Prediabetes, a serious but common health condition that often precedes a type 2 diabetes diagnosis, affects an estimated 88 million adults in the U.S., or 1 in 3 people. But the majority of the time, they have no idea: 84% of people with prediabetes are unaware of their condition, in large part because they aren’t experiencing any noticeable prediabetes symptoms.
Below, we answer some of the most common questions about the condition and explain what you can do to take preventative measures for prediabetes.
What is prediabetes?
First, let’s start with a quick review of type 1 and type 2 diabetes. Both involve complications with the body’s relationship to insulin, a hormone that transforms a simple sugar called glucose into energy.
In contrast to type 1, which often begins during childhood or adolescence, type 2 develops gradually due to a mixture of genetic, lifestyle, and environmental factors. Over time, the body becomes unable to convert glucose into fuel, leading to the higher blood sugar levels found in type 2 diabetes. In the long term, high blood sugar can lead to serious health issues including heart disease, vision loss, and kidney disease.
Prediabetes is a health condition that can lead to a diagnosis of type 2 diabetes. Without noticeable symptoms, it is defined primarily by blood sugar levels that are higher than normal but still fall below the official range for a type 2 diabetes diagnosis. If left untreated, prediabetes can lead to serious complications down the road. But it doesn’t have to — prediabetes treatment, including simple lifestyle changes, can keep you from developing type 2 diabetes.
How do I know if I’m prediabetic?
Since there aren’t any visible prediabetes symptoms, the only way to know if you have it is to get a prediabetes test. If you’re concerned you might have prediabetes, or if you’re at risk for type 2 diabetes, talk to your healthcare provider. They can suggest the best course of action, including ordering an A1C blood test.
In people with prediabetes and diabetes, glucose accumulates and binds to hemoglobin, which carries oxygen to all of your organs and is stored in red blood cells. Higher blood sugar levels correspond with more sugar-coated hemoglobin. The A1C — the main prediabetes test — determines blood sugar levels over a two to three-month period by measuring the percentage of hemoglobin proteins attached to sugar.
In general, results fall into one of three main levels:
An A1C level below 5.7% is considered normal
An A1C level between 5.7% and 6.4% is considered prediabetes
An A1C level of 6.5% or higher on two separate tests indicates type 2 diabetes
The blood sugar ranges are the same for both children and adults.
If prediabetes progresses into type 2 diabetes, the A1C test may also be used to monitor how you’re managing your blood sugar levels. When you’re living with diabetes, higher A1C percentages correspond to a greater risk for long-term or life-threatening complications. Anyone with a higher A1C should eat healthy foods and exercise frequently. The American Diabetes Association’s recipe list is a great starting point as you plan a prediabetes diet.
If the A1C results are inconsistent, or if you are unable to take it, your doctor may use other tests to diagnose prediabetes:
The random blood sugar test, which consists of a blood sample taken at a random time
The fasting blood sugar test, which consists of a blood sample taken after an overnight fast
The oral glucose tolerance test, which is primarily used during pregnancy
Who does prediabetes affect?
The same risk factors for type 2 diabetes also apply to prediabetes. Because prediabetes often remains undetected, with no clear prediabetes symptoms, it’s important to be proactive and get a blood test if you are at risk. Talk to your doctor about a prediabetes test if you are:
Over 45 years old
Black, Hispanic/Latino, Native American, Asian American, or Pacific Islander — for reasons not yet understood, researchers have found higher rates of type 2 diabetes in these racial and ethnic groups
Or if you have:
High blood pressure or take medication for it
Low HDL cholesterol and/or high triglycerides
A parent or sibling with diabetes
Been diagnosed with Polycystic Ovary Syndrome (PCOS)
Had gestational diabetes
As childhood obesity becomes more prevalent, we’re seeing higher rates of both prediabetes and type 2 diabetes in younger groups. Younger or middle-aged people with prediabetes face a greater risk for more serious diabetes-related complications like chronic kidney disease and cardiovascular disease. These groups should be extra vigilant in discussing prediabetes treatment and diet with their doctor given the heightened risk.
Your doctor may order a prediabetes test for children and adolescents if they:
Are overweight or obese
Belong to a racial or ethnic group with higher rates of type 2 diabetes
Have a family history of type 2 diabetes
Had a low birth rate
Were born to a mother with gestational diabetes
On the other hand, some research suggests that higher blood sugar levels are a common part of aging, and prediabetes is less likely to turn into a diagnosis of type 2 diabetes for seniors..
What should I do for prediabetes?
If left untreated, prediabetes can lead to serious complications like heart disease and kidney damage. In fact, long-term damage to the heart, blood vessels, and kidneys may begin even before the progression to type 2 diabetes. Despite the severity of the risk, however, prediabetes can be successfully managed and reversed, and a diagnosis of type 2 diabetes is preventable.
The most important thing to do for prediabetes is to commit to a healthier lifestyle. Take up a nutritious prediabetes diet, aim for about 30 minutes of moderate physical activity most days of the week, and, if relevant, quit smoking and work with your doctor on controlling blood pressure and cholesterol levels. With these simple changes, you’ll be well on your way toward lowering your risk.
We’re here to help you navigate life with diabetes.
It’s important to take whatever steps you can to prevent prediabetes from progressing into type 2 diabetes. A full life is possible, however, when you are living with any type of diabetes. If insulin becomes part of your treatment plan, our pharmacists will walk you through your first injections and answer any questions you have about symptoms or side effects.
The last thing you need while settling into a new routine is the stress of managing prescriptions and dealing with insurance. We’re here to help, by consolidating medications into streamlined monthly deliveries, setting up automatic refills, and offering fast delivery.
Learn how we can support your diabetes treatment plan by contacting us via in-app messaging or phone at 1-800-874-5881.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.