Prediabetes is a term that is used when you are at risk for type 2 diabetes. It means that your blood sugar is higher than it should be. Most people who get type 2 diabetes have prediabetes first. The good news is that lifestyle changes may help you get your blood sugar back to normal and avoid or delay diabetes.
Type 2 diabetes is a lifelong disease that happens when the pancreas can't make enough insulin and/or the body's tissues can't use insulin properly. Insulin is a hormone that helps the body’s cells use sugar (glucose) for energy. It also helps the body store extra sugar in muscle, fat, and liver cells.
Without insulin, the sugar can't get into the cells to do its work. It stays in the blood instead. This can cause high blood sugar levels. A person has diabetes when the blood sugar stays too high too much of the time.
Over time, high blood sugar can cause serious problems with the eyes, heart, blood vessels, nerves, and kidneys. High blood sugar also makes a person more likely to get serious illnesses or infections.
Doctors don't know exactly what causes prediabetes. People who are overweight, aren't physically active, and have a family history of diabetes are more likely to get prediabetes. Women who have had gestational diabetes are also more likely to get prediabetes.
Most people with prediabetes don't have any symptoms. But if you have prediabetes, you need to watch for signs of diabetes, such as:
A blood test can tell if you have prediabetes. You have prediabetes if:
The key to treating prediabetes and preventing type 2 diabetes is getting your blood sugar levels back to a normal range. You can do this by making some lifestyle changes.
Making these changes may help delay or prevent diabetes. You may also avoid or delay some of the serious problems that you can get when you have diabetes, such as heart attack, stroke, and heart, eye, nerve, and kidney disease.
Some doctors may use medicine to control blood sugar in people with prediabetes. If your doctor prescribed medicine to help control your blood sugar, take it as prescribed.
Staying at a healthy weight, eating healthy foods, and getting regular exercise can help prevent prediabetes.
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Learning about prediabetes:
Living with prediabetes:
Prediabetes occurs when your body isn't able to keep your sugar (glucose) at a normal level. Your blood sugar is higher than normal, but it's not high enough to be diabetes.
The food you eat turns into blood sugar, which your body uses for energy. Normally, the pancreas makes insulin, which allows the sugar in blood to get into the body's cells. But when your body can't use insulin the right way, the sugar doesn't move into cells. It stays in your blood instead. This is called insulin resistance.
The buildup of sugar in the blood causes prediabetes. If your blood sugar stays too high for too long, prediabetes can turn into type 2 diabetes.
People who are overweight, aren't physically active, and have a family history of diabetes are more likely to get prediabetes. Women who have had gestational diabetes are also more likely to get prediabetes.
Most of the time, prediabetes has no symptoms. But if you have prediabetes, you need to watch for signs of type 2 diabetes, such as:
Prediabetes is a warning sign that you are at risk for getting type 2 diabetes.
It is estimated that 7 out of 10 people who have prediabetes will get type 2 diabetes.1 Studies have shown that by losing weight and increasing physical activity, people can prevent or delay prediabetes from becoming diabetes.2
Over time, high blood sugar levels increase your risk for diabetes and heart disease, even if you're still healthy. Compared to people with normal blood sugar levels, people with prediabetes have a higher risk of heart attack or stroke.3
When you have prediabetes, you're also at higher risk for eye, nerve, kidney and heart disease, and for stroke. For more information on these complications, see the topic Type 2 Diabetes.
One Man's Story:
When he first found out he had prediabetes, Jerry felt angry and frustrated. His doctor told him to lose weight and get more exercise, or else run the risk of getting type 2 diabetes.
"I thought, 'What's the point? I might still get diabetes.' I felt like I was stuck either way. But it turns out there's a lot you can do."—Jerry
You can reduce your risk for type 2 diabetes and related health problems by making healthy lifestyle changes, such as:
For more information, see Prevention.
Things that can increase your chances of prediabetes are called risk factors. Some risk factors you can control, and others you can't.
Other health problems that put you at risk for prediabetes and type 2 diabetes include:
One Woman's Story:
With a family history of type 2 diabetes, Linda says she should have watched her weight more carefully. She wasn't too surprised by her prediabetes diagnosis. But she got motivated right away to do what she could about it.
"I watched my mom inject herself with insulin every day. Sometimes she needed my help. She had the hardest time keeping her blood sugar down and figuring out what to eat. I don't want to go down that road if I can help it."—Linda
There are some things you can do to reduce your chances of getting prediabetes and diabetes:
When you have prediabetes, it's important to follow your treatment. This can reduce your risk of prediabetes turning into type 2 diabetes.
For more tips about things you can do to reduce your risk, see Prevention.
When you have prediabetes, it's important to watch for symptoms of type 2 diabetes. Call your doctor if you notice that you are:
If you haven't yet been diagnosed with prediabetes, you may want to talk to your doctor about testing. The American Diabetes Association recommends testing for prediabetes, which may lead to type 2 diabetes, if you:3
Blood tests used to identify prediabetes include:
You have prediabetes if:
Phrases such as "a touch of diabetes," "borderline diabetes," and "your sugar is a little high" are unclear. If you hear these phrases, ask your doctor if your blood sugar level is in the prediabetes or diabetes range.
If you are diagnosed with prediabetes, your doctor may also want to:
Your treatment for prediabetes will focus on losing weight, eating right, and getting active. This is your chance to reverse prediabetes so it doesn't turn into type 2 diabetes. Doing these things will also help you avoid other health problems, such as heart disease and stroke, that are linked to diabetes.
You may also need to take diabetes medicine along with doing these things. But research has shown that over the long term, healthy lifestyle changes can work better than medicine at reducing your risk of getting type 2 diabetes.2
Most people who have prediabetes are overweight and have a body mass index (BMI) of 25 or higher. To find out your BMI, use the Interactive Tool: Is Your BMI Increasing Your Health Risks?
If you have a BMI of 25 or higher, losing 5% to 10% of your body weight may help you prevent or delay type 2 diabetes.2 For example, if you weigh 200 pounds, losing 10 to 20 pounds can reduce your risk for type 2 diabetes. It is especially helpful to lose belly fat.
A healthy weight helps your body use insulin the way it should. Losing weight can also lower insulin resistance in people who have prediabetes. The more you lose, the more you benefit, as long as you do it in a healthy way.
How you do it is up to you. One way to start is by making healthy eating changes that you can keep doing over time. Try reducing the number of calories you eat and drink and adding more activity to your day. For help, see the topic Weight Management.
One Man's Story:
Jerry signed up for a weight-loss program and started a daily food diary to track what and when he ate. He added walks around the neighborhood and visits to the gym to his routine. In 7 months, he dropped 25 pounds—about 10% of his body weight.
"It hasn't been easy. I've had some ups and downs, especially over the holidays. Hey, I love to eat. Sometimes it's hard to stay focused. But tracking what, when, and why I eat helps me to eat less."—Jerry
Eating a balanced diet is one of the best things you can do for yourself and for your health. Try to:
For help, see the topic Healthy Eating.
The more active you are, the more sugar (glucose) your body uses for energy. This keeps the sugar from building up in your blood. Exercise can also improve insulin resistance.
Moderate activity is safe for most people, but it's always a good idea to talk to your doctor before you start an exercise program. For more help, see the topic Fitness.
One Woman's Story:
Linda works full-time, has three young children, and has zero time for the gym. So when she learned she had prediabetes, she had to find creative ways to fit activity into her day. For example, after dinner she turns up the stereo and does dance moves while washing dishes, putting food away, and cleaning the kitchen.
"It takes about a half-hour and is a great workout. My kids get a big kick out of it too."—Linda
If you do need medicine, be sure to take it as directed.
Quitting smoking can help you reduce your risk for type 2 diabetes and avoid other health problems that make diabetes worse. Quitting can also reduce your risk of heart attack and stroke. For more information, see the topic Quitting Smoking.
When you have prediabetes, you are more likely to get heart disease than someone with normal blood sugar levels. High cholesterol is also linked to an increased risk for type 2 diabetes.3 So it's important to keep your blood pressure and cholesterol under control.
Your risk for prediabetes is higher if you are overweight and physically inactive. So:
The National Diabetes Education Program's "Small Steps, Big Rewards" program shows ways you can make small changes to your lifestyle that can have a big impact on preventing prediabetes and type 2 diabetes.
These changes include:
For more information, see the National Diabetes Education Program website at www.ndep.nih.gov.
Prediabetes is a warning sign that you are at risk for type 2 diabetes. But you can make the healthy changes needed to prevent it.
Losing weight, getting active, eating better, and quitting smoking are all important changes you can make for your health. But you don't have to do them all at once. Just pick one to start, such as losing weight. It's one of the best things you can do to prevent prediabetes or to stop it from turning into type 2 diabetes. Three steps can help you get started.
1. Know your reason. Before you set a goal, think about why you want to make a change. If your reason comes from you—and not from someone else—it will be easier for you to make a healthy change for good.
Maybe you want to avoid the hassles that come with type 2 diabetes, such as taking insulin or testing blood sugar. Or maybe you are worried about the health problems diabetes brings. You might simply want to enjoy your life and have more energy. Your reason for wanting to change is important.
2. Set long-term and short-term goals. Start by setting a big, or long-term, goal. Maybe you want to lose 10% of your body weight to reduce your risk of type 2 diabetes. If you weigh 200 pounds, that means losing 20 pounds. Break down your big goal into smaller, short-term goals. These are the steps you'll take to reach your big goal.
Do what works best for you. It's important to set goals you can reach. For example:
3. Prepare for slip-ups and barriers. Plan for setbacks. Use a personal action plan(What is a PDF document?) to write down your goals, any possible barriers, and your ideas for getting past them. By thinking about these barriers now, you can plan ahead for how to deal with them if they happen.
Losing 5% to 10% of your body weight may help you prevent or at least delay type 2 diabetes.6 For example, if you weigh 200 pounds, losing 10 to 20 pounds can reduce your risk.
Losing weight can be hard, but you can do it. The easiest way to start is by cutting calories and becoming more active. For help, see the topic Weight Management.
Planning meals to manage prediabetes can often mean looking at food in a new way. There are several easy ways to make healthy changes to the way you eat. One way to start is by eating foods that are low in saturated fat and high in fiber. Or you might try cutting down on foods that are high in calories but low in nutrition, such as soda.
A registered dietitian can help you make a meal plan that fits your lifestyle.
For help, see the topic Healthy Eating.
The more active you are, the more sugar (glucose) your body uses for energy. This keeps the sugar from building up in your blood. Being active also:
Don't worry. You don't have to sign up for a gym membership or train for a marathon to get the activity you need to manage prediabetes. Even everyday activities can help.
Any type of activity helps, including:
Moderate activity is safe for most people, but it's always a good idea to talk to your doctor before you start an exercise program.
For help, see the topic Fitness.
One Man's Story:
"Taking care of yourself can make a huge difference in your health. It's possible that I may still get type 2 diabetes at some point. But I know that even if I do, I'm way ahead in terms of managing it. So don't sit around and wait for it to happen. Get up and move!"—Jerry
Quitting smoking can help you reduce your risk of getting type 2 diabetes and other health problems. Quitting can also reduce your risk of heart attack and stroke. For help, see the topic Quitting Smoking.
When you have prediabetes, you are more likely to get heart disease than someone who has normal blood sugar levels. High cholesterol also increases your risk for type 2 diabetes.3 So it's important to keep your blood pressure and cholesterol under control.
Most people who have prediabetes get better results by making lifestyle changes than by taking diabetes medicine.5 You can make these changes too:
Your doctor may prescribe:
Talk with your doctor to find out if you need medicine in addition to lifestyle changes to lower your insulin resistance.
Avoid products that promise a cure for prediabetes. The best way to treat prediabetes is to:
If you have questions about a diet or product for diabetes, check with your local American Diabetes Association office. Or talk with your doctor or a diabetes educator.
|American Diabetes Association (ADA)|
|1701 North Beauregard Street|
|Alexandria, VA 22311|
The American Diabetes Association (ADA) is a national organization for health professionals and consumers. Almost every state has a local office. ADA sets the standards for the care of people with diabetes. Its focus is on research for the prevention and treatment of all types of diabetes. ADA provides patient and professional education mainly through its publications, which include the monthly magazine Diabetes Forecast, books, brochures, cookbooks and meal planning guides, and pamphlets. ADA also provides information for parents about caring for a child with diabetes.
|Centers for Disease Control and Prevention (CDC)|
|1600 Clifton Road|
|Atlanta, GA 30333|
The Centers for Disease Control and Prevention (CDC) is an agency of the U.S. Department of Health and Human Services. The CDC works with state and local health officials and the public to achieve better health for all people. The CDC creates the expertise, information, and tools that people and communities need to protect their health—by promoting health, preventing disease, injury, and disability, and being prepared for new health threats.
|National Diabetes Education Program (NDEP)|
|1 Diabetes Way|
|Bethesda, MD 20814-9692|
|Phone:||1-800-438-5383 to order materials
The National Diabetes Education Program (NDEP) is sponsored by the U.S. National Institutes of Health (NIH) and the U.S. Centers for Disease Control and Prevention (CDC). The program's goal is to improve the treatment of people who have diabetes, to promote early diagnosis, and to prevent the development of diabetes. Information about the program can be found on two Web sites: one managed by NIH (http://ndep.nih.gov) and the other by CDC (www.cdc.gov/team-ndep).
|National Diabetes Information Clearinghouse (NDIC)|
|1 Information Way|
|Bethesda, MD 20892-3560|
This clearinghouse provides information about research and clinical trials supported by the U.S. National Institutes of Health. This service is provided by the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK), a part of the National Institutes of Health (NIH).
- Nathan DM, et al. (2007). Impaired fasting glucose and impaired glucose tolerance. Diabetes Care, 30(3): 753–759.
- Diabetes Prevention Program Research Group (2009). 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet, 374: 1677–1686.
- American Diabetes Association (2012). Standards of medical care in diabetes—2012. Diabetes Care, 35(Suppl 1): S11–S63.
- American Diabetes Association (2004). Smoking and diabetes. Clinical Practice Recommendations 2004. Diabetes Care, 27(Suppl 1): S74–S75.
- Diabetes Prevention Program Research Group (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine, 346(6): 393–403.
- American Diabetes Association (2004). Prevention or delay of type 2 diabetes. Clinical Practice Recommendations 2004. Diabetes Care, 27(Suppl 1): S47–S50.
Other Works Consulted
- Buse JB, et al. (2008). Type 2 diabetes mellitus. In PR Larsen et al., eds., Williams Textbook of Endocrinology, 11th ed., pp. 1329–1381. Philadelphia: Saunders Elsevier.
- McCall AL, Saunders JT (2009). Metabolic disorders. In RE Rakel, ET Bope, eds., Conn's Current Therapy, pp. 575–583. Philadelphia: Saunders Elsevier.
- National Diabetes Education Program (2006). Small steps, big rewards: Your game plan for preventing type 2 diabetes. Available online: http://ndep.nih.gov.
- Norris SL, et al. (2005). Long-term non-pharmacological weight loss interventions for adults with prediabetes. Cochrane Database of Systematic Reviews. Oxford: Update Software.
- Rao SS, et al. (2004). Impaired glucose tolerance and impaired fasting glucose. American Family Physician, 69(8): 1961–1968.
- Riddle MC, Genuth S (2010). Type 2 diabetes mellitus. In EG Nabel, ed., ACP Medicine, section 9, chap. 2. Hamilton, ON: BC Decker.
|Primary Medical Reviewer||E. Gregory Thompson, MD - Internal Medicine|
|Specialist Medical Reviewer||David C.W. Lau, MD, PhD, FRCPC - Endocrinology|
|Last Revised||July 15, 2010|
Last Revised: July 15, 2010
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