Prediabetes Causes, Symptoms, and Treatments

Prediabetes is a health issue that can lead to diabetes. It's a diagnosis no one wants.

But the good news is that catching it early can help you reverse it and prevent diabetes. If you or a loved one has prediabetes or are at risk, it's time to take action. With the help of UPMC's care team, you can stop prediabetes in its tracks.

On this page:

• Prediabetes causes.
• Prediabetes symptoms.
• Prediabetes diagnosis.
• Prediabetes treatment.

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What Is Prediabetes?

Prediabetes is a warning sign that your body isn't metabolizing sugar (glucose) correctly.

Prediabetes glucose levels are higher than normal but not as high as those for someone with diabetes. They approach the borderline diabetic range. Prediabetes increases your risk of type 2 diabetes, heart attack, or stroke. One in three adults in the U.S. has prediabetes.

More than 80% of those with prediabetes don't know they have it. Without treatment, it will likely become type 2 diabetes within five years.

What causes prediabetes?

Prediabetes forms when your pancreas doesn't make enough insulin or your cells become resistant to insulin (or sometimes both).

Insulin's job is to get sugar from your blood into your cells. Too much sugar stays in your bloodstream when insulin doesn't work well.

What are prediabetes risk factors and complications?

Prediabetes risk factors

The risk factors for prediabetes include:

• Age. Although you can get diabetes at any age, the risk of prediabetes increases after age 45.
• Family history of type 2 diabetes. Prediabetes and type 2 diabetes often run in families due to genes or lifestyle.
• Race. African-Americans, Hispanics, Native Americans, Asian Americans, and Pacific Islanders have a higher risk of prediabetes and type 2 diabetes.
• Having polycystic ovary syndrome. This common condition increases women's risk of prediabetes.
• A history of gestational diabetes. If your baby weighed more than nine pounds at birth or had gestational diabetes while pregnant, you're at increased risk.
• Overweight. The more fatty tissue you have, the more resistant your cells become to insulin.
• A large waist size. The risk increases for men with waists larger than 40 inches and women with waists larger than 35 inches.
• Diet. Consuming many sugar-sweetened drinks, sweets and desserts, packaged snack foods, and fast foods causes weight gain, increasing your risk.
• Sedentary lifestyle. Sitting too much can also cause weight gain and muscle loss. This makes your cells less sensitive to insulin.
• Poor sleep. Disrupted sleep, as with sleep apnea or shift work, increases the risk of insulin resistance.

Complications of prediabetes

Left undiagnosed or unmanaged, prediabetes increases your risk of getting diabetes, a serious chronic health condition that can lead to:

• Blindness or vision problems.
• Heart attack.
• Kidney failure.
• Loss of your toes, feet, or legs.
• Stroke.

Diabetes is also the eighth leading cause of death in the U.S.

How can I reduce my risks of prediabetes?

Anyone at risk for prediabetes should make diet and lifestyle changes to reduce risk.

Effective strategies include:

• Eat a healthy diet.
• Get regular physical activity.
• Maintain a healthy weight.

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Prediabetes Symptoms and Diagnosis

What are the signs and symptoms of prediabetes?

Prediabetes rarely causes symptoms, which is why so many people don't know they have it.

If it progresses to diabetes, your symptoms might include:

• Blurred vision.
• Fatigue.
• Frequent urination.
• Increased hunger.
• Increased thirst.
• Unexplained weight loss.

If you have these symptoms, tell your doctor so they can check your blood sugar. Alert them if you have a family history of diabetes so they can assess your risk and screen you.

Adults should start diabetes screenings at age 35. If you're overweight or have other risk factors, your doctors may suggest earlier screening.

How do you diagnose prediabetes?

The only way to diagnose prediabetes is with a blood test. There are two tests to diagnose prediabetes. Your doctor might order one or both.

The A1C test measures your average blood sugar level for two to three months.

• An A1C of 5.7% or less is normal.
• A prediabetes A1C between 5.7 and 6.4%.
• An A1C of 6.5% or higher on two separate tests means type 2 diabetes.

A fasting blood sugar test also detects prediabetes.

The ranges for this test are:

• Below 100 mg/dL = normal.
• 100 to 125 mg/dL = prediabetes.
• 126 mg/dL or higher = type 2 diabetes.

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How Do You Treat Prediabetes?

Prediabetes treatments focus on diet and lifestyle changes. Depending on your health and risk factors, your doctor may also suggest medicines or weight loss surgery.

At UPMC, we have a team-based approach to prediabetes education and care. We aim to provide tailored treatment for prediabetes with the support and tools you need to stay healthy.

Our team includes:

• Exercise therapists.
• Family practice and internal medicine doctors.
• Mental health specialists.
• Nurses.
• Registered dietitians.
• Certified diabetes care and education specialists.

Lifestyle changes to treat prediabetes

Long-term lifestyle changes can help you lose weight and keep it off.

You may reverse prediabetes by losing 5 to 7% of your starting weight with these techniques:

• Eat a healthy diet most of the time. Eat smaller portions to reduce the calories you eat each day and help you lose weight. Add more fruits and veggies to meals and snacks. And drink water instead of sweetened beverages.
• Eat healthy, high-fiber carbohydrates. These include fruits, vegetables, whole grains, beans, nuts, and seeds. Cut back on foods made with white flour or added sugar.
• Get at least 30 minutes of physical activity five days a week. If you have not been active, ask your doctor which activities are best. Start slowly to build up over time.
• Optimize sleep. Aim for eight hours of restful sleep each night. Going to bed and waking at the same time each day can help you sleep better.

Medicine to treat prediabetes

Most people don't need medicines for prediabetes.

But based on your health history and risk factors, your doctor may suggest:

• Pills to help your insulin work better so your liver makes less glucose.
• Shots to help your insulin work better and promote weight loss.

Weight loss surgery for prediabetes

Weight loss or bariatric surgery may reverse prediabetes if you are extremely overweight.

This surgery is effective for people who can't lose weight and keep it off with diet and lifestyle.