Prediabetes is a condition when blood glucose, or blood sugar, levels are higher than normal, but not yet high enough to be considered diabetes. It develops when the body begins to have difficulty processing the hormone insulin. Insulin is made by the pancreas and helps transport glucose, which is used to create energy, throughout the body. Insulin regulates sugar levels in the bloodstream to prevent levels from being too high, hyperglycemia, or too low, hypoglycemia. People with prediabetes either do not make enough insulin or their body does not use it to its full capacity, which is known as insulin resistance. Evidence indicates that people with prediabetes can take steps to return their blood sugar levels to a normal range. This can prevent or delay complications that are linked to diabetes.

How Serious is Prediabetes?

If you have prediabetes, then you are at risk for type 2 diabetes and other serious conditions, like heart attack and stroke. Other long-term health problems can result if you do not have good control over your blood sugar levels. Complications related to type 2 diabetes include but are not limited to:

  • Blindness
  • Impotence
  • Kidney disease
  • Nerve damage
  • Limb amputation
  • Cognitive decline
  • Increased risk of infection
  • Joint problems


Diabetes develops slowly, so there may not be any symptoms when people are still in the prediabetes stage. When symptoms are present, though, they include:

  • Being more hungry than normal
  • Losing weight even when eating more
  • Being thirstier than normal
  • Having to use the bathroom more frequently
  • Being more tired than usual

Risk Factors

While it is not completely known why insulin levels become higher than normal, there are some risk factors that many people with prediabetes have in common, most of which are the same risk factors for developing Type 2 diabetes:

  • Being overweight: Those with a body mass index (BMI) of more than 25, have an increased risk of prediabetes, especially if much of the weight is carried in the abdomen.
  • Lack of exercise
  • Poor diet: a high intake of processed meats, fats, sugar-sweetened foods and beverages, and calories
  • Family history of a first-degree relative with type 2 diabetes
  • High blood pressure and/or high cholesterol
  • History of cardiovascular disease
  • History of gestational diabetes or having a baby that weighs over 9 pounds at birth
  • Endocrine disorders including Cushing’s syndrome, hyperthyroidism, polycystic ovary syndrome
  • Belonging to an at-risk ethnic group (African American, Hispanic, Native American, Hispanic American, Asian American, or Pacific Islander)

The American Diabetes Association (ADA) recommends that the following people get screened for diabetes:

  • Adults of any age who are overweight or obese with 1 or more of the risk factors listed above
  • Adults aged 45 or older without any risk factors
  • Overweight children aged 10 years and older who have two of these risk factors:
    • High body mass index (BMI) based on child's weight and height
    • Family history of any type of diabetes, including during pregnancy
    • Signs of insulin resistance or having a condition associated with insulin resistance
    • At-risk ethnic background
  • Screening should be repeated at least every three years if the results are normal, or every year for those people who are at increased risk for future diabetes.

Diagnosis and Treatment

Prediabetes and diabetes can be diagnosed with a simple blood test. During a routine office visit, your doctor can order tests, such as:

  • Fasting plasma glucose test —You will fast for at least 8 hours and have your blood glucose measured before eating. Your results may be read as follows:
    • Normal: 60-99 milligrams per deciliter (mg/dL)
    • Prediabetes: 100-125 mg/dL
    • Diabetes: 126 mg/dL or above
  • Oral glucose tolerance test —You will fast for at least 8 hours and have your blood glucose measured after the fast. Then you will drink a sugary drink and have your blood glucose measured 2 hours later. Results 2 hours after the drink are usually as follows:
    • Normal: below 140 mg/dL
    • Prediabetes: 140-199 mg/dL
    • Diabetes: 200 mg/dL or above
  • Hemoglobin A1c (HbA1c) — A blood test that does not require any fasting. The HbA1c is an indicator of your average blood sugar levels over the previous 2 to 3 months. Your results may be read as follows:
    • Normal: below 5.7%
    • Prediabetes: 5.7%-6.4%
    • Diabetes: 6.5% or above

If your test indicates prediabetes, you should have it repeated for accuracy. If you do have prediabetes, you will need to be retested every year. Fortunately, we know that people with prediabetes can delay or prevent the onset of diabetes with lifestyle changes. Experts recommend that people with prediabetes reduce their weight by 5-7% and engage in modest physical activity for at least 150 minutes each week. In addition to exercising, your doctor may recommend that you make changes to your diet, including eating more fruits and vegetables and whole grain foods. You should also limit your intake of sugar-sweetened drinks. If you already drink alcohol, limit your drinking to moderate amounts of alcohol (2 drinks per day for men and 1 drink per day for women). In some cases, medications commonly used to treat diabetes may be prescribed to prevent people from developing diabetes.

If you have any questions regarding your general health, please reach out to Lisa Roseberry, FNP-C, or one of our expert providers at Appledore Medical Group. You can book your next appointment online, and learn about our network of skilled practitioners.

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American Diabetes Association®: American Diabetes Association