Prediabetes FAQ

Prediabetes is the early onset of type 2 diabetes, which is a health condition where the body can’t control blood sugar levels. Whether you’re newly diagnosed or know someone with this prediabetes, we go over the basics and other key facts to help answer your questions about this condition.

What is Prediabetes?

Prediabetes is the early stage of type 2 diabetes, which is a condition where blood sugar (glucose) levels exceed normal or healthy range – which is called hyperglycemia.

What Causes Prediabetes?

Similar to type 2 diabetes, high blood sugar levels is caused by the body not producing enough insulin or early stages of insulin resistance.

Insulin is an important hormone released by the pancreas into the blood and absorbs sugar into the cells. But when there isn’t enough insulin, glucose stays in the blood and over time leads to several disorders and complications.

What are Warning Signs of Prediabetes?

There are no obvious symptoms of this condition so you may have it without knowing . This is why it’s important to talk to your care provider and get screened for prediabetes. Especially if you have risk factors for prediabetes including obesity, family history of or had gestational diabetes. 

What is the Prediabetes Range?

There’s a few ways to test measure blood glucose. One way is to measure Hemoglobin A1C, which reflects the blood sugar average from the last 2-3 months.  Another way is measuring fasting glucose which tests the amount of glucose in the blood at that specific time.  And the glucose tolerance test involves drinking a special sugar solution followed by a blood test to see how much blood sugar increases and decreases over certain times. 

These test results are then compared to normal or average blood sugar levels like the table below based on the American Diabetes Association (ADA) guidelines:

StageHemoglobin A1CFasting Plasma Glucose (FPG)Oral Glucose Tolerance Test
NormalA1C < 5.7%FPG < 100 mg/dl2-hour Plasma Glucose (2hPG) < 140 mg/dl
PrediabetesA1C = 5.7% – 6.4%FPG = 100-125 mg/dl2hPG = 140 -199 mg/dl
DiabetesA1C ≥ 6.5%FPG ≥ 126 mg/dl2hPG ≥ 200 mg/dl
Source: ADA 2021 Standards of Care

What Happens if You’re Prediabetic?

As shown in the table above, prediabetes is diagnosed if your fasting blood glucose is between 100-125 mg/dl or your A1C is 5.7% – 6.4%.

Being diagnosed with this condition means that the beta cells in the pancreas are damaged and not functioning as well. Beta cells are responsible for the pancreas creating, storing and releasing insulin so damage to these cells negatively affects how well sugar is absorbed from the blood.

What Percentage of Prediabetics Develop Diabetes?

According to research, anywhere from 5%-10% of prediabetic people will develop diabetes annually but will vary based on certain populations. And the research also notes that up to 70% of prediabetic people will eventually develop diabetes.

How to Treat Prediabetes?

Lifestyle changes with diet and exercise is often what care providers recommend to treat prediabetes.

Medication may be used to treat prediabetes with Metformin one of the most common medications used. But there’s different opinions on whether it should be used for prediabetes.

Some research does not recommend Metformin for treating this condition because it may not be needed, while others believe it should be used for higher risk individuals.

And insulin treatment is not usually recommended for people with prediabetes.

How to Reverse Prediabetes Naturally?

Fortunately, this condition is fully reversible by lowering glucose through a combination of lifestyle diet and exercise. In fact, research on lifestyle interventions – like diet and exercise – shows they’re actually more effective at reducing the incidence of Type 2 diabetes than Metformin.

walking on a treadmill

With diet, reducing carbohydrate intake is key so stick with eating low-starch vegetables, protein and complex carbs. Exercise also helps lower glucose levels by using glucose for energy and improves insulin sensitivity.

Stress is another big factor of prediabetes and should be kept low. When your stress increases, hormones and chemicals tell your body to release more glucose in the blood, which can cause blood sugar levels to spike!

How Long Does it Take to Reverse Prediabetes?

There is no standard time frame and will depend on the lifestyle changes you make (diet, exercise and stress) and genetics. The more aggressive lifestyle changes you make will help reverse the condition faster, while modest lifestyle changes may mean a longer period. And people with risk factors of diabetes may have to work harder to reverse this condition.

When to Check Blood Sugar for Prediabetics?

Care providers usually don’t regularly checking glucose levels for prediabetes and will screen for Type 2 diabetes once a year. But if you’re making lifestyle change to reverse this condition, then it’s actually good idea to regularly check glucose to see your progress.

There are a lot of simple and inexpensive glucometers, which you’d use two hours after the first bite of a meal. This will give you instant feedback on whether you need to adjust your meals to control blood sugar.

blood glucose test for diabetes

What to eat with prediabetes?

Like with diabetes, the goal is to keep blood sugar levels to normal or healthy range. So this usually means lowering daily carbohydrate intake.

It’s also recommended to avoid highly refined, processed carbs that can often cause blood sugar levels to spike. Instead, try to choose more complex carbs that break down slower and are less likely to spike glucose levels like the examples below.

examples of carbs for diabetes

How Many Carbs a day for Prediabetes?

There is no set amount of carbohydrates allowed for prediabetes because it’s still in the early stages of the condition. This is different than gestational or type 2 diabetes, where you need stricter limits on carb intake because they’re more serious conditions and are much harder to reverse with diet.

But you still want to control your carb intake. A simple way to do this is using the diabetes plate method to portion meals to help minimize glucose spikes.

What is the Best Diet for Prediabetics?

There is good research showing that Mediterranean-style and low carbohydrate can help prevent prediabetes or type 2 diabetes . A large study compared a Mediterranean-style to a low-fat diet and the Mediterranean diet showed a lower relative risk for diabetes.

Another study showed remission of prediabetes to normal glucose tolerance levels with participants on a high-protein diet but only about 30% remission for those on a high-carb diet.

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