabetes, they almost always have prediabetes. It doesn’t mean you’ll absolutely develop type 2 if you have prediabetes, particularly if you follow a treatment plan and a diet and exercise routine. Even small changes can have a huge impact on managing diabetes or preventing it all together. In the past, you may have heard it referred to as “borderline diabetes”. I worked as a diabetes educator many years ago at Mayo Clinic. One of our mantras was, “There is no such thing as borderline diabetes. Either you have it, or you don’t. It is like being pregnant—there is no such thing as borderline pregnancy.” Alas, times have changed and in 1997 the term prediabetes originated, but not without some controversy.
What causes prediabetes?
According to Mayo Clinic, the exact cause of prediabetes is unknown. But family history and genetics appear to play an important role. Race and ethnicity are also a factor: African Americans, Hispanic/Latino Americans, Native Americans, Pacific Islanders, and some Asian Americans are at higher risk.
A lack of regular physical activity and being overweight with excess fat around your abdomen also seem to be important factors. People with prediabetes (and type 2 diabetes) don’t process sugar (glucose) properly anymore. As a result, sugar builds up in the blood instead of doing its normal job of giving energy to the cells that make up muscles and other tissues. That’s why an elevated blood sugar shows up on our lab test results—more sugar in the bloodstream instead of being used for energy in the cells of the body.
What are the symptoms of prediabetes?
There are no clear symptoms of prediabetes so you may have it and not know it. It is possible that you may have some of the symptoms of diabetes or even some of the complications. If you think you may have diabetes or prediabetes, check with your health care provider and get tested.
How will I know if I have prediabetes?
The only way to know is by talking to your health care provider and getting tested. A normal blood sugar level is 70 – 99 mg/dl. If it is higher than this, it could indicate prediabetes or diabetes.
How is prediabetes treated?
So, you have been diagnosed with prediabetes, what can you do about it? The goal is to stop prediabetes in its tracks and prevent it from becoming type 2 diabetes. You may wonder why this matters. If left untreated, prediabetes can cause several health issues, including type 2 diabetes, heart disease, and stroke. On average, people with diagnosed diabetes have medical expenditures approximately 2.3 times higher than what expenditures would be in the absence of diabetes (American Diabetes Association). All good reasons to take a prediabetes diagnosis seriously. The good news is that even small changes can significantly lower your risk for developing Type 2 diabetes and lowering your blood sugar.
The CDC recommends the following:
- Weight loss: Losing 5% to 7% of your body weight can have an impact. For example, a 200-pound person who loses 10 to 14 pounds could see a significant health improvement.
- Regular activity: Aim for 30 minutes a day, five days a week, for a total of 150 minutes a week. Try walking, hiking, biking, or another activity you enjoy.
- Take medications prescribed by your health care provider.
- Lowering your risk factors for prediabetes can often get your blood sugar levels back to healthy levels.
- Work with a nutritionist or dietitian to plan a healthful diet you can stick with long-term.
- Find ways to reduce or manage stress.
- Quit smoking and limit alcohol.
- Diagnose and treat sleep disorders.
- Manage related disorders, such as high cholesterol and high blood pressure.
Be well. Take your health into your own hands.
American Diabetes Association. (n.d.). https://www.diabetes.org/
Centers for Disease Control and Prevention. (2020). Prediabetes – your chance to prevent type 2 diabetes. https://www.cdc.gov/diabetes/basics/prediabetes.html
Cleveland Clinic. (2021). Prediabetes. https://my.clevelandclinic.org/health/diseases/21498-prediabetes
Mayo Clinic. (2020). Prediabetes. https://www.mayoclinic.org/diseases-conditions/prediabetes/symptoms-causes/syc-20355278