Prediabetes: What Is It and Why Should You Care?
When I was a child, my mom worked full-time. So, many of my young memories involve sitting in the backseat of my grandparents car. I’d strain my neck upwards to marvel at the skyscrapers as my grandmother navigated us to the “foot doctor” or whatever doctor appointment my grandfather had that day.
As a child I didn’t understand everything that was happening. I liked spending time with my grandparents, but these trips didn’t seem too enjoyable to them.
Today, as I step into these memories, I can see the worry on my grandfather’s face. I now realize the uncertainty and stress that was belayed upon his heart.
But at the time I knew very little. My grandfather would give himself shots before and after meals. I knew that he had foot problems. And, I also knew that he had heart problems, because I remember waiting in a hospital with concerned family as he had “open heart surgery” one rainy Seattle night. I didn’t know much, but I knew that sounded serious.
Learning the Word Diabetes
Through the years, I became familiar with the word diabetes. My grandfather had type-2-diabetes. My uncle was diagnosed years later. As I became a teen and then an adult I became more and more familiar with the diagnosis. It seemed, diabetes was lurking around every corner.
In 1990, an estimated 2.5% of Americans had diabetes (6.6 million people). By 2010 that number had grown to 6.95% (21.13 million).
It was clear to me. Not only was I at risk of developing diabetes some day, but so were my friends, family, and the rest of society. So, how could we prevent diabetes?
As I’ve studied nutrition and exercise over the last several years, this has been a continued area of interest for me, in particular, prediabetes. Because, if you can detect prediabetes, you can then reduce the risk of developing type 2 diabetes, as well as other diseases.
What is Prediabetes?
Diabetes is all about blood sugar levels. When someone is diagnosed with diabetes, their blood sugar levels are elevated. Similarly, with prediabetes your blood sugar level is higher than normal, but it’s not quite high enough to fall into the range of diabetes.
3 Different Types of Blood Sugar Tests
There are three different blood sugar tests that physicians typically use. An overview of each is below.
Please keep in mind that the following values are provided for educational purposes only. If you have questions or concerns about your health, please consult with your physician.
Fasting Blood Glucose (FBG) Test – Prior to having your blood pulled, your doctor will have you fast for 8 hours. This allows your blood sugar to come down to more normal levels, so the reading is more accurate.
- Normal FBG is less than 100 mg/dL
- Prediabetes FBG is 100-125 mg/dL
- Diabetes FBG is 126 mg/dL or more
A1C Test – A1C is short for Hemoglobin A1C. In your blood, hemoglobin is responsible for transporting oxygen throughout your body. But, with elevated blood sugar over time, sugar molecules can stick to hemoglobin.
So, the A1C test looks at how much sugar is attached to your hemoglobin. And, since hemoglobin has a lifespan of 3 months, this test provides a three month average for your blood sugar levels.
- Normal A1C is below 5.7%
- Prediabetes A1C is 5.7-6.4%
- Diabetes A1C is 6.5% or more
Oral Glucose Tolerance (OGT) Test – The glucose tolerance test is less common than fasting blood glucose or A1C, but is still sometimes used for assessing blood sugar response. For this test you’re given a sweet, sugary liquid to drink. Then your blood sugar is checked two hours after ingesting the liquid to see how your body responded.
- Normal OGT is 140 mg/dL or less
- Prediabetes OGT is 140-199 mg/dL
- Diabetes OGT is 200 mg/dL or more
To understand prediabetes, you first have to understand a little bit about diabetes. First of all, there are two different types of diabetes, and both of them involves a hormone called insulin.
What is Insulin? Insulin is produced in the beta cells of the pancreas. When you eat food your blood sugar rises and your pancrease releases insulin into your blood stream. The insulin allows your liver, muscle, and fat to absorb glucose.
Type 1 Diabetes is an autoimmune disease that causes damage to the beta cells of the pancrease, so little to no insulin can be produced. So, insulin injections are necessary. Type 1 diabetes is typically diagnosed in children and young adults. It is not related to prediabetes.
Type 2 Diabetes progresses differently from type 1 diabetes. With type 2, the pancrease produces insulin, but the body loses sensitivity to it, so blood sugar levels rise. To compensate, the pancrease produces more insulin. Over time, the pancrease cannot produce enough insulin to lower blood sugar levels adequately, and they continue to rise.
Prediabetes refers to the early stages on the road to type 2 diabetes. At this stage the body is likely developing some insulin resistance, which then causes sugar to build up in your blood. If changes are not made, prediabetes is likely to progress to type 2 diabetes.
Why Should You Care About Prediabetes?
Today, there are an estimated 88 million adults in America who have prediabetes. Worst of all, 80% of them don’t even know they have it.
For those who have prediabetes, it’s estimated that 37% will progress to type 2 diabetes in 4 years. Within 10 years it’s estimated that most of them will have type 2 diabetes.
That should be alarming to all of us. The CDC estimates that more than 1 in 3 American adults have prediabetes.
If you don’t know what your A1C or blood glucose numbers are now, it’s a good time to become familiar with them. Compare them to the ranges provided above, and then have a conversation with your doctor.
By preventing or treating prediabetes now, you can help reduce your risk of not only diabetes, but heart disease, cancer and other chronic diseases as well.
Prediabetes Symptoms and Risk Factors
With type 2 diabetes, there are a number of symptoms that can occur, such as diminished sensation in the limbs, and vision problems. However, there typically aren’t any noticeable symptoms for prediabetes because symptoms usually don’t occur until blood sugar levels have risen enough to cause damage.
So, it’s important to pay attention to your blood sugar levels. They will be the main indicator that something’s wrong.
There are however some factors that put you at a higher risk for prediabetes:
- Over 45 years of age
- Being overweight
- Having an immediate family member with type 2 diabetes
- Having a sedentary lifestyle
The Good News About Prediabetes
Now, there is some good news. You can slow or even halt the progression of prediabetes to type 2 diabetes. Through diet, and activity you can boost insulin sensitivity, and help preserve the insulin production of the pancreas. That’s why it’s so important to know about prediabetes, and to be familiar with your risk level.
Even if you don’t fall into the category of prediabetes, the basic recommendations for those with prediabetes are fairly universal for maintaining a healthy lifestyle.
- Maintain a healthy weight.
- Eat a well balanced diet with an emphasis on whole foods, plants, healthy fats, and minimal processed foods.
- Get at least 150 minutes of physical activity per week, or an average of 7000 steps per day.
- Aim for 7-8 hours of sleep per night.
We live at a point in time where we’re fortunate enough to be able to detect prediabetes before it progresses to type 2 diabetes. That means we have more control over our health than our grandparents, and the generations that came before us.
We are more informed than any other generation. But, we still have to take individual action to benefit from that information. So, if you’re concerned about your health or risk for developing diabetes, take action. Get active. Talk to your physician. Schedule an appointment with a dietitian. Learn what you can do today.
As a prediabetes nutritionist, I also work with people one-on-one to make lifestyle changes that help reduce their risk of developing diabetes. You can learn more about my prediabetes counseling here.
For more information on prediabetes, check out the CDC’s National Diabetes Prevention Program.