Prediabetes means you have a higher than normal blood sugar level. It's not high enough to be considered type 2 diabetes yet, but without lifestyle changes, adults and children with prediabetes are more likely to develop type 2 diabetes.
If you have prediabetes, the long-term damage of diabetes — especially to your heart, blood vessels and kidneys — may already be starting. There's good news, however. Progression from prediabetes to type 2 diabetes isn't inevitable.
Eating healthy foods, making physical activity part of your daily routine and staying at a healthy weight can help bring your blood sugar level back to normal. The same lifestyle changes that can help prevent type 2 diabetes in adults might also help bring children's blood sugar levels back to normal.
Prediabetes doesn't usually have any signs or symptoms.
One possible sign of prediabetes is darkened skin on certain parts of the body. Affected areas can include the neck, armpits, elbows, knees and knuckles.
Classic signs and symptoms that suggest you've moved from prediabetes to type 2 diabetes include:
See your doctor if you're concerned about diabetes or if you notice any type 2 diabetes signs or symptoms. Ask your doctor about blood sugar screening if you have any risk factors for diabetes.
The exact cause of prediabetes is unknown. But family history and genetics appear to play an important role. A lack of regular physical activity and being overweight with excess fat around your abdomen also seem to be important factors.
What is clear is that people with prediabetes 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.
Most of the glucose in your body comes from the food you eat. When food is digested, sugar enters your bloodstream. Moving sugar from your bloodstream to your body's cells requires a hormone called insulin.
Insulin comes from a gland located behind the stomach called the pancreas. Your pancreas sends insulin to your blood when you eat.
As insulin circulates, it allows sugar to enter your cells — and lowers the amount of sugar in your blood. When your blood sugar level starts to drop, the pancreas slows down the secretion of insulin into the blood.
When you have prediabetes, this process doesn't work as well. Your pancreas may not make enough insulin or cells become resistant to insulin and don't allow as much sugar in. So, instead of fueling your cells, sugar builds up in your bloodstream.
The same factors that increase the odds of getting type 2 diabetes also increase the risk of prediabetes. These factors include:
Other conditions associated with prediabetes include:
When these conditions occur with obesity, they are associated with insulin resistance.
The combination of three or more of these conditions is often called metabolic syndrome.
The most serious consequence of prediabetes is progression to type 2 diabetes. That's because type 2 diabetes can lead to:
Prediabetes has been linked with unrecognized (silent) heart attacks and can damage your kidneys, even if you haven't progressed to type 2 diabetes.
Healthy lifestyle choices can help you prevent prediabetes and its progression to type 2 diabetes — even if diabetes runs in your family. Try to:
The American Diabetes Association (ADA) recommends that diabetes screening for most adults begin at age 45. The ADA advises diabetes screening before age 45 if you're overweight and have additional risk factors for prediabetes or type 2 diabetes.
There are several blood tests for prediabetes.
This test shows your average blood sugar level for the past three months. The test measures the percentage of blood sugar attached to the oxygen-carrying protein in red blood cells called hemoglobin. The higher your blood sugar levels, the more hemoglobin you'll have with sugar attached.
Certain conditions can make the A1C test inaccurate — such as if you're pregnant or have an uncommon form of hemoglobin.
A blood sample is taken after you fast for at least eight hours or overnight.
This test is usually used to diagnose diabetes only during pregnancy. A blood sample is taken after you fast for at least eight hours or overnight. Then you'll drink a sugary solution, and your blood sugar level will be measured again after two hours.
If you have prediabetes, your doctor will typically check your blood sugar levels at least once a year.
Type 2 diabetes is becoming more common in children and adolescents, likely due to the rise in childhood obesity. The ADA recommends prediabetes testing for children who are overweight or obese and who have one or more other risk factors for type 2 diabetes.
These other risk factors include:
The ranges of blood sugar level considered normal, prediabetic and diabetic are the same for children and adults.
Children who have prediabetes should be tested annually for type 2 diabetes — or more often if the child experiences a change in weight or develops signs or symptoms of diabetes, such as increased thirst, increased urination, fatigue or blurred vision.
Healthy lifestyle choices can help you bring your blood sugar level back to normal, or at least keep it from rising toward the levels seen in type 2 diabetes.
To prevent prediabetes from progressing to type 2 diabetes, try to:
Children with prediabetes should undertake the lifestyle changes recommended for adults with type 2 diabetes, including:
Medication generally isn't recommended for children with prediabetes unless lifestyle changes aren't improving blood sugar levels. If medication is needed, metformin (Glumetza, others) is usually the recommended drug.
Many alternative therapies have been touted as possible ways to treat or prevent type 2 diabetes. But, there's no definitive evidence that any alternative treatments are effective. Therapies that have been said to be helpful in type 2 diabetes and are also likely to be safe, include:
Talk to your doctor if you're considering dietary supplements or other alternative therapies to treat or prevent prediabetes. Some supplements or alternative therapies might be harmful if combined with certain prescription medications. Your doctor can help you weigh the pros and cons of specific alternative therapies.
You're likely to start by seeing your primary care doctor. He or she may refer you to a doctor who specializes in diabetes treatment (endocrinologist), a dietitian or a certified diabetes educator.
Here's some information to help you get ready for your appointment.
Before your appointment, take these steps:
For prediabetes, some basic questions to ask your doctor include:
Your doctor is likely to ask you a number of questions, such as:
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