Pre-diabetes is a condition that comes before type 2 diabetes. Blood glucose (sugar) levels are higher than normal but aren’t high enough to be called diabetes. Pre-diabetes is a silent disease, meaning you can have it but not know it. The good news is that cutting back on calories and fat, being physically active, and losing weight can reverse pre-diabetes and therefore delay or prevent type 2 diabetes. Diabetes doesn’t go away once you have it, so it’s better to prevent it in the first place.
How can type 2 diabetes bedelayed or prevented?
In a recent study, people at high risk for type 2 diabetes greatly reduced their risk of getting it by eating less than usual, increasing their physical activity, and losing weight. They
- Cut down on fat
- Cut back on calories
- Exercised about 30 minutes a day, 5 days a week, usually by brisk walking
- Lost weight—an average of 15 pounds in the first year of the study
These strategies worked equally well for men and women and particularly well for people aged 60 and older. Several other studies also have shown that type 2 diabetes can be delayed or prevented.
Often, prediabetes has no signs or symptoms.
Darkened areas of skin, a condition called acanthosis nigricans, is one of the few signs of prediabetes. Common areas that may be affected include the neck, armpits, elbows, knees and knuckles.
Classic red flags of type 2 diabetes to watch for include:
- Increased thirst
- Frequent urination
- Blurred vision
As you get older, especially if you’re overweight, your chances of having pre-diabetes increase. Your doctor should check your blood glucose level if you are
- 45 or older and overweight
- Under age 45 and overweight and have other risk factors for diabetes
If you are 45 or older and your weight is normal, ask your doctor if you need to be checked for pre-diabetes.
Are you at increased risk for diabetes?
You’re at risk for diabetes if you
- Are overweight
- Are physically inactive
- Have a parent, brother, or sister with diabetes
- Are African American, Native American,Asian American, Pacific Islander, or Hispanic American
- Have had a baby weighing more than 9 pounds or have had gestational diabetes
- Have high blood pressure (over 140/90 mmHg)
- Have low HDL cholesterol (35 mg/dl or lower) or high triglycerides (250 mg/dl or higher)
How it is Diagnosed:
Pre-diabetes has no symptoms. You’ll need a blood test to check your blood glucose level. Your doctor will use one of these two tests:
The fasting plasma glucose test measures your blood glucose after you have gone overnight without eating. This test is most reliable when done in the morning. Pre-diabetes is diagnosed when fasting glucose levels are between 100 and 125 mg/dl. These glucose levels are above normal but not high enough to be called diabetes. A fasting plasma glucose of 126 mg/dl or higher means diabetes and must be confirmed with repeat testing on another day.
The oral glucose tolerance test measures your blood glucose after an overnight fast and 2 hours after you drink a sweet liquid provided by the doctor or laboratory. Pre-diabetes is diagnosed when blood glucose is between 140 and 199 mg/dl 2 hours after drinking the liquid. These glucose levels are above normal but not high enough to be called diabetes. A 2-hour blood glucose of 200 mg/dl or higher means diabetes and must be confirmed with repeat testing on another day.
To help bring your blood glucose levels back to normal, you can
- Cut back on calories and fat
- Increase your physical activity
Doing so will make it more likely that you’ll lose weight. If you’re overweight, losing 5 to 7 percent of your total weight can help you a lot. For example, if you weigh 200 pounds, your goal would be to lose 10 to 15 pounds.
Cutting Back on Calories and Fat
Place a check mark next to steps you’d like to try for cutting down on calories and fat.
- I’ll cut back on my usual serving sizes.
- I’ll order the smallest portion size when I’m eating out. Or I’ll share an entree.
- I’ll try calorie-free drinks or water instead of regular soft drinks and juice.
- I’ll try low-fat versions of the foods I usually eat. I’ll check the labels to make sure the calories are reduced too.
- When cooking, I’ll bake, broil, or grill and use nonstick pans and cooking sprays.
- I’ll eat more vegetables and whole grain foods.
Increasing Your Physical Activity
Place a check mark next to the ways you’ll try to add physical activity to your daily routine.
- I’ll take the stairs instead of the elevator.
- I’ll park at the far end of the parking lot.
- I’ll find an activity I enjoy, such as working in the yard or riding a bike.
- I’ll take a walk every day, working up to 30 minutes of brisk walking, 5 days a week.
Or I’ll split the 30 minutes into two or three walks.
- I’ll try strength training by lifting light weights several times a week.
- Other ways I’ll try to add physical activity to my daily routine are
- Other steps I’ll take to cut down on calories and fat are
No drug has been approved by the U.S. Food and Drug Administration specifically for prediabetes. However, several medications available by prescription for diabetes or weight loss have been used in studies. Though certain drugs do seem to delay or prevent diabetes, they don’t work nearly as well as eating less, being active, and losing weight. At this time, experts recommend eating less, increasing physical activity, and losing weight as the best ways to treat pre-diabetes, instead of taking medications.