Prediabetes

Prediabetes is something of a last shot; a telling and reversible condition that will almost always result in type 2 diabetes if major changes to dietary and lifestyle choices are not made. It is defined by higher than normal blood glucose levels, though still not consistently elevated enough to be clinically recognized as type 2 diabetes.

Though up for debate whether early-stage type 2 diabetes is reversible or merely manageable, prediabetes is generally accepted to be reversible. Studies have consistently shown “dietary and lifestyle intervention,” meaning eating healthier and performing more physical activity, to be effective in preventing or greatly delaying the onset of type 2 diabetes in prediabetics. For those overweight, losing only a small amount of weight (10 to 15 pounds for most adults) can also greatly reduce the risk of prediabetes becoming type 2 diabetes.

A diagnosis of prediabetes often includes a parallel diagnosis of Insulin resistance, which occurs when the cells of the body, specifically the muscle, liver and fat cells, stop responding properly to insulin. This leads to glucose remaining in the bloodstream instead of being absorbed for energy and storage. Over time these elevated blood glucose levels often lead to prediabetes, metabolic syndrome and type 2 diabetes. This is the result of the insulin-producing beta cells in the pancreas becoming overwhelmed by the body’s need for more insulin, itself a result of the diminished insulin sensitivity of the aforementioned muscle, liver and fat cells. Not enough insulin and glucose absorption to maintain glucose homeostasis translates to diabetes, and if not properly managed, serious diabetes complications like cardiovascular disease.

Besides avoiding the numerous complications associated with type 2 diabetes, it is important to note that the elevated blood glucose levels in prediabetes increases the risk of cardiovascular disease(CVD), including heart attack and stroke, even before developing type 2 diabetes. So if for some inexplicable reason preventing type 2 diabetes is not enough incentive on its own to get healthier through improved dietary and physical activity patterns, limiting risk of death from heart attack and stroke should be an additional motivator.

Being diagnosed with prediabetes, which comes via an A1C test or fasting glucose test, should be interpreted as a major wake-up-call. Oftentimes insulin resistance has already taken hold, though remained asymptomatic and undiagnosed, and a prediabetes diagnosis should be an indicator that troubling trends have been going on inside the body for some time. Even more seriously, prediabetes can be a component of metabolic syndrome, which represents a cluster of conditions closely related to type 2 diabetes incidence and cardiovascular mortality risk. It’s generally agreed that the majority of prediabetics become type 2 diabetics within 10 years if major lifestyle changes are not made.

It is estimated that in the United States alone more than 80 million adults have prediabetes, and since in many cases prediabetes does not have evident symptoms, the majority of the time it goes undiagnosed.

Obesity, age, and most other risk factors independently linked to type 2 diabetes, are also major risk factors for prediabetes. Take our screening test and better know your risk. If it is moderate-to-high, even if you are not displaying symptoms related to diabetes, and especially if you are overweight and inactive, have your doctor test you for prediabetes.

Resources and Further Reading

For more about prediabetes: 
https://www.cdc.gov/diabetes/basics/prediabetes.html

A meta-study showing lifestyle intervention to be effective in preventing type 2 diabetes for people with prediabetes: 
https://www.hindawi.com/journals/jdr/2017/8493145/

A solid and standard resource about insulin resistance and prediabetes: 
https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance