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7 Things You Might Not Know About Prediabetes

What You Should Know About Prediabetes

What is Prediabetes?

Woman doing injection

If you have prediabetes, your blood sugar levels are high, but not high enough to be classified as type 2 diabetes…yet. Without intervention, prediabetes is likely to become type 2 diabetes in 10 years or less.

What is Insulin Resistance?

If you have insulin resistance, the cells in your body don’t respond well to the production of insulin, the hormone responsible for regulating blood sugar. Over time, unchecked insulin resistance can lead to the development of prediabetes and type 2 diabetes.

You’re probably familiar with the symptoms of type 2 diabetes: increased thirst, fatigue, a frequent need to urinate—and of course, elevated blood sugar. But are you aware that prediabetes, which is considered the precursor to type 2, often goes unnoticed? Here are seven little-known facts about this common condition.

By Jessica Leigh Brown

There are typically no symptoms.

While some patients with prediabetes experience dark patches of skin on the neck, knuckles, knees, or armpits, most have no warning signs. The only way to tell if you’ve developed prediabetes is to have a blood glucose screening at your doctor’s office.

“Usually, by the time you have symptoms, you’ve already lost around 80% of your pancreatic function,” says Dr. Carl Lancaster, diabetologist and internist with Hamilton Physician Group.

Instead of focusing on how you feel, it’s far better to focus on risk factors. If any of the following apply to you, it might be time to check up on your numbers:

•  You’re over 45. Aging increases your risk of developing prediabetes or type 2 diabetes.
•  You’re overweight or obese. Nearly 90% of people living with type 2 diabetes are overweight.
•  You have a family history of type 2 diabetes. Type 2 diabetes often runs in families. If your mother, father, or sibling has the disease, you’re at increased risk.
•  You’re of a certain race/ethnic background. Certain people are more likely to develop prediabetes and type 2 diabetes. For example, Native Americans, Hispanics, African-Americans, and Asian-Americans are all at increased risk.
•  You’re physically active less than three times per week. A lack of regular physical activity tends to increase insulin resistance and risk of prediabetes. “The increase in prediabetes and diabetes over the last 20 years parallels the increase in sedentary lifestyles,” says Dr. Lancaster. “You can even chart it against the rise of computers.”

Dr. Ramya Embar, Endocrinologist, Erlanger Health System, Department of Medicine, Division of Endocrinology UT College of Medicine Chattanooga
Dr. Ramya Embar, Endocrinologist, Erlanger Health System, Department of Medicine, Division of Endocrinology UT College of Medicine Chattanooga

Most people at high risk aren’t identified or treated.

An estimated 90% of those with prediabetes don’t know it, despite the fact that the American Diabetes Association recommends all adults over age 45 should be screened for diabetes annually. If you think you may be at risk, ask your doctor to check your blood glucose levels at your next appointment.

Screening begins with a fasting blood glucose test, which is usually measured in the morning after an overnight fast. If your glucose levels indicate you have prediabetes, your doctor may also run a Hemoglobin A1c test. “These tests are critical, as they can identify prediabetes right away,” says Dr. Ramya Embar, endocrinologist at Erlanger Health System and the UT College of Medicine Chattanooga. “If you aren’t getting these at your annual exam, ask! Everyone should get these through their primary care physician.”

Prediabetes increases the risk of stroke or heart disease.

Prediabetes and type 2 diabetes are associated with a group of cardiovascular risk factors, including elevated LDL cholesterol, low HDL cholesterol, high blood pressure, and obesity. Because of these factors, people with prediabetes are far more likely to experience heart and blood vessel diseases, including heart disease and stroke. High blood glucose levels can also damage nerves and blood vessels, sometimes leading to blindness, kidney damage, and neuropathy.


Sleep deprivation can increase your risk of prediabetes.

If you have trouble getting enough rest at night, you could be at an increased risk for prediabetes. Studies show that untreated sleep problems, particularly obstructive sleep apnea (OSA), can increase the likelihood of developing insulin resistance. Sleep apnea involves an interruption of breathing during the night, causing the patient to fall in and out of deeper and lighter sleep. Typically, OSA results in daytime exhaustion, tension, and irritability. Struggling to breathe during the night can release stress hormones in the body, causing elevated blood glucose levels.

According to Dr. Embar, both quality and quantity of sleep play an important role. “A recent study showed lack of sleep or bad sleeping habits can actually increase your risk of diabetes two-fold,” she says.


Losing as little as 10 pounds can significantly decrease your risk.

Diabetes healthy diet concept, raw vegetables and fruits with blood glucose meter and insulin syringe

If you have prediabetes, losing just 5 to 10% of your body weight could keep you from developing type 2 diabetes, according to the Centers for Disease Control (CDC). So if you weigh 200 pounds, that means you only need to lose 10 pounds to start seeing results. 

“You don’t always have to make a total life transformation,” says Dr. Embar. “Even simple changes like cutting out soda, parking father away, and taking the stairs can help you reach your goal.”

pd-3Going for a walk five days a week can significantly decrease your risk.

If you lack muscle mass and live a sedentary lifestyle, you’re at risk for prediabetes even if you’re not overweight. People with decreased muscle mass generally have a slower metabolism and need more insulin because they burn less fat while resting.

Regular exercise enhances your body’s response to insulin by forcing your muscles to use the glucose in your bloodstream for fuel. This, in turn, can lower your body’s resistance to insulin by making your cells work harder to use up the available glucose.

To see results, your workout program doesn’t have to be anything dramatic. Something as simple as walking briskly for 30 minutes five days a week can significantly lower your risk.

Dr. Carl Lancaster, Diabetologist and Internist, Hamilton Physician Group
Dr. Carl Lancaster, Diabetologist and Internist, Hamilton Physician Group

Type 2 diabetes isn’t inevitable.

While the term “prediabetes” implies the later onset of the full-blown version, type 2 diabetes doesn’t have to be the inevitable outcome. It’s never too late to make lifestyle changes that could prevent or manage diabetes. In fact, people who make changes to their diet and exercise habits can decrease the development of type 2 diabetes by 58% in as little as three years, according to the landmark Diabetes Prevention Program Outcomes Study,

Initiating a change starts with finding your motivation. “I like to ask my patients, ‘what are your goals, and what would you like to see for yourself health-wise?’” says Dr. Lancaster. “The answer varies tremendously depending on the person. Some people are motivated to simply feel better, while others are motivated to do it for their family or friends.”

The most important thing you can do is address your prediabetes before you progress to the point of needing medication. “We can spend thousands of dollars on medication, but if we don’t get to the root of the issue and change our diet and exercise habits, we won’t have any lasting change,” says Dr. Embar. “You don’t want medicine to simply to act as a mask to your lifestyle.”



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