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Understanding Prediabetes: Symptoms, Causes, and Treatment Options

Oghenefejiro Okifo | MD

Medically reviewed by Oghenefejiro Okifo | MD, Harvard Medical School | Henry Ford Hospital - Detroit, MI on September 22nd, 2023.

Key Takeaways

  • Blood glucose levels between 100-125 mg/dL (fasting) or A1c of 5.7-6.4% indicate this condition, which affects 96 million American adults—over 1 in 3 people.
  • Most individuals experience no symptoms initially, though some develop acanthosis nigricans (dark, velvety skin patches) around the neck, armpits, or groin areas.
  • Being overweight increases risk 7-fold, while having a parent or sibling with type 2 diabetes doubles your likelihood of developing the condition.
  • Structured lifestyle interventions can prevent progression to type 2 diabetes in 58% of cases—more effective than medication alone (31% reduction with metformin).
  • Three diagnostic tests are used: fasting plasma glucose, 2-hour oral glucose tolerance test, or hemoglobin A1c, with abnormal results requiring confirmation through repeat testing.

Prediabetes, also known as borderline diabetes, is a condition where your blood sugar levels are higher than normal but not high enough to be diagnosed as type 2 diabetes. It is a serious health concern, as it can lead to type 2 diabetes and other complications if left untreated. However, with proper management and lifestyle changes, prediabetes can be reversed or prevented from progressing to diabetes.

Prediabetes Symptoms

Most people with prediabetes do not experience noticeable symptoms. However, some signs may include:

  • Increased thirst

  • Frequent urination

  • Blurred vision

  • Fatigue

  • Darkened skin in certain areas (acanthosis nigricans)

Causes and Risk Factors

Prediabetes is caused by insulin resistance, which occurs when your body doesn't respond properly to the insulin it produces. Several factors can contribute to the development of prediabetes, including:

  • Being overweight or obese

  • Having a family history of diabetes

  • Being physically inactive

  • Having high blood pressure or high cholesterol

  • Being over the age of 45

  • Having a history of gestational diabetes

Certain ethnic and racial groups, such as African Americans, Hispanics, Native Americans, and Asian Americans, are at a higher risk of developing prediabetes and type 2 diabetes.

Understanding Prediabetes: Symptoms, Causes, and Treatment Options

Diagnosing Prediabetes

Prediabetes is diagnosed through blood tests, which may include:

  • Fasting plasma glucose test

  • Oral glucose tolerance test

  • Hemoglobin A1c test

Your doctor will interpret the results and determine if you have prediabetes based on established blood sugar level ranges.

Treatment and Management

The primary treatment for prediabetes is adopting a healthy lifestyle, which includes:

  • Eating a balanced diet rich in fruits, vegetables, whole grains, and lean proteins

  • Engaging in regular physical activity (at least 150 minutes per week)

  • Losing weight if you are overweight or obese

  • Quitting smoking

  • Managing stress

In some cases, your doctor may prescribe medication, such as metformin, to help control your blood sugar levels.

Preventing Prediabetes

Preventing prediabetes involves maintaining a healthy lifestyle, as described above. Regular check-ups with your doctor can help detect prediabetes early, allowing for timely intervention. If you have a family history of diabetes or other risk factors, it's essential to be proactive about your health and discuss your concerns with your healthcare provider.

For more information on prediabetes and diabetes prevention, visit the Centers for Disease Control and Prevention (CDC) and the American Diabetes Association websites.

The Bottom Line

The window for prevention closes as insulin resistance worsens, making early detection and intervention crucial for the millions who don't realize they have elevated blood sugar. Losing 5-10% of body weight through diet and 150 minutes of weekly moderate exercise remains the most powerful intervention. If you're concerned about diabetes risk factors or want to understand your blood sugar levels, Doctronic can provide quick, expert guidance.

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