Prediabetes and Diabetes Risk

Prediabetes is a common health condition where blood sugar levels start to rise even before you get Type 2 diabetes. This is prediabetes. Unlike diabetes itself, prediabetes often develops silently, with most people with prediabetes do not experience symptoms. Because of this, many individuals are unaware they have the condition until it is detected through a blood test. This silent progression makes routine screening particularly important for people with risk factors.

About 1 in 3 adults in the United States has prediabetes. Even more concerning, about 98 million people in the U.S. have prediabetes, but more than 80% don't know that they have it. However, there's encouraging news: prediabetes can often be turned around with lifestyle changes. When caught early, many people can prevent or delay the progression to type 2 diabetes through targeted interventions.

The main cause of prediabetes is insulin resistance. Insulin resistance happens when cells in your muscles, fat and liver don't respond as they should to insulin. This means that the hormone insulin, which normally helps move glucose from the bloodstream into cells for energy, becomes less effective over time.

Several interconnected factors can increase the likelihood of developing insulin resistance and prediabetes. "Body weight, diet and physical activity all play important roles," Zilbermint explains. "Genetics can also contribute, since people with prediabetes often have close family members with type 2 diabetes." Other significant risk factors include having overweight, obesity, or a large waist size. being age 35 or older. Children and teens can also develop insulin resistance and prediabetes, but the risk goes up as a person gets older. Certain medical conditions like polycystic ovary syndrome (PCOS), Cushing's syndrome, acromegaly, sleep apnea, or viral diseases like COVID-19 may also contribute to insulin resistance and prediabetes development.

Get an A1C test if you're over age 45. A1C testing is also recommended if you're younger, have overweight, and any other risk factor for prediabetes and type 2 diabetes. Regular screening becomes especially important because you can have prediabetes for years without symptoms. This means you likely won't know you have prediabetes until serious health problems show up.

Consider getting tested if multiple risk factors apply, such as having a family history of diabetes, being physically inactive, or belonging to certain ethnic groups that face higher risk. African American, Hispanic/Latino, American Indian, Alaska Native, Pacific Islander, and some Asian American people are at higher risk. Healthcare providers may also recommend testing for people with a history of gestational diabetes or those taking certain medications that can affect blood sugar levels. Early detection allows for timely intervention before prediabetes progresses to type 2 diabetes.

You have prediabetes if your A1C results are between 5.7% to 6.4%. For fasting glucose tests, you have prediabetes if your FPG results are between 100 to 125 mg/dL (milligrams per deciliter). These ranges indicate that blood sugar levels are elevated above normal but haven't yet reached the threshold for a diabetes diagnosis. It's important to understand that prediabetes results are not a guarantee of future diabetes, but rather a warning sign that intervention may be beneficial.

A normal A1C is below 5.7%, while diabetes is diagnosed at 6.5% or higher. If test results fall into the prediabetes range, healthcare providers often recommend repeat testing to confirm the diagnosis. Because of these differences in test results, health care professionals repeat tests before making a diagnosis. People with differing test results may be in an early stage of the disease, when blood glucose levels have not risen high enough to show up on every test. Understanding these results helps guide decisions about lifestyle changes and monitoring frequency.

Research shows that lifestyle modifications can be remarkably effective in managing prediabetes. For some people with prediabetes, early treatment can actually return blood glucose levels to the normal range. Research shows that you can lower your risk for type 2 diabetes by 58% by: Losing 7% of your body weight (or 15 pounds if you weigh 200 pounds) Exercising moderately (such as brisk walking) 30 minutes a day, five days a week The encouraging news is that losing even 10 to 15 pounds can make a huge difference.

Beyond weight management and exercise, dietary changes play a crucial role. Focus on reducing processed foods and added sugars while increasing whole grains, lean proteins, and vegetables. Regular stress has been associated with higher blood sugar levels. Not getting enough sleep can increase your risk of type 2 diabetes. It may also lead to weight gain — a risk factor for both prediabetes and diabetes — and make it harder to shed pounds. Managing stress through relaxation techniques and prioritizing 7-9 hours of quality sleep can support healthy blood sugar levels alongside diet and exercise improvements.