Prediabetes

What Is Prediabetes?

Prediabetes is a health condition where your blood sugar levels are higher than normal—but not high enough to be diagnosed as type 2 diabetes. It means your body isn’t using insulin properly (a condition called insulin resistance), and without lifestyle changes, it can lead to type 2 diabetes, heart disease, or stroke.

The good news? Prediabetes can be reversed with early intervention.

Who Is Affected?

More than 1 in 3 adults in the U.S. (approximately 96 million people) have prediabetes—and most don’t even know it. It affects people of all ages, but is more common in adults over 45, especially those who are overweight or have other health risk factors.

What Causes Prediabetes?

Prediabetes happens when your body becomes insulin resistant, meaning it doesn’t respond to insulin as it should. This leads to glucose building up in the blood instead of being used for energy.

Risk Factors

Not Controllable

• Age 45 and older
• Family history of type 2 diabetes
• Ethnic background: Higher risk among African American, Hispanic/Latino, Native American, Asian American, and Pacific Islander populations
• History of gestational diabetes or having a baby over 9 lbs
• Polycystic ovary syndrome (PCOS)

Controllable

• Overweight or obesity
• Lack of physical activity
• Poor diet high in sugar and refined carbs
• High blood pressure
• High cholesterol or triglycerides
• Smoking

Who Is Most at Risk?

People with multiple risk factors, especially those with an unhealthy lifestyle and family history of diabetes, are at the highest risk. Even children and teens are now being diagnosed with prediabetes due to increasing obesity rates.

How to Reduce Your Risk

• Lose weight: Even a 5–7% reduction in body weight makes a big difference
• Eat a healthy, balanced diet
• Exercise regularly (at least 150 minutes of moderate activity per week)
• Quit smoking
• Manage blood pressure and cholesterol
• Attend diabetes prevention programs

To better understand your own risk of prediabetes, take the CDC’s Prediabetes Risk Test.  

What Are the Signs and Symptoms?

Most people with prediabetes have no noticeable symptoms, which is why routine screening is important.

Some may experience:

• Increased thirst
• Frequent urination
• Fatigue
• Blurred vision
• Darkened skin on the neck, armpits, elbows, knees, or knuckles (called acanthosis nigricans)

How Is Prediabetes Diagnosed?

Your doctor will recommend routine blood tests if you’re at risk or show early symptoms.

Common Diagnostic Tests

• Fasting Blood Glucose Test: Measures blood sugar after 8 hours of fasting.
• Hemoglobin A1C Test: Shows average blood sugar over the past 2–3 months.
• Oral Glucose Tolerance Test (OGTT): Measures blood sugar before and after drinking a sugary drink.
  
  

Prediabetes thresholds:

• Fasting blood glucose: 100–125 mg/dL
• A1C: 5.7–6.4%
• OGTT: 140–199 mg/dL after 2 hours

How Is Prediabetes Treated?

The primary treatment for prediabetes is lifestyle change—it’s proven to delay or even prevent the onset of type 2 diabetes.

Lifestyle Changes

• Weight loss: A modest 5–10% drop can improve insulin sensitivity
• Nutrition: Focus on whole grains, vegetables, lean protein, and healthy fats
• Physical activity: 30 minutes/day, 5 days/week 
• Quit smoking and limit alcohol 
• Stress management and adequate sleep 
  
  

Devices

• Blood glucose monitors may be recommended for high-risk individuals
• Fitness trackers can support physical activity and weight loss goals
  
  

Medical Treatments

• Some patients may benefit from metformin, especially if they are under 60, obese, or have gestational diabetes history.
  
  

Surgical Options

• Bariatric surgery may be considered for those with severe obesity when lifestyle and medications are not enough.
  
  

Other Support

• Diabetes prevention programs
• Nutrition counseling
• Behavioral health services to support emotional well-being and motivation

When to Seek Care

When to See a Doctor

Schedule a visit if you:

• Have any risk factors
• Are over 45 and haven’t had a blood sugar test
• Notice signs like fatigue, excessive thirst, or frequent urination
  
  

When to Call 911

Call 911 if you experience:

• Sudden confusion or slurred speech
• Loss of consciousness
• Chest pain or shortness of breath
  
  

These are not typical signs of prediabetes, but they could indicate serious complications like stroke or heart issues in people with underlying conditions.

Concerned You May Have Prediabetes?

If you are concerned that you or a loved one may have type 2 diabetes, the best thing to do is speak with your primary care provider about your concerns. They can run lab work to diagnose any issues. Connect to your Riverside primary care provider through Riverside MyChart. If you don’t have a primary care provider, you can find one here.

Additionally, you should work to address lifestyle changes that could reduce your risk of diabetes, such as healthy eating, exercise and quitting smoking.

If You Have Been Diagnosed with Prediabetes

• Commit to lifestyle changes such as changing your diet and exercising more frequently.
• Join a diabetes prevention class through Diabetes Services or a local fitness center.
• Track your progress by monitoring your blood sugar, weight and activity levels.
• See your primary care provider regularly to address any other concerns.