Medically Reviewed and Written By: Kathleen O’Shea Northrup, MD
Most of us have some understanding of what it means to have diabetes- medication, blood sugar monitoring, careful food intake- but what about prediabetes? And what do I do if my doctor tells me I have it?
What Does “prediabetic” Mean?
If you have been told that you are “prediabetic” that means you are at risk of developing Type 2 diabetes. To better understand this, it helps to know what diabetes is and the different types that exist. “Diabetes” means that someone cannot process glucose (sugar) in their bloodstream. This can happen for two reasons: either the body cannot produce insulin, or the body can no longer use insulin properly. Insulin is the hormone the pancreas produces to help the body process glucose.
Differences Between Type 1 Diabetes and Type 2 Diabetes
Type 1 diabetes (or Juvenile diabetes) is the condition where your body attacks the pancreas's cells that produce insulin. Eventually, the body can no longer process glucose. People who have Type 1 diabetes rely on shots of insulin to survive.
Type 2 diabetes is when the body becomes resistant to insulin. A person with Type 2 diabetes might still be able to produce insulin, but their body cannot use it as effectively. Type 2 diabetes is the most common type and can vary greatly in severity. Some people with Type 2 might only need to control their diet to manage their diabetes; some might rely on daily medications, and some might need insulin shots.
Are There Other Types of Diabetes?
Gestational diabetes is another type; this happens to some pregnant women because the placenta makes hormones that interfere with how the mother’s body uses insulin. Like Type 2, this can vary in severity and must be managed carefully to help protect the health of the mother and child.
Click here to learn more about Type 1 Diabetes.
Where Does Prediabetes Fit Into All Of This?
If you have been told you have prediabetes, it means that your blood sugar is higher than it should be but not quite high enough to diagnose you with diabetes. This means that you are at high risk of developing Type 2 diabetes at some point in the future. But not everyone diagnosed with prediabetes will develop diabetes…there are actions you can take to prevent or delay this diagnosis.
Diagnosing Prediabetes
There are no symptoms of prediabetes. If your doctor is worried that you might have it, they will likely check the Hemoglobin A1C level in your blood. This number measures your average glucose level over the past three months. A normal number is less than 5.7%. If your number is between 5.7% and 6.4%, you would be considered prediabetic; anything higher than this means you have diabetes. If you have prediabetes or diabetes, your doctor will check this number once or twice yearly to determine how well your blood sugar is controlled.
Who Should Be Tested?
Prediabetes can develop in anyone, regardless of age, race, or family history. However, certain people are at higher risk of developing prediabetes. This includes people with a strong family history of diabetes (maybe your parents were both diabetic, or your brother was just diagnosed) or people who are overweight. Inactive people with high blood pressure and over 45 years of age are also at higher risk, as well as anyone diagnosed with gestational diabetes while pregnant.
The risk also increases in African American, American Indian, Asian American, Hispanic/Latino, or Pacific Islander descent. If you are concerned that you might have prediabetes, discuss checking your Hemoglobin A1C with your doctor. The CDC recommends that anyone with risk factors be tested at least every three years; this means everyone aged 45 and over should get a baseline A1C level and then be checked every three years after that (more often if prediabetic). Take the CDC’s test to determine your risk of having prediabetes: https://www.cdc.gov/prediabetes/risktest/index.html
I Have Prediabetes…Now What?
Now is the time to act. A diagnosis of diabetes is not inevitable- there are things you can do to prevent or delay it. But you must start now! The most important things you can do are to eat a healthy diet, control your weight, and exercise. This does not mean you have to start running marathons and eating only kale. Simple changes can make a huge difference!
Exercising can include anything that increases your activity level. Go for a walk, take up pickleball, swim… Start with even 5 minutes a day and increase your activity level gradually. Aim for 30 minutes of exercise five days per week. Pick something you enjoy, and stick with it! Not only will increasing your activity level help ward off diabetes, it also has many other health benefits.
Losing weight- even just 5-10% of your total body weight- has been shown to decrease your risk of developing diabetes by 50%. If you weigh 200 lbs, losing even 10 pounds will make a difference!
Your food choices also matter. First, cut out sugary beverages. These are a huge source of empty calories. Drink more water- maybe add a squeeze of lemon, or try flavored unsweetened seltzer. Try to focus on adding more vegetables and fiber to your diet. Lentils and beans are filling and loaded with healthy fiber. Eat whole grains like brown rice, oatmeal, and whole wheat bread.
Focus on adding healthy foods to your diet- this will make you less hungry for the unhealthy snacks you are cutting out. Foods high in fiber are typically more filling and less calorie-dense than things like chips and cookies. Before you know it, you will be dropping pounds, and with it, your risk of developing Type 2 diabetes!
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