Prediabetes
Prediabetes is a condition in which individuals have blood glucose levels higher than normal but not high enough to be classified as diabetes. People with prediabetes have an increased risk of developing type 2 diabetes, heart disease, and stroke. There are 79 million people in the U.S. who have prediabetes. Studies show that many people with prediabetes develop Type 2 diabetes in 10 years.
Progression to diabetes among those with prediabetes is not inevitable. Studies have shown that people with prediabetes who lose weight and increase their physical activity can prevent or delay diabetes and return their blood glucose levels to normal. The Diabetes Prevention Program, a large prevention study of people at risk for diabetes, showed that lifestyle intervention reduced developing diabetes by 58% during a 3-year period. The reduction was even greater, 71%, among adults aged 60 years or older. Interventions to prevent or delay type 2 diabetes in individuals with prediabetes can be feasible and cost-effective.
Risk Factors for Prediabetes
Risk factors include:
- Family history of diabetes
- Being overweight or obese
- African American, American Indian, Asain American, Pacific Islander, or Hispanic heritage
- Prior history of gestational diabetes or delivered a baby weighing more than 9 pounds.
- High blood pressure (140/90 mm Hg or higher)
- Abnormal cholesterol with HDL ("good") cholesterol is 35 or less or triglyceride level is 250 or higher
- Physical inactivity (exercising less than 3 times a week for at least 30 minutes)
How to Tell if You Have Prediabetes
There are three different tests your doctor can use to determine whether you have prediabetes:
- The A1c test - This is a test that gives an estimate of what your blood sugar levels have averaged during the past three months. An A1c below 5.7% is normal, an A1c level from 5.7 - 6.4% is indicative of Prediabetes, and an A1c greater than 6.5 is diagnostic of Diabetes.
- The fasting plasma glucose test (FPG) - Normal fasting blood glucose is below 100 mg/dl. A person with prediabetes has a fasting blood glucose level between 100 and 125 mg/dl. If the blood glucose level rises to 125 mg/dl or above, a person has diabetes.
- The oral glucose tolerance test (OGTT) - In the OGTT, a person's blood glucose is measured after a fast and 2 hours after drinking a glucose-rich beverage. Normal blood glucose is below 140 mg/dl two hours after the drink. In prediabetes, the 2-hour blood glucose is 140 - 199 mg/dl. If the 2-hour blood glucose rises to 200 mg/dl or above, a person has diabetes.
Why do I Need to Know if I Have Prediabetes?
If you have prediabetes, you can and should do something about it. Studies have shown that people with prediabetes can prevent or delay the development of Type 2 diabetes by up to 58% through changes to their lifestyle that include modest weight loss and regular exercise. The national Diabetes Prevention Program, a major federally funded study of over 3,300 people at high risk for diabtes, showed that people can delay and possibly prevent the disease by losing a small amount of weight (5-7% of total body weight) through 30 minutes of physical activity 5 days a week, along with healthier eating. For some people with prediabetes, intervening early can actually turn back the clock and return elevated blood glucose levels to the normal range.
Who Should Get Tested for Prediabetes?
If you are overweight and age 45 or older, you should be checked for prediabetes during your next routine medical office visit. If your weight is normal and your're over age 45, you shold ask your doctor during a routine office visit if testing is appropriate. For adults younger than 45 and overweight, your doctor may recommend testing if you have other risk factors for diabetes or prediabetes. If your blood glucose levels are in the normal range, it is reasonable to be checked every 3 years. If you have prediabetes, you should be checked for Type 2 diabetes every year after your diagnosis.
Prediabetes Education Materials
The National Diabetes Education Program has designed a national awareness campaign to target preople at risk for Type 2 diabetes called Small Steps. Big Rewards. Prevent Type 2 Diabetes. The SD Diabetes Coalition has included these tools from the National Diabetes Education Program on this website along with a DVD that further describes prediabetes and the treatment for it. Please take a little time to view the DVD and download the diabetes prevention materials.