Pre-Diabetes: Are You at Risk?

According to the Centers for Disease Control and Prevention (CDC), more than a third of adults in the U.S. have prediabetes—and the majority of people don’t know it.

This condition is a precursor to diabetes, a serious disease of elevated blood sugar that has related health complications such as vision loss, heart disease, stroke, kidney failure and nerve damage called diabetic neuropathy. Diabetes is managed through a healthy diet, regular physical activity, and the use of pills or insulin to lower blood sugar levels.

“People with prediabetes definitely have an increased risk for diabetes, however, embracing a healthier lifestyle can reduce that risk dramatically,” says BIDMC endocrinologist Jody Dushay, MD. “A diagnosis of prediabetes is a warning sign. It’s a chance for you to make some important changes to prevent more serious health issues.”

What is prediabetes?

Prediabetes is when your blood sugar level is elevated, but not high enough to reach the diagnosis of diabetes.

Who is at risk?

People who have a higher risk of developing prediabetes include overweight adults, age 45 and older, and those under age 45 who are overweight with one or more of the following risk factors:

• Sedentary lifestyle
• Family history of diabetes
• High blood pressure
• History of gestational diabetes (diabetes during pregnancy)
• Asian American, African American, Hispanic American or Native American

If you have any of the above risk factors, you should be tested for prediabetes.

How can you be tested?

“There are a few ways to test for prediabetes – a fasting plasma glucose test, a two-hour oral glucose tolerance test, or a hemoglobin A1C test,” says Dushay.

• Fasting plasma glucose test: this test measures your blood glucose first thing in the morning, before eating. A normal fasting blood glucose level is below 100 mg/DL (the unit measurement for blood sugar level). Prediabetes is diagnosed when the fasting blood sugar is above 100 but below 126 mg/DL. This fasting glucose test should be repeated once more to confirm the diagnosis.
• Oral glucose tolerance test: this test measures your blood glucose first thing in the morning, and again two hours after drinking a sugary liquid. Normal blood glucose two hours after drinking the sugary liquid is below 140 mg/DL. Prediabetes is diagnosed when the two-hour level is above 140 but less than 200 mg/DL.
• Hemoglobin A1C test: this test measures how much sugar is attached to your red blood cells, reported as a percentage. A normal test show less than 5.7%, with prediabetes between 5.7-6.5%.

What lifestyle changes can help decrease the risk of developing diabetes?

Moderate weight loss (5% of body weight) and increased physical activity can help lower your risk of developing diabetes.

“Many large studies show that prediabetes is reversible,” Dushay says. “Lifestyle changes that result in weight loss, including improving your diet and increasing how often you exercise, along with taking any prescription medications recommended your doctor, can help lower your risk.”

The experts in BIDMC’s Division of Endocrinology, Diabetes and Metabolism, together with Joslin Diabetes Center, provide patient-centered care to treat and manage diabetes. Learn more about the BIDMC services and our team.