Understand the cause, risk factors, and diagnosis of prediabetes. Adopt lifestyle changes to lower your risk of getting diabetes and diabetes-related complications


Prediabetes is a condition where your blood sugar levels are higher than normal levels but not high enough to be considered Type 2 Diabetes. Prediabetes is a silent condition and does not usually cause any symptoms. If left unaddressed it can progress to Type 2 diabetes and its various related complications. Prediabetes has also been linked to long-term damage to your heart, blood vessels, and kidneys. However, the good news is that progression from Prediabetes to Diabetes is not inevitable. You can get your blood sugar levels to normal or prevent Type 2 diabetes by making healthy lifestyle choices.  

What causes Prediabetes?

Insulin resistance or resistance of the cells to insulin which affects the movement of glucose into the cells results in high blood glucose levels in people with prediabetes. Insulin resistance can worsen over time as you age or gain weight. The exact cause of why insulin resistance occurs is not known. But family history and genetics play a key role. The factors that can increase the risk include: 

  • Being overweight and having a large waist size  

The risk of insulin resistance and Prediabetes/Diabetes goes up for men with waists larger than 40 inches and for women with waists larger than 35 inches. Other conditions that are associated with obesity such as high blood pressure, low good cholesterol, and high triglycerides can cause insulin resistance increasing the risk of Type 2 Diabetes. 

  • Diet that contains sugar-sweetened beverages, red and processed meat 
  • A parent or a sibling with Type 2 Diabetes 
  • Gestational diabetes (Diabetes that occurs during pregnancy) 
  • Polycystic ovary syndrome (PCOS), is a syndrome characterized by irregular menstrual cycles, obesity, and excess hair growth 
  • Smoking tobacco

What are the signs and symptoms that suggest progression to Type 2 diabetes? 

The signs and symptoms that suggest that you have progressed to Type 2 Diabetes include increased thirst, increased hunger, frequent urination, fatigue, and frequent infections. 

How is Prediabetes Diagnosed? 

The same tests used to diagnose Type 2 diabetes are used to diagnose Prediabetes. These tests include: 

  • Hemoglobin A1C (HbA1C) blood test – Prediabetes is diagnosed if the value is between 5.7% and 6.4%. HbA1C test tells you what your average blood sugar level has been over the past 2 to 3 months. 
  • Oral Glucose Tolerance Test – In the Oral glucose tolerance test, your blood sugar levels are first measured after an overnight fast and then 2 hours after consumption of a sugary solution. Prediabetes is diagnosed if the blood sugar levels 2 hours after consumption of sugary solution are between 140 mg/dL and 199 mg/dL 
  • Fasting Blood Glucose Test – The fasting blood glucose must be between 100 and 125 mg/dL to be diagnosed as Prediabetes. Fasting blood glucose is defined as no intake of any calories for at least 8 hours

How do I prevent Type 2 diabetes and return my blood sugar levels to normal? 

Maintaining an ideal body weight 

You can start by losing weight if you are overweight. You can lower your risk significantly by just losing 5 to 7% percent of your body weight. That is losing 10 to 14 pounds if you weigh 200 pounds. Research has shown that people with Prediabetes can reduce the risk for diabetes during the next 3 years by almost 60% if they lose 5% to 7% of their body weight and exercise about 30 minutes a day. Eventually, aim for a body mass index (BMI) between 18.5 and 25. 

Eat a healthy diet 

You should eat the healthiest foods in moderate amounts. Your overall diet should be low in fat and calories and rich in nutrients. Try to eat a diet with lots of fruit, vegetables, and whole grains. Try to avoid sweet drinks, like soda and juice.  

Age, sex, height, weight, and level of physical activity are determinants of the target calorie number, you need to maintain and lose weight.  

General guidelines for calories needed per day to maintain weight: 

MOST MEN  15 calories/lb. 
SEDENTARY MEN  13 calories/lb. 
MOST WOMEN  13 calories/lb. 
ACTIVE WOMEN  15 calories/lb. 
SEDENTARY WOMEN  10 calories/lb. 
MEN & WOMEN OVER AGE 55  13 calories/lb. 
OBESE MEN & WOMEN  10 calories/lb. 
PREGNANT WOMEN  15-17 calories/lb. 
LACTATING WOMEN  15-17 calories/lb. 

Be active for at least 30 minutes a day 

Physical activity helps the body use insulin more effectively. Whether it is walking, gardening, dancing, or going to the gym, aim for at least 150 minutes (about 2 and a half hours) of moderate physical activity or 75 minutes of vigorous aerobic activity a week, or a combination of moderate and vigorous exercise. 

Quit Smoking

Smoking cessation can improve the blood sugar levels by improving the way Insulin works. 

Is there any medication to treat Prediabetes? 

Medication is not recommended for prediabetes unless lifestyle changes are not improving blood sugar levels. If medication is needed, metformin is usually the recommended drug. 


Getting a diagnosis of Prediabetes is a “wake-up call” to make the necessary changes to prevent a chronic condition that cannot be cured from happening. Even small changes can have a huge impact on delaying or preventing diabetes all together.