What is prediabetes?


Prediabetes: Overview

Prediabetes is a warning sign that you're at risk for getting type 2 diabetes. It means that your blood sugar is higher than it should be. But it's not high enough to be diabetes.

The food you eat naturally turns into sugar. Your body uses the sugar for energy. Normally, an organ called the pancreas makes insulin. And insulin allows the sugar in your blood to get into your body's cells. But sometimes the body can't use insulin the right way. So the sugar stays in your blood instead. This is called insulin resistance. The buildup of sugar in your blood means you have prediabetes.

The good news is that you may be able to prevent or delay diabetes. Making small lifestyle changes, like getting active and changing your eating habits, may help you get your blood sugar back to normal. You can work with your doctor to make a treatment plan.


Prediabetes is a condition in which your blood sugar is too high, but not high enough to call it diabetes. Having prediabetes makes you at risk for type 2 diabetes.

What are the symptoms of prediabetes?

Most of the time, people with prediabetes do not have symptoms.

How is prediabetes treated?

Prediabetes can be treated by making lifestyle changes, taking medicine, or doing both. Lifestyle changes include losing weight if you need to, keeping healthy eating habits, and getting active. Treatment may help get your blood sugar level back to a more normal range. It could help you prevent or delay type 2 diabetes.

How can you prevent prediabetes?

You can help prevent prediabetes by staying at a healthy weight, eating healthy foods, and getting regular exercise.

How is prediabetes diagnosed?

Your doctor will ask questions about your medical history. You will also get a physical exam and blood sugar (glucose) testing. The results help your doctor see if you have prediabetes and are at risk for getting type 2 diabetes.

Blood tests used to diagnose prediabetes in adults include:

Fasting blood glucose test.
This test is usually done after you fast overnight for 8 hours.
Hemoglobin A1c.
This test estimates your blood sugar over the past 2 to 3 months.
Oral glucose tolerance test (OGTT).
For an OGTT, your blood sugar is measured after fasting. Then it's tested again 2 hours after you drink a special glucose liquid.

How is medicine used to treat prediabetes?

If you need medicine, your doctor is most likely to prescribe metformin (Glucophage). It reduces how much glucose the liver makes. It can also lower insulin resistance.

How can you care for yourself when you have prediabetes?

You can make healthy changes to help prevent or delay type 2 diabetes.

  • Limit the amount of calories, sweets, and unhealthy fat you eat.
  • Lose weight if you need to. Even losing a small amount of weight can help.
  • Try to exercise at least 2½ hours a week. Bit by bit, increase the amount you do every day.

When you have prediabetes, you're also at higher risk for heart disease and stroke. You can lower your risk by:

  • Managing other health problems, such as high blood pressure and high cholesterol. Exercise, healthy eating, and/or medicine can help with these goals.
  • Quitting smoking. Quitting smoking might help you reduce your risk for type 2 diabetes and heart disease and help you avoid other health problems that make diabetes worse.

What puts you at risk for prediabetes?

You are more likely to get prediabetes if you:

  • Are overweight.
  • Get little or no exercise.
  • Have type 2 diabetes in your family.

Other things that may increase your risk for prediabetes include:

The risk of getting prediabetes and type 2 diabetes increases with age.
Race and ethnicity.
African Americans, Hispanics, Native Americans, Asian Americans, and Pacific Islanders are at higher risk for type 2 diabetes.
History of gestational diabetes.
Women who have had gestational diabetes are at higher risk for developing type 2 diabetes later in life.

Other health problems can put you at risk for prediabetes and type 2 diabetes. These include:

  • Polycystic ovary syndrome (PCOS).
  • History of heart disease.
  • High blood pressure.
  • Low HDL cholesterol and high triglyceride level.
  • Conditions linked with insulin resistance.

Linda's story: Busy mom finds ways to stay active

Linda, 39
Read more about Linda and how she found ways to add exercise to her day.
"Walking is great for me, because I don't have to buy anything to do it, and it doesn't take a lot of my time."

Linda works full time, has three young children, and has zero time for the gym. So when she learned that she had prediabetes, she had to find creative ways to fit activity into her day.

"My trick is to not call it 'exercise.' Instead, I just look for ways to add small workouts to my day," she says.

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," she says. "My kids get a big kick out of it too."

At work, she walks at lunch by herself or with a friend.

"Walking is great for me, because I don't have to buy anything to do it, and it doesn't take a lot of my time," she says.

While watching TV, Linda uses small hand weights to do arm lifts during commercial breaks.

Every little bit helps

At 39, 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 give herself shots every day. Sometimes she needed my help," Linda says. "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 avoid it."

Linda uses the plate method to help her make healthy eating choices. She fills half of her plate with non-starchy vegetables like a salad. She places protein foods like meat, fish, tofu, eggs, nuts, or cheese on a fourth of her plate. And she puts carbohydrate foods like grains, starchy vegetables, fruit, and yogurt and milk on the final fourth of her plate.

"In general, I try to limit added sugar," she says. "But you have to live a little. My motto is: Everything in moderation."

This story is based on information gathered from many people facing this health issue.

What is prediabetes?

Prediabetes is a warning sign that you are at risk for getting type 2 diabetes. It means that your blood sugar is higher than it should be, but not high enough to be diabetes.

How can you lower your risk for heart disease when you have prediabetes?

When you have prediabetes, you’re more likely to get heart disease than someone who has normal blood sugar levels. If you have high blood pressure or high cholesterol, your risk for heart disease is even higher. To help lower your risk, it's important to keep a heart-healthy lifestyle. This includes being active, eating healthy foods, staying at a healthy weight, and not smoking.

What causes prediabetes?

The food you eat turns into sugar, which your body uses for energy. Normally, an organ called the pancreas makes insulin, which allows the sugar in your blood to get into your body's cells. But when your body can't use insulin the right way, the sugar doesn't move into your cells. It stays in your blood instead. The buildup of sugar in your blood causes prediabetes.

Prediabetes: When to call

When you have prediabetes, it's important to watch for symptoms of type 2 diabetes.

Call your doctor now or seek immediate medical care if:

  • You have symptoms of high blood sugar, such as:
    • Blurred vision.
    • Trouble staying awake or being woken up.
    • Fast, deep breathing.
    • Breath that smells fruity.
    • Belly pain, not feeling hungry, and vomiting.
    • Feeling confused.
  • You have a wound that will not heal.
  • You have an infection that will not go away.

Jerry’s story: Beating prediabetes

Jerry, 54
Read more about Jerry and how he got support for his lifestyle changes.
"I met a lot of other people who felt the same way I did at first about prediabetes. Like, how can I fight it? But it turns out there's a lot you can do."

Jerry has a message for everyone who is diagnosed with prediabetes.

"Take it seriously," he says. "Of all the risks for diabetes you can have, this one is really influenced by the choices you make."

That wasn't how Jerry felt when he first learned he had prediabetes. His doctor told him to lose weight and get more exercise or else run the risk of getting type 2 diabetes. Jerry was angry and frustrated.

"I thought, 'What's the point? I might still get diabetes,'" Jerry says. "I felt like I was stuck either way."

He also didn't see how he could fit exercise into his day. Four days a week he works 12-hour shifts as an engineer at a computer company. The other days he catches up on household chores and yard work.

Gift of motivation

So for a few months, Jerry did nothing. At 54, he figured it was too late for him to make any big changes in his life anyway.

On his 18th wedding anniversary, Jerry's wife, Laura, gave him a present that changed his attitude. It was a scrapbook of photos from camping trips they'd taken during their marriage. One showed Jerry and Laura atop Half Dome in Yosemite National Park, smiling like crazy.

With the book came a note from Laura. It said, "Let's still be doing this 18 years from now."

"I looked at those pictures and thought about the future," he says. "I realized I wanted to get healthy so I could keep doing all those things I enjoy so much."

Jerry went to a prediabetes class that his doctor prescribed. During the 2-hour class, Jerry learned about how being overweight and inactive makes it harder for the body to keep blood sugar levels normal. And he finally understood why making lifestyle changes is so important.

"I met a lot of other people who felt the same way I did at first about prediabetes. Like, how can I fight it? But it turns out there's a lot you can do."

Staying focused

Jerry signed up for a weight-loss program, and he started keeping a daily food diary to track what and when he ate. He was able to see where he could cut back on calories and saturated fats. He also ate fewer sweets. He added walks around the neighborhood to his routine, and he started doing light weights at the gym.

He also uses a phone app to track his activity, and he tries to think up ways to get more steps.

"I park my car at the back of the lot and take the stairs when I can," he says. "On my break, I walk around the outside of the building a few times."

In 7 months, Jerry dropped 25 pounds—about 7% 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 on the long-term goal. But tracking what, when, and why I eat helps me to eat less," he says.

Jerry's wife, Laura, has been a big help, he says. She joined the weight-loss program too. They plan and cook meals together on weekends. That way, Jerry has healthy food ready to take for his long shifts at work.

Making a difference

When he went back to his doctor for another blood test, Jerry's blood sugar had dropped below the prediabetes range. He still needs to get tested on a regular basis. But that motivates him to keep up his routine.

"Taking care of yourself can make a huge difference in your health," he says. "It's possible I might 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!"

This story is based on information gathered from many people facing this health issue.

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