Prediabetes is a state in which blood sugar is above normal but has not yet reached the diabetes threshold. It is not something to fear but a serious warning – because this stage can be reversed.
What is prediabetes?
When blood sugar is above the normal level but not high enough for a diagnosis of diabetes, the condition is called prediabetes. In everyday language it is also known as “hidden sugar”, a “tendency to diabetes” or a “pre-diabetic state”.
Diabetes does not develop overnight or within a month – it is preceded by a long period of prediabetes. During this time, against the background of insulin resistance, first after-meal and then fasting blood sugar rises. At first the pancreas “hides” the high sugar by releasing extra insulin, but over time it can no longer meet the growing demand, and prediabetes turns into type 2 diabetes.
Even if prediabetes never turns into type 2 diabetes, persistently elevated blood sugar can harm the cardiovascular system and other organs.
What signs may appear?
The key point is that prediabetes often causes no clear complaints: a person may feel completely healthy while changes in blood sugar have already begun. Sometimes, however, the following may be noticed:
- frequent hunger, especially cravings for sweets;
- weight gain, or being unable to lose weight despite diet and exercise;
- daytime sleepiness, weakness, getting tired easily;
- irritability and a tendency towards low mood;
- increased sweating, especially on the head and neck;
- thirst and occasional blurred vision;
- difficulty waking up in the morning.
Who is at risk?
- people whose first-degree relatives (mother, father, sister, brother) have diabetes;
- people with excess weight – a body mass index above 25 kg/m², a waist circumference over 80 cm in women or over 94 cm in men;
- people with high blood pressure, high cholesterol or triglycerides;
- people with a sedentary lifestyle;
- women with polycystic ovary syndrome;
- women who had diabetes during pregnancy or gave birth to a baby weighing more than 4 kg.
How is prediabetes detected?
Prediabetes can only be detected with blood tests. That is why waiting for classic signs of diabetes such as strong thirst or frequent urination is the wrong approach – if you are at risk, talk to your doctor about testing without waiting for symptoms. The following results point to prediabetes:
- fasting blood glucose – 100–125 mg/dl;
- 2-hour glucose in the oral glucose tolerance test (OGTT) – 140–199 mg/dl;
- HbA1c (average blood sugar over the last 3 months) – 5.7–6.4%.
The glucose tolerance test is done as follows: blood sugar is measured after a 10–12-hour fast, then a specially prepared solution of 75 g of glucose is drunk and blood sugar is measured again 2 hours later. In people with fasting sugar of 100–125 mg/dl, this test helps to confirm prediabetes.
Prediabetes is a reversible stage – with the right approach, blood sugar levels can be brought back to normal.
Dr. Samir Shukurov
Can prediabetes be reversed?
Yes. Unlike diabetes, prediabetes is a reversible condition. Detected in time and properly managed, it makes it possible to prevent or delay type 2 diabetes. Treatment does not always mean medication – the main approach is changing your lifestyle:
- controlling your weight and losing excess kilos;
- a low glycaemic index diet;
- regular physical activity;
- managing sleep and stress.
For patients at high risk of diabetes whose weight does not go down despite diet and exercise, the doctor may also prescribe medication. If your test results match prediabetes, see an endocrinologist – an individual plan will help reduce your risk of diabetes in the future.
After prediabetes is found, it is important to keep checking your blood sugar at the intervals your doctor recommends – this lets you see the results of the changes and act in time.
This article is for general information only and does not replace a medical examination.