How to prevent pre-diabetes from becoming type 2 diabetes
What Is Pre-diabetes?
Pre-diabetes (sometimes written without the hyphen—prediabetes) is a “pre-diagnosis” of diabetes—you can think of it as a warning sign. It’s when your blood glucose level (blood sugar level) is higher than normal, but it’s not high enough to be considered diabetes.
- you’re hungrier than normal
- you’re losing weight, despite eating more
- you’re thirstier than normal
- you have to go to the bathroom more frequently
- you’re more tired than usual
- Weight: If you’re overweight (have a body mass index—a BMI—of higher than 25), you’re at a high risk for developing pre-diabetes. Especially if you carry a lot of extra weight in your abdomen, you may develop pre-diabetes. The extra fat cells can cause your body to become more insulin resistant.
- Lack of physical activity: This often goes hand-in-hand with being overweight. If you aren’t physically active, you’re more likely to develop pre-diabetes.
- Family history: Pre-diabetes has a hereditary factor. If someone in your close family has (or had) it, you are more likely to develop it.
- Race/ethnicity: Certain ethnic groups are more likely to develop pre-diabetes, including African-Americans, Hispanic Americans, Native Americans, and Asian Americans.
- Age: The older you are, the more at risk you are for developing pre-diabetes. At age 45, your risk starts to rise, and after age 65, your risk increases exponentially.
- Gestational diabetes: If you developed diabetes while you were pregnant, that increases your risk for developing pre-diabetes later on.
- Other health problems: High blood pressure (hypertension) and high cholesterol (the “bad” LDL cholesterol) increase your risk of getting type 2 diabetes.
Polycystic ovary syndrome (PCOS) also raises the risk for pre-diabetes because it’s related to insulin resistance. In PCOS, many cysts form in your ovaries, and one possible cause is insulin resistance. If you have PCOS, that means you may be insulin resistant and therefore at risk for developing pre- diabetes.
- Fasting plasma glucose test (FPG): The fasting plasma glucose test is abbreviated FPG. You can’t eat anything for eight hours leading up to the test, so this test is often done in the morning. The doctor checks your blood glucose level (blood sugar level) after drawing a small blood sample.
If your blood glucose level is between 100 and 125mg/dL, you have pre-diabetes. You may hear the doctor use the phrase “impaired fasting glucose” or IFG, which is another term for pre-diabetes when it’s diagnosed with the fasting plasma glucose test.
If your blood glucose level is above 126mg/DL with the FPG test, you may have diabetes.
- Oral glucose tolerance test (OGTT): This is another test used to diagnose pre-diabetes. The doctor will give you instructions on how to prepare for the test, but you won’t be able to eat anything for eight hours before the test; you’ll be fasting. In that way, the oral glucose tolerance test, abbreviated OGTT, is similar to the fasting plasma glucose test.
On the day of the test, the doctor will test your blood glucose level at the beginning of the appointment; that’s called your fasting blood glucose level. Then, you’ll drink 75g of a very sugary mixture. Two hours later, your blood glucose level will be measured.
If your blood glucose level is between 140 and 199mg/dL two hours after drinking the sugary mixture, you have pre-diabetes. You may hear the doctor use the phrase “impaired glucose tolerance” or IGT, which is another term for pre-diabetes when it’s diagnosed with the OGTT.
If your blood glucose level is above 200mg/DL with the oral glucose tolerance test, you may have diabetes.
- Eat well: A registered dietitian (RD) or certified diabetes educator (CDE) can help you create a meal plan that’s full of good-for-you and good-for-your-blood-glucose-level food. The goal of the meal plan is to control your blood glucose level and keep it in the healthy, normal range. Your meal plan will be made just for you, taking into account your overall health, physical activity, and what you like to eat.
- Exercise: When you exercise, your body uses more glucose, so exercising can lower your blood glucose level. Also when you exercise, your body doesn’t need as much insulin to transport the glucose; your body becomes less insulin resistant. Since your body isn’t using insulin well when you have pre-diabetes, a lower insulin resistance is a very good thing.
And of course, there are all the traditional benefits of exercise: it can help you lose weight, keep your heart healthy, make you sleep better, and even improve your mood.
The American Diabetes Association recommends at least 150 minutes of moderate activity a week—that’s 30 minutes five days a week. You can get that through activities such as walking, bike riding, or swimming.
- Lose weight: If you’re overweight, you should get started on a weight loss program as soon as you’re diagnosed with pre-diabetes. Losing just 5 to 10% of your weight can significantly reduce your risk of developing type 2 diabetes. The combination of eating well and exercising more is a great way to lose weight—and then maintain your new, healthy weight.
- Metformin: For people who are at a very high risk of developing type 2 diabetes after being diagnosed with pre-diabetes, the doctor may recommend a medication. The American Diabetes Association says that metformin should be the only medication used to prevent type 2. It works by keeping the liver from making more glucose when you don’t need it, thereby keeping your blood glucose level in a better range.