Prediabetes means that your blood sugar level is higher than normal, but it's not yet high enough to be classified as type 2 diabetes. Still, without intervention, prediabetes is likely to become type 2 diabetes in 10 years or less. And, if you have prediabetes, the long-term damage of diabetes — especially to your heart and circulatory system — may already be starting.
There's good news, however. Prediabetes can be an opportunity for you to improve your health, because progression from prediabetes to type 2 diabetes isn't inevitable. With healthy lifestyle changes — such as eating healthy foods, including physical activity in your daily routine and maintaining a healthy weight — you may be able to bring your blood sugar level back to normal.
Often, prediabetes has no signs or symptoms.
Darkened areas of skin, a condition called acanthosis nigricans, is one of the few signs suggesting you are at risk for diabetes. Common areas that may be affected include the neck, armpits, elbows, knees and knuckles.
Classic red flags of type 2 diabetes to watch for include:
When to see a doctor
Ask your doctor about blood glucose screening if you have any risk factors for prediabetes, such as:
The exact cause of prediabetes is unknown, although researchers have discovered some genes that are related to insulin resistance. Excess fat — especially abdominal fat — and inactivity also seem to be important factors in the development of prediabetes.
What is clear is that people who have prediabetes aren't quite processing sugar (glucose) properly anymore. This causes sugar to build up in the bloodstream instead of doing its normal job of fueling the cells that make up muscles and other tissues.
Most of the glucose in your body comes from the foods you eat, specifically foods that contain carbohydrates. Any food that contains carbohydrates can affect your blood sugar levels, not just sweet foods.
During digestion, sugar enters your bloodstream and with the help of insulin is then absorbed into the body's cells to give them energy.
Insulin is a hormone that comes from the pancreas, a gland located just behind the stomach. When you eat, your pancreas secretes insulin into your bloodstream. As insulin circulates, it acts like a key that unlocks microscopic doors that allow sugar to enter your cells. Insulin lowers the amount of sugar in your bloodstream. As your blood sugar level drops, so does the secretion of insulin from your pancreas.
When you have prediabetes, this process begins to work improperly. Instead of fueling your cells, sugar builds up in your bloodstream. This occurs when your pancreas doesn't make enough insulin or your cells become resistant to the action of insulin or both.
The same factors that increase the risk of developing type 2 diabetes increase the risk of developing prediabetes, including:
Other conditions associated with diabetes include:
When these conditions — high blood pressure, high blood sugar, and abnormal blood fats and cholesterol — occur together along with obesity, they are associated with resistance to insulin. This is often referred to as metabolic syndrome.
Progression into type 2 diabetes is the most serious consequence of untreated prediabetes.
Type 2 diabetes complications include:
Preparing for your appointment
You're likely to start by seeing your family doctor or a general practitioner. However, you may then be referred to a doctor who specializes in diabetes treatment (endocrinologist).
Here's some information to help you get ready for your appointment and know what to expect from your doctor.
What you can do
Preparing a list of questions can help you make the most of your time with your doctor. For prediabetes, some basic questions to ask your doctor include:
Don't hesitate to ask any other questions that occur to you. Be sure you understand your doctor's recommendations.
What to expect from your doctor
Tests and diagnosis
Who should be tested
Tests used to diagnose prediabetes
Following are other tests that your doctor may use to diagnose prediabetes:
If your blood sugar level is normal, your doctor may recommend a screening test every three years. If you have prediabetes, further testing may be needed. For example, your doctor should check your fasting blood sugar, A1C, total cholesterol, HDL cholesterol, low-density lipoprotein (LDL) cholesterol and triglycerides at least once a year, possibly more frequently if you have additional risk factors for diabetes. Your doctor may also recommend an annual microalbuminuria test, which checks for protein in your urine — an early sign of damage to the kidneys.
Treatments and drugs
If you have prediabetes, 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. Guidelines from the American College of Endocrinology suggest the following to treat prediabetes:
In other cases, medications to control cholesterol — statins, in particular — and medications to control high blood pressure are needed. Healthy lifestyle choices remain essential, however.
Because the findings from several recent studies suggest that regularly getting a good night of sleep may reduce insulin resistance, try to get at least six hours or more of sleep each night.
Many alternative therapies — including cassia cinnamon, chromium, ginseng, glucomannan, guar gum, gymnema, magnesium, milk thistle, prickly pear cactus, soy and stevia — have been touted as possible ways to treat or prevent type 2 diabetes. Although some of these substances have shown promise in early trials, there's no definitive evidence that any of these alternative therapies are effective.
If you're considering dietary supplements or other alternative therapies to treat or prevent prediabetes, consult your doctor. He or she can help you weigh the pros and cons of specific alternative therapies.
Healthy lifestyle choices can help you prevent prediabetes and its progression to type 2 diabetes — even if diabetes runs in your family.
The same lifestyle changes that can treat or even reverse prediabetes help prevent the condition, too.
Last Updated: 2012-01-26
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