Prediabetes: What it is — and how to help reverse it

Read time: 5 minutes

If you’ve recently learned you have prediabetes, you’ve got company. Estimates range from 84 million to 98 million people in the U.S. have prediabetes. That’s one in three adults under age 65 and half of people over 65. And 80% of them don’t know it.

That’s the bad news. The good news is that a prediabetes diagnosis gives you the opportunity — genetics notwithstanding — to try to turn things around.

Check out this Q&A about the condition, including steps you can take to help reverse it.

Q. What is prediabetes?

A. Prediabetes occurs because you have insulin resistance. That’s when your pancreas makes insulin (a hormone essential for life and regulating blood sugar levels), but cells in your muscles, fat and liver don’t respond to the insulin like they should, resulting in blood sugar levels that are elevated — but not enough to be Type 2 diabetes. Healthy blood sugar (glucose) levels are 70 to 99 milligrams per deciliter (mg/dL). If you have undiagnosed prediabetes, your levels are typically 100 to 125 mg/dL.

Q. What are the symptoms of prediabetes?

A. Most people who have prediabetes don’t have any symptoms. However, a few people might experience darkened skin on the back or sides of the neck, in the armpit, as well as skin tags.

Q. How is prediabetes diagnosed?

A. Here are two of the tests that can check for prediabetes:

The A1C test measures blood sugar over the past two to three months. A result in the range of 5.7%–6.4% indicates prediabetes. Diabetes is 6.5% or higher.
The fasting blood sugar test measures blood sugar after an overnight fast. A result of 100–125 mg/dL indicates prediabetes.

Diabetes screenings and Medicare:

Want to know if diabetes screenings are covered through Medicare? Read up on it here.

Q. What causes prediabetes and what are the risk factors for it?

A. Doctors aren’t sure why people develop prediabetes, but there are things that can contribute to it such as heredity — your genetic makeup — and some hormonal health conditions, such as hypothyroidism.

There are also many risk factors for developing prediabetes. Here are just a few. You’re more likely to develop prediabetes if you:

Are over 45
Have a family history of Type 2 diabetes (parent or sibling)
Eat a lot of red and processed meat
Frequently eat a lot of highly processed, high-carbohydrate foods and saturated fats
Don’t eat enough vegetables, fruits, nuts, whole grains, or olive oil
Have excess weight or obesity, especially if you tend to carry weight around your middle.
Rarely exercise
Have high cholesterol, high triglycerides, low HDL (“good” cholesterol), and high LDL (“bad” cholesterol)
Have high blood pressure
Have chronic stress, or a sleep problem, such as sleep apnea

Q. What are the possible complications of prediabetes?

A. The main complication of prediabetes is having it develop into Type 2 diabetes — and all the complications that go along with that, including: high blood pressure, high cholesterol, heart disease, kidney disease, nerve damage, eye damage, and amputations.

But prediabetes is more than just an alarm bell. It’s a serious health issue in which some of the long-term damage to blood vessels, heart and kidneys may already be starting. Prediabetes has also been linked to unrecognized “silent” heart attacks, with symptoms so mild, people may not realize they occurred.

Q. Can prediabetes be reversed?

A. Depending on your situation, adopting healthy lifestyle changes might help return your blood sugar to healthy levels and prevent or delay Type 2 diabetes. (A doctor may prescribe certain oral diabetes medications, too.)

In general, here’s what you can do to help turn the prediabetes ship around:

Lose weight/maintain a weight that’s healthy for you.

Losing excess weight can help combat insulin resistance. One study showed that losing 7% of weight can reduce the onset of Type 2 diabetes by 58%.
Exercise regularly.

A single session of moderate-intensity exercise can increase glucose uptake from your blood and into your muscles by at least 40%. This helps lower blood sugar levels. Aim for 30 minutes a day, five days a week, for a total of 150 minutes a week. Try walking or another activity you enjoy.
Eat nutritious food.

Cutting out added sugars, swapping simple carbohydrates for complex carbohydrates, and eating more veggies can help your blood sugar return to healthy levels. Your doctor can suggest an eating plan or help you find a nutritionist or dietitian for help with your new diet. Also, be sure to drink plenty of water.

Other healthy lifestyle changes may include quitting smoking, getting tested for (and treating) sleep disorders, managing related conditions (like high blood pressure or cholesterol), and even finding a prediabetes support group. Your doctor might be able to suggest a group, or check out resources through the National Diabetes Prevention Program.

Receiving news about any illness can be hard. But being told you have prediabetes presents both a challenge and an opportunity to do what you can to throw the whole thing into reverse. By getting on top of a few healthy lifestyle changes, you can do it!

Quick tips for a prediabetes diet

Your doctor can direct you to the best resource for your new prediabetes diet, but here are a few quick tips:

Add whole-grain breads and pastas, brown rice, beans and lentils, sweet potatoes or yams, and redskin potatoes.
Add healthy proteins like eggs, fish, lean meats, nuts and seeds, part-skim cheese, cottage cheese and Greek yogurt.
Add lots of vegetables, especially non-starchy ones like broccoli, Brussels sprouts, carrots, cauliflower, etc.
Add fruit in moderation. Lower-sugar fruits include berries and kiwi. To slow the rate of glucose entering your bloodstream, eat a serving of fruit with a protein source like a boiled egg, string cheese, cottage cheese, or a handful of nuts and seeds.
Cut added sugar (candy, desserts, sweets, baked goods, sweetened drinks).
Cut simple carbs (known as “empty-calorie” white foods) like chips, crackers, pretzels, white rice, white bread, white pasta.
Cut back on alcoholic beverages. Alcohol is a form of carbohydrate that should be consumed in moderation — in general, and especially if you have prediabetes.

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