Prediabetes is on the rise. Between 2013 and 2020, the rate of prediabetes among adults grew by 3.5%. As of 2019, 96 million adults in the United States had diabetes. That’s more than 1 in 3 people. The only thing more concerning than this rise in prediabetes is the fact that 80% of those 96 million adults—more than 76 million people—aren’t even aware they have the condition.

But what is prediabetes? And how do you protect yourself against it? In this blog article, we’ll look at your best options for prevention and treatment: how to protect yourself against this condition and what to do if you get it.

What is Prediabetes?

Prediabetes is a medical condition characterized by elevated blood sugar levels that are higher than normal but not yet in the diabetic range. It serves as a warning sign that an individual is at increased risk of developing type 2 diabetes, which is a chronic and potentially life-threatening disease. Prediabetes typically occurs when the body's cells become less responsive to insulin, a hormone that helps regulate blood sugar levels. As a result, the pancreas has to produce more insulin to keep blood sugar within a healthy range.

One of the concerning aspects of prediabetes is that it often presents no apparent symptoms, which is why it's often referred to as a "silent" condition. People may not realize they have prediabetes until routine blood tests, like the fasting blood sugar test or the A1c test, reveal elevated glucose levels. However, some individuals with prediabetes may experience mild symptoms like increased thirst, frequent urination, and fatigue.

Prediabetes is commonly diagnosed through blood tests that measure your blood sugar levels. There are three standard tests used to diagnose prediabetes:

Fasting Blood Sugar Test (FBS): This test measures your blood sugar level after an overnight fast. You'll be asked to refrain from eating or drinking anything (except water) for at least 8 hours before the test. If your fasting blood sugar level is between 100 and 125 milligrams per deciliter (mg/dL), you may be diagnosed with prediabetes. Fasting blood sugar levels of 126 mg/dL or higher are typically indicative of diabetes.

Oral Glucose Tolerance Test (OGTT): This test involves fasting overnight and then drinking a sugary solution containing a standardized amount of glucose. Blood sugar levels are measured at intervals (usually 1 and 2 hours) after drinking the solution. If your blood sugar level is between 140 and 199 mg/dL two hours after drinking the glucose solution, it may indicate prediabetes. A reading of 200 mg/dL or higher suggests diabetes.

Hemoglobin A1c Test (A1c): The A1c test estimates your average blood sugar levels over the past 2-3 months. An A1c level between 5.7% and 6.4% is often used to diagnose prediabetes. An A1c level of 6.5% or higher typically indicates diabetes.

The good news is that prediabetes is reversible and can often be managed effectively through lifestyle changes. Adopting a healthier diet rich in whole grains, fruits, vegetables, lean proteins, and regular physical activity can help improve insulin sensitivity and lower blood sugar levels. Sometimes, health care providers may recommend medications to help control blood sugar. Regular monitoring and follow-ups with a healthcare professional are essential to track progress and reduce the risk of progressing to full-blown diabetes.

Prediabetes is a serious warning sign of the potential development of type 2 diabetes. Early detection and intervention are crucial to prevent diabetes and its associated complications. Therefore, individuals need to be aware of their risk factors and consult with a healthcare provider for proper evaluation and guidance if they suspect they may have prediabetes.

Prediabetes Risk Factors

There is no singular cause for prediabetes. However, several factors can increase your odds of developing prediabetes and type 2 diabetes.

Risk factors for prediabetes include:

• Excess Body Weight: Being overweight or having obesity increases the risk of prediabetes.
  
• Inactive Lifestyle: Lack of regular physical activity can contribute to insulin resistance and prediabetes.
  
• Unhealthy Diet: A diet high in sugar, refined carbohydrates, and saturated fats can elevate blood sugar levels.
  
• Family History: A family history of diabetes increases the likelihood of prediabetes.
  
• Age: Prediabetes risk tends to increase with age, especially after 45 years old.
  
• Ethnicity: Certain ethnic groups, such as African Americans, Hispanics, Native Americans, and Asian Americans, have a higher risk.
  
• Gestational Diabetes: Women who have a history of gestational diabetes during pregnancy are at an increased risk of developing prediabetes.
  
• Polycystic Ovary Syndrome (PCOS): Women with PCOS are at high risk of prediabetes due to insulin resistance.
  
• High Blood Pressure: Hypertension is often associated with prediabetes. In addition, individuals with a history of heart disease may be more likely to develop prediabetes.
  
• High Cholesterol: Elevated levels of triglycerides and low HDL (good) cholesterol can increase the risk.
  
• Sleep Disorders: Conditions like sleep apnea can contribute to insulin resistance and prediabetes.
  
• Smoking: Smoking can raise the risk of insulin resistance and worsen prediabetes.
  
  

It's important to note that having one or more of these risk factors does not guarantee the development of prediabetes, but they do increase the likelihood. Regular check-ups and a healthy lifestyle can help manage and mitigate these risks.

Prediabetes Treatment

Prediabetes, unlike other forms of diabetes, can be reversed. If a health care provider diagnoses you with prediabetes, they will work with you on diabetes care to undo the condition. This treatment will also minimize your risk of developing type 2 diabetes.

The first step in prediabetes treatment is often a lifestyle intervention meant to encourage weight loss and bring your blood sugar levels under control. To this end, the Centers for Disease Control and Prevention has created a national Diabetes Prevention Program (DPP) to curb the rise of prediabetes. Its Outcomes Study shows that losing 5-7% of your body weight can reduce the risk of developing diabetes by 58%.

A healthy diet plays a crucial role in treating and managing prediabetes. Here’s how:

Balancing Blood Sugar Levels: One of the primary objectives of a prediabetes-friendly diet is to keep blood sugar levels within a healthy range. This is achieved by focusing on foods with a low glycemic index (GI). Low-GI foods are digested and absorbed more slowly, leading to a gradual rise in blood sugar levels. These foods include whole grains, legumes, non-starchy vegetables, and most fruits. Additionally, protein-rich foods can help control appetite and reduce the need for excessive carbohydrates. Including lean protein sources into your diet, such as poultry, fish, tofu, and legumes, aids with blood sugar management.

Carbohydrate Management: Carbohydrates significantly impact blood sugar levels, so managing carbohydrate intake is crucial. Prediabetes management often involves portion control and choosing complex carbohydrates over simple ones. Complex carbohydrates, like whole grains, provide a steady energy supply and don't cause rapid spikes in blood sugar.

Fiber-Rich Foods: A diet rich in dietary fiber helps stabilize blood sugar levels by slowing down glucose absorption. Fiber is found in whole grains, beans, lentils, vegetables, and fruits. Including these foods in the diet can improve insulin sensitivity and lower the risk of diabetes.

Lean Proteins: Including lean protein sources, such as poultry, fish, tofu, and legumes, helps with blood sugar management. Protein-rich foods can help control appetite and reduce the need for excessive carbohydrates.

Healthy Fats: Replacing saturated and trans fats with healthy fats like those found in nuts, seeds, avocados, and olive oil can improve insulin sensitivity and reduce inflammation.

Portion Control: Controlling portion sizes is essential for managing calorie intake and maintaining a healthy weight. Smaller, well-balanced meals and snacks throughout the day can help prevent overeating and stabilize blood sugar levels.

Regular Meal Timing: Consistency in meal timing can also help regulate blood sugar. Eating meals and snacks at regular intervals prevents large fluctuations in blood glucose levels.

Limiting Sugary Foods and Beverages: Sugary foods and drinks should be limited or avoided altogether, as they can cause rapid spikes in blood sugar levels. This includes sodas, candies, desserts, and sugary cereals.

Consultation with a Registered Dietitian: Individualized dietary plans and ongoing support from a registered dietitian can be invaluable in tailoring a prediabetes diet to specific needs and goals.

By adopting a healthy diet that focuses on these principles, individuals with prediabetes can effectively manage their condition and reduce their risk of developing type 2 diabetes.

Exercise is often one of the primary prescriptions for prediabetes, along with a healthy diet. Exercise helps with:

Improved Insulin Sensitivity: Exercise helps the body become more sensitive to insulin, which means that cells are better able to use glucose for energy. This enhanced sensitivity allows for better blood sugar control and can prevent the development of type 2 diabetes.

Lowering Blood Sugar Levels: Physical activity helps lower blood sugar levels by facilitating glucose uptake into muscle cells, even without requiring as much insulin. This can lead to immediate reductions in post-meal blood sugar spikes.

Weight Management: Exercise is crucial for achieving and maintaining a healthy weight, especially for individuals with prediabetes. Shedding excess pounds can improve insulin sensitivity and reduce the risk of developing diabetes.

Cardiovascular Health: Regular exercise improves cardiovascular health by reducing the risk factors associated with heart disease, often higher in people with prediabetes. It can lower blood pressure, improve cholesterol levels, and reduce the risk of heart attacks and strokes.

Enhanced Muscle Mass: Resistance or strength training exercises can help build and maintain muscle mass. Muscles are one of the primary sites for glucose utilization, and having more muscle can lead to better blood sugar control.

Stress Reduction: Physical activity has been shown to reduce stress and improve mental well-being. Lowering stress levels can positively impact blood sugar regulation, as stress hormones can raise blood sugar.

Energy Balance: Regular exercise helps balance calorie intake and expenditure better. This can prevent excessive calorie consumption and weight gain, which are risk factors for prediabetes.

The American Diabetes Association (ADA) recommends at least 150 minutes of moderate-intensity aerobic activity per week, spread over at least three days, with no more than two consecutive days without exercise. Alternatively, 75 minutes of vigorous-intensity aerobic activity can be equally effective.

Before starting any exercise program, individuals with prediabetes should consult their health care provider to ensure that the chosen exercise plan is safe and appropriate for their health and fitness levels.

Medication for prediabetes is often only prescribed when lifestyle intervention has been ineffective at curbing a patient’s blood sugar levels. Even if you have been prescribed medication, these drugs will be used in conjunction with healthy lifestyle adjustments like those described above.

Metformin is the most commonly prescribed medication for prediabetes. It is classified as a biguanide. These drugs reduce the amount of insulin your liver produces and releases into the bloodstream. Biguanides also make muscle tissue more sensitive to insulin, allowing the tissue to absorb more insulin and use the glucose for energy.

Metformin is generally well-tolerated but has been shown to cause some side effects, such as:

• Diarrhea
  
• Nausea
  
• Vomiting
  
• Flatulence
  
• Fatigue
  
• Indigestion
  
• Abdominal discomfort
  
• Headache
  
  

If any of these side effects persist or become severe, talk to your health care provider right away.

Prediabetes can significantly increase your risk of developing type 2 diabetes and other complications. Luckily, the condition can be reversed. Crafting a treatment plan with a care team that includes your primary care provider, a dietitian, and an endocrinologist can protect you from having prediabetes develop into type 2 diabetes.

If you want more information or to talk to a licensed health care provider today, book an online doctor appointment on Sesame.

Sources:

• Alvarez, S., Coffey, R., & Algotar, A. M. (2023). Prediabetes. In StatPearls. StatPearls Publishing.
  
• (n.d.). With prediabetes, action is the best medicine. American Diabetes Association. diabetes.org
  
• (n.d.). Prediabetes. Centers for Disease Control and Prevention. cdc.gov
  
• (n.d.). Diabetes Prevention Program (DPP). National Institute of Diabetes and Digestive and Kidney Diseases. niddk.nih.gov
  

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