Prediabetes: Early Signs, Testing, and How to Reverse It
Prediabetes means that your blood sugar is higher than normal, but not high enough to be called diabetes. It usually causes no symptoms, so many people live with it for years without knowing. The good news is that it can often be slowed or even reversed with changes you can start now.
This article explains who is more likely to have prediabetes, how it is tested, and which steps help most. For other tests that are worth having at different ages, see Preventive Screenings: What You Actually Need and When.
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Quick Answer
Prediabetes means blood glucose levels are higher than normal but not high enough to be diagnosed as type 2 diabetes, and people with it usually have no symptoms, according to the NIDDK (1). The CDC says that more than 2 in 5 American adults have prediabetes and that 8 in 10 of them do not know it (2). A simple blood test can find it, and weight loss and activity can lower the chance of type 2 diabetes.
Why Most People Do Not Know They Have It
People with insulin resistance and prediabetes usually have no symptoms (1). Insulin resistance means that the body does not respond to insulin as it should. Because nothing hurts and nothing feels different, a blood test is the only way to find out.
Some people have signs that look like those of diabetes, such as more thirst or needing to urinate more often (1). These signs have many other causes, so only a blood test can tell you what is going on. If you cannot explain why you often feel worn out, a blood test can be a useful first step.
Who Is More Likely to Have Prediabetes
The NIDDK lists these factors that raise the risk (1):
- You have overweight, obesity, or a large waist size.
- You are 35 years or older.
- Someone in your family has diabetes.
- You are not physically active.
- You smoke.
- You had gestational diabetes during a pregnancy.
- You belong to an ethnic group with a higher risk, such as African American, Hispanic or Latino, or American Indian.
If you had diabetes during pregnancy, read Gestational Diabetes: Screening, Symptoms, and What Helps. A risk factor does not mean you will get prediabetes, and having none does not rule it out. The CDC offers a one-minute risk test at DoIHavePrediabetes.org (2).
How It Is Tested
Three blood tests can show prediabetes (1):
- An A1C test, which shows your average blood sugar over about 3 months. A result of 5.7% to 6.4% means prediabetes.
- A fasting plasma glucose test. A result of 100 to 125 mg/dL means prediabetes.
- An oral glucose tolerance test, which checks your blood sugar two hours after a sweet drink. A result of 140 to 199 mg/dL means prediabetes.
If your tests show prediabetes, the NIDDK advises that you should be tested for type 2 diabetes every year (1). Your doctor usually confirms a result with a second test, and people with normal results should be retested every 3 years (3). Ask your doctor to include a blood sugar test in your next routine blood work.
What It Can Lead To
People with prediabetes have a high chance of developing type 2 diabetes within 5 to 10 years (1). This is why finding it early matters. At the prediabetes stage, your body can still respond to changes, and many people can return their blood sugar to a healthy range.
What You Can Do
Healthy Eating and Weight
In the large Diabetes Prevention Program study, people who lost 5% to 7% of their starting weight reduced their chance of getting type 2 diabetes (1). For a person who weighs 200 pounds, this means 10 to 14 pounds. Small, steady changes in food are easier to keep than strict diets.
Physical Activity
The NIDDK includes regular physical activity among the healthy habits that help (1). Choose something you enjoy and can do most days, such as walking. If you are new to exercise, start slowly and ask your doctor if you have a heart condition or other health problems.
Sleep and Other Habits
Sleep and weight management are also part of a healthy lifestyle for people with prediabetes (1). If you smoke, quitting also helps lower your risk. For ideas on better rest, see 9 Evening Habits That Help You Sleep Better Naturally.
Programs and Medicine
The CDC lists lifestyle change programs near you at DoIHavePrediabetes.org (2). In some cases a doctor may also prescribe the medicine metformin (1). The follow-up study of the Diabetes Prevention Program found that lifestyle changes or metformin can prevent or delay type 2 diabetes for at least 15 years (1).
When to See a Doctor
Consider speaking with a healthcare professional if:
- You are 35 or older and have never had a blood sugar test.
- You have a family history of diabetes or other risk factors.
- You have excess thirst, frequent urination, or blurred vision.
- You had gestational diabetes in the past.
- You were told you have prediabetes and have not been retested in the last year.
High blood pressure is a separate condition, but it is worth checking at the same visit. For the basics, see High Blood Pressure Explained.
Conclusion
Prediabetes is common, it usually has no symptoms, and a simple blood test can find it. Without changes, the chance of developing type 2 diabetes within 5 to 10 years is high. Losing 5% to 7% of your weight, moving more, and sleeping well can lower that chance, and a doctor can help you make a plan. If you have risk factors and have not been tested, ask for a blood sugar test at your next visit.
