Blood sugar levels start to rise even before you get type 2 diabetes. Find out what steps you can take to prevent diabetes from developing.
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 at high risk 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 and groin.
Classic signs and symptoms that suggest you've moved from prediabetes to type 2 diabetes include:
See your health care provider if you're concerned about diabetes or if you notice any type 2 diabetes signs or symptoms. Ask your health care provider 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. What is clear is that people with prediabetes don't process sugar (glucose) properly anymore.
Most of the glucose in your body comes from the food you eat. When food is digested, sugar enters your bloodstream. Insulin allows sugar to enter your cells — and lowers the amount of sugar in your blood.
Insulin is produced by a gland located behind the stomach called the pancreas. Your pancreas sends insulin to your blood when you eat. 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. As a result, instead of fueling your cells, sugar builds up in your bloodstream. This can happen because:
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 an increased risk of prediabetes include:
When certain conditions occur with obesity, they are associated with insulin resistance, and can increase your risk for diabetes — and heart disease and stroke. A combination of three or more of these conditions is often called metabolic syndrome:
Prediabetes has been linked with long-term damage, including to your heart, blood vessels and kidneys, even if you haven't progressed to type 2 diabetes. Prediabetes is also linked to unrecognized (silent) heart attacks.
Prediabetes can progress to type 2 diabetes, which can lead to:
Healthy lifestyle choices can help you prevent prediabetes and its progression to type 2 diabetes — even if diabetes runs in your family. These include:
The American Diabetes Association (ADA) recommends that diabetes screening for most adults begin at age 35. The ADA advises diabetes screening before age 35 if you're overweight and have additional risk factors for prediabetes or type 2 diabetes.
If you've had gestational diabetes, your health care provider will likely check your blood sugar levels at least once every three years.
There are several blood tests for prediabetes.
This test indicates your average blood sugar level for the past 2 to 3 months.
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 haven't eaten for at least eight hours or overnight (fast).
Blood sugar values are expressed in milligrams of sugar per deciliter (mg/dL) or millimoles of sugar per liter (mmol/L) of blood. In general:
This test is less commonly used than the others, except during pregnancy. You'll need to fast overnight and then drink a sugary liquid at the primary care provider's office or lab testing site. Blood sugar levels are tested periodically for the next two hours.
If you have prediabetes, your health care provider 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, such as:
The ranges of blood sugar level considered normal, prediabetes and diabetes 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 follow 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 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 health care provider 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 health care provider can help you weigh the pros and cons of specific alternative therapies.
You're likely to start by seeing your primary care provider. He or she may refer you to a specialist 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:
Some basic questions to ask include:
Your health care provider is likely to ask you a number of questions, such as: