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August 25, 2022

What is Prediabetes?

A diagnosis of prediabetes means that you are at high risk of developing type 2 diabetes later in life. This is when cells in your body do not respond to insulin properly, and so your blood sugar level continuously rises.

Prediabetes describes when your blood sugar levels are higher than normal but not high enough to be diagnosed with type 2diabetes. Increased metabolic disturbance because of worsening hyperglycaemia and insulin resistance can also cause prediabetes.

Although prediabetes is not a term recognised by the World Health Organisation (WHO), the word is sometimes used to refer to people who are at high risk of developing type 2 diabetes.

Blood tests can help check for prediabetes and the risk of type 2 diabetes. The National Institute of Health (NIH)[1] suggests taking the same test twice to confirm a diagnosis.

Not only will prediabetes increase your risk of developing type 2 diabetes, but it will also significantly increase your risk of cardiovascular disease, including heart attacks and strokes.

The good news, however, is that the condition can be treated and reversed.

How is prediabetes medically defined?

There are a variety of tests which can be done to investigate for pre-diabetes. Here in the UK, the most commonly used blood test is the Hba1c level.

HbA1c levels (average blood sugar levels) between 42mmol/mol to 47mmol/mol or 6% and 6.4% - or 42mmol/mol indicate prediabetes.

Other tests include a fasting plasma glucose test and an oral glucose tolerance test.

A fasting plasma glucose (FPG) test includes fasting for eight hours, or overnight, and having a blood test. A blood sugar level of 5.6mmol/L-6.9mmol/L or 100–125 mg/dL indicates prediabetes.

For an oral glucose tolerance test (OGTT), blood is taken once and then again two hours later after drinking a sugary drink. Blood sugar level between 7.8mmol/L and 11.1mmol/L (140–199mg/dL) indicates prediabetes or impaired glucose tolerance (IGT). 

Prediabetes risk factors

Unmodifiable risk factors

Unmodifiable risk factors include carrying extra weight and having a first-degree relative with prediabetes or type 2 diabetes. For women, having diabetes during a pregnancy can also increase your risk of developing prediabetes later in life. Your ethnicity is also a risk factor, with people from South Asia, the Afro-Caribbean and Native America being at an increased risk.

Prediabetes is often found in patients over 40years of age, but it is, unfortunately, becoming more prevalent in younger patients, even among children.

Modifiable risk factors

Certain lifestyle factors can increase our risk of developing prediabetes. These include leading a sedentary lifestyle, smoking, drinking alcohol above the recommended levels for your sex, having a diet which is sub-optimal for our nutritional needs, having poor sleep habits and having constantly raised stress hormones.

Being at moderate or high risk means that you may be eligible for a free NHS Health Check[2] and a free place on the Healthier You: NHS Diabetes Prevention Programme.[3]

What are the symptoms of prediabetes?

Prediabetes has no clear symptoms, but some people can experience acanthosis nigricans, a sign of insulin resistance associated with polycystic ovarian syndrome (PCOS). Symptoms include dark, thick, and velvety patches of skin appearing.

If you have symptoms, such as increased thirst and urination, tiredness, and blurry vision, you have likely already developed type 2 diabetes.

If you have prediabetes, you have not developed type 2 diabetes yet and can make healthy life choices to reduce your risk or avoid it.

Can I reverse prediabetes?

Around 50 per cent of type 2 diabetes cases can be avoided or delayed in some people by adopting a healthier diet, becoming more active, and losing weight. In some circumstances, your doctor may prescribe medication. 

If you are overweight or obese and at high risk of developing type 2 diabetes, losing five per cent of your body weight can drastically reduce your risk. 

Try simply eating healthier and being more active. A dietitian or your GP surgery can also help you with weight management.

Frequently consuming food and drinks that have a high GI (short for glycaemic index), and low fibre content, is linked to an increased risk of type 2 diabetes.

However, eating healthy foods and eating a low carbohydrate, ketogenic, or low calorie diet is associated with prediabetes remission and a decreased risk of type 2 diabetes later in life.

Try to consume more:

  • Fruit and vegetables
  • Whole grains
  • Unflavoured yoghurt and cheese
  • Fish with omega-3 fatty acids

Try consuming less:

  • Sugar-sweetened drinks
  • Refined carbohydrates
  • Sugar

Being sedentary (spending a lot of time sitting down) is associated with a higher risk of type 2 diabetes. Being more active can reduce this risk. Aim for at least 150 minutes of activity per week.

Even making little changes can make a big difference, for example, try taking the stairs instead of the lift or going for a walk on your lunch break.

If you smoke, it is recommended you quit smoking.

To better manage your stress, try practicing meditation, yoga, or deep breathing.

If you do not treat prediabetes and it develops into type 2 diabetes, it can lead to other complications, including heart disease, stroke, eye damage, foot damage – including amputations – and Alzheimer’s disease.

The good news is that you can do something about it.






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