How to Spot Prediabetes

By:    Medically Reviewed: Tom Iarocci, MD   Published: November 21, 2013

Before being diagnosed with type 2 diabetes, people may suffer a slew of telltale warning signs.

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There are currently nearly 26 million people in this country who suffer from diabetes. But according to recent estimates, there are as many as 79 million who are classified as having prediabetes, a condition that almost always precedes type 2 diabetes.

Without intervention, most people with this condition could develop type 2 diabetes within 10 years, and as many as 30 percent may become diabetic in only five years. But, it doesn’t have to be that way.

 

“Simple steps like losing weight and walking more can help prevent prediabetes from progressing into diabetes,” says Vivian Fonseca, M.D., an endocrinologist, professor of medicine at Tulane University and former president of Medicine and Science at the American Diabetes Association. In fact, in a study by the Diabetes Prevention Program — a public-private partnership that works together to prevent or delay the onset of type 2 diabetes among people with prediabetes in the U.S. — researchers found that overweight prediabetes participants who significantly dieted and exercised were able to reduce their risk of type 2 diabetes by a whopping 58 percent.

 

What exactly is prediabetes?

Before people develop type 2 diabetes, they almost always have a condition called prediabetes, which is asymptomatic, but not completely unpredictable. It means that blood glucose levels are not completely normal, but not yet at levels classified as diabetes. Prediabetes is also called impaired glucose tolerance or impaired fasting glucose, and there are different blood tests that can be used to screen for this condition, says Fonseca.

 

Recognize your risk factors

Prediabetes is essentially a symptomless condition. Without being tested, it’s possible to have it and not know. However, there are well-established risk factors that increase the probability of having it already. You should be screened if you are overweight or obese and also have one or more of the following risk factors:

 

  • A physically inactive lifestyle;
  • A parent or sibling who has diabetes;
  • A family background in one or more of the following ethnicities: African American, Alaska Native, American Indian, Asian American, Hispanic/Latino or Pacific Islander;
  • A previous diagnosis of gestational diabetes or experience giving birth to a baby over 9 pounds;
  • High blood pressure;
  • HDL cholesterol lower than 35 mg/dL or triglyceride levels about 250 mg/dL;
  • Polycystic ovarian syndrome;
  • A previous diagnosis of prediabetes; or
  • A history of heart disease.

 

“Everyone over age 45 should be screened, but younger people with those risk factors should also get tested,” says Fonseca. The current recommendation calls for testing every three years if results are normal, but those with more risk factors may warrant more frequent testing.

 

Take the next steps

Thankfully, prediabetes is often a completely reversible condition. “Just because your test shows that you have higher glucose levels doesn’t mean that it will definitely progress into diabetes,” says Fonseca.

 

Healthy lifestyle changes — that can benefit everyone, whether affected by prediabetes or not — have been shown to possess a huge impact on diabetes prevention, even among those at high risk for the disease. Here’s what you can do:

 

  • Switch to a diet that’s lower in fat and overall calories, and start getting more physically active. Participants in the Diabetes Prevention Program study (mentioned above) successfully lowered their risks by walking briskly for at least 30 minutes a day, five days a week — thus losing 5 to 7 percent of their body weight.

 

  • Make sure you’re getting enough sleep each night, and if not, make it a priority. “Not getting adequate sleep makes it harder to lose weight by interfering with insulin production,” Fonseca says.

 

  • Talk to your health care provider every three to six months about your risks or even if you would just like more details on living well with prediabetes and preventing type 2 diabetes. 
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sources
  • Fonseca, V., M.D., chief of the Section of Endocrinology at Tulane University Medical Center Tullis-Tulane alumni chair in diabetes and professor of medicine. http://tulane.edu. Interviewed November 2013.
  • American Diabetes Association. “Diabetes Statistics.” Updated August 2013. http://www.diabetes.org. Accessed November 2013.
  • American Diabetes Association. “Prediabetes.” Updated July 2013. http://www.diabetes.org. Accessed November 2013.
  • Centers for Disease Control and Prevention. “Prediabetes.” Updated August 2012. http://www.cdc.gov. Accessed November 2013.
  • National Diabetes Information Clearinghouse (NDIC). “Diabetes Prevention Program (DPP).” Updated September 2013. http://diabetes.niddk.nih.gov. Accessed November 2013.
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