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What is Pre-Diabetes?

A.E. Freeman
Updated Mar 03, 2024
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People who have pre-diabetes have blood sugar levels that are higher than they should be but not quite high enough to be diagnosed as type 2 diabetes. The condition is quite common in the United States and affects about 57 million people, some of whom may not know that they have the condition since it is usually asymptomatic. Pre-diabetes, formerly known as borderline diabetes or impaired glucose tolerance, usually leads to type 2 diabetes unless the patient takes steps to prevent or reverse the condition.

When a person has type 2 diabetes, his or her body is usually unable make or use insulin to metabolize the glucose, or sugar, found in many foods. The sugar then builds up in the blood and can cause damage to the heart, kidneys, and central nervous system. People who have type 2 diabetes are at a higher risk of heart disease and stroke. Likewise, people with this condition also face a higher risk of these conditions.

Although the risks are high, many people do not know that they have pre-diabetes. The American Diabetes Association (ADA) recommends that adults who are overweight and over 45 years old talk with their doctor about being tested for the condition. There are two tests for the condition, both of which measure the level of glucose in the blood. Both tests are considered equally effective.

Before taking either test, the patient must fast for at least eight hours. For the first test, known as the fasting plasma glucose test, a blood sample is taken and the glucose level is measured. If the glucose is between 100 and 125 mg/dl, then the patient has pre-diabetes. During the oral glucose tolerance test, a patient's glucose is tested after a fast. He or she then drinks something high in sugar and has his or her blood tested after two hours. If the level in glucose is between 140 and 199 mg/dl after two hours, he or she is pre-diabetic.

After a person is diagnosed with pre-diabetes, he or she can take steps to slow the progression to type 2 diabetes or to even reverse the condition. Patients who lose about 5 percent of their body weight often slow down or prevent the development of diabetes. Patients may also benefit from increased exercise and a change in diet, such as cutting back on sweets and making sure to eat nutritious meals. Cutting back on risky behaviors, such as smoking, and working to lower blood pressure and cholesterol can also cut a patient's chances of developing diabetes-related illnesses.

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A.E. Freeman
By A.E. Freeman
Amy Freeman, a freelance copywriter and content creator, makes engaging copy that drives customer acquisition and retention. With a background in the arts, she combines her writing prowess with best practices to deliver compelling content across various domains and effectively connect with target audiences.
Discussion Comments
By cloudel — On Feb 27, 2012

@Perdido – I wish the pre-diabetes test had been around decades ago, when my grandmother died from diabetes. I truly believe that if she had known she was at risk, she would have done all she could to prevent it.

She didn't even realize she had diabetes until she got rushed to the hospital after passing out. After that, she had to be on medication all the time, and she lost her zeal for life.

She was persistent and determined at everything she did, and I know she could have worked to prevent her diabetes if she had only had access to a pre-diabetes test. I make it a point to get a yearly physical, because I know that genetically, I could be in danger.

By Perdido — On Feb 26, 2012

@seag47 – I know how hard it can be to stop eating your favorite foods. I was diagnosed with pre-diabetes five years ago, and I cried for days, thinking about how I would have to give up fudge and raspberry-filled chocolate candy!

So, I learned to like sugar-free candy made for diabetics. At first, the taste doesn't compare to the original, but over time, you learn to appreciate it, because the alternative is eating none at all.

See if you can get your dad to eat diabetic cookies and candy. Encourage him to keep trying, because nothing is as important as his health!

I have followed my doctor's instructions, and I have brought my levels back to normal. I will have to live like this for the rest of my life, because I don't want to risk getting actual diabetes.

By Oceana — On Feb 25, 2012

Fasting for 48 hours can be hard. Your stomach starts to feel like it is curling in on itself, and you can think of nothing but food.

This is why my mother cheated during her fast before her pre-diabetes test. She only ate a few grapes here and there to slow the hunger pangs, but the test showed that she had pre-diabetes.

She told herself that the grapes made her fail the test. So, she decided to ignore the doctor's advice. She continued to eat the way she always had, which was both excessive and unhealthy.

Today, she has full-fledged diabetes. She cannot ignore it, and she has to obey the doctor's instructions, because it is a matter of life and death.

By seag47 — On Feb 24, 2012

My dad has a major sweet tooth, and I am amazed that he didn't get diagnosed with pre-diabetes sooner. He is 71, and he just found out last month that he has the condition.

If there are cookies in the house, he can't seem to control himself. He cannot eat just one or two, and often, cravings will hit him late at night. Since eating late can contribute to weight gain, that is probably why he is about forty pounds overweight.

He knows that he needs to give up sweets, but I only saw him avoiding them for about the first two weeks. He is back to eating cake and cookies again, and I am worried about his health.

By dfoster85 — On Feb 24, 2012

Something to know about pre-diabetes is that it might be connected with gestational diabetes. Women who have had GD are at risk for pre-diabetes and I think vice versa.

A good friend of mine was pre-diabetic for a long time and unfortunately didn't really make lifestyle changes. She sees that her father was a pretty fit guy and he still had high blood pressure and metabolic issues, so she feels that she might as well be fat and eat what she wants since she has bad genes anyway. She has developed gestational diabetes - pretty seriously, in that she had to be treated with insulin injections - during both her pregnancies.

It makes me sad to see her not even try. But I know it's hard. She's used to eating and drinking certain things.

By myharley — On Feb 23, 2012

@bagley79 - While I agree there are many kids who can make significant changes to prevent diabetes, there are others who are not as fortunate.

I have a nephew who was diagnosed with juvenile diabetes at a very young age. No one else in his family has diabetes, so they have no idea where this came from.

Much of his life revolves around his food choices and checking his blood sugar levels. In his situation, there was nothing he could have done to prevent this disease. All he can do now is make the right choices to try and keep his diabetes under control.

For a young boy this is really hard when you are surrounded by kids who are eating junk food and drinking soda pop. It is something that he really struggles with and it almost seems like the older he gets, the harder it is for him.

One good thing is there is a lot more diabetes info available today than there was years ago. More people are aware of the dangers of this disease. If you receive a diagnosis of pre-diabetes, there is help available to make the necessary changes to lower your glucose readings.

By bagley79 — On Feb 23, 2012

@simrin - Years ago I think that many of the kids' diabetes diagnoses were genetic. Now I think they are saying that even many of these are caused by lifestyle choices.

Because there are so many children who are overweight and sedentary, they are really concentrating on making changes in the school lunch programs.

It has been several years since they removed the vending machines at our school that had a lot of sugary snacks and juice choices.

If many of these overweight kids were tested, I think some parents might be surprised to find out what their kids blood sugar levels might be.

The sooner you can make changes and start eating healthier and getting exercise, the better off you will be. If they are going to be changes you continue to use, it would make a big difference down the road when it comes to normal or high blood sugar readings.

By honeybees — On Feb 22, 2012

@sunshined - That is exactly what happened with my husband. Over the years, he kept putting on weight. He also drinks a lot of pop and eats more than his share of sweets. The sad thing is, this is common for many people.

He didn't have any typical diabetes symptoms. When he was 50 and had a complete physical done, his fasting blood glucose reading came back at 112.

They told him this was a pre-diabetic level and that he needed to concentrate on losing some weight. At first he worked at this pretty hard, but has slowly gone back to his old habits.

Because he didn't have any pre-diabetes symptoms he was surprised when they told him he was in the pre-diabetic range.

Even though a lot of this is preventable, it is still hard because it takes constant discipline and work.

By sunshined — On Feb 22, 2012

@simrin - The way I understand it is that the diagnosis of pre-diabetes can be a warning sign that you need to make some changes.

There are some types of diabetes that are genetic, but many of the diabetics and pre-diabetics can make changes to slow down the process or reverse their high blood sugar readings.

I think the biggest reason people don't realize they have a problem is because there aren't usually any pre-diabetic symptoms.

Many times the high blood sugar readings happen slowly and gradually over the years. Because of diets that are high in sugar and lifestyles that don't get much exercise, this gradually leads to higher blood glucose readings.

Unless you have your blood sugar levels tested, you might not know you are even at risk.

By SteamLouis — On Feb 21, 2012

I don't really understand the concept of "pre-diabetes." If doctors are relying on glucose tolerance tests to determine diabetes and if these tests are accurate, why is there such a thing as "pre-diabetes?" It seems like someone can either be non-diabetic or a diabetic to me.

If someone's glucose levels are not high enough to label them as diabetic, than they're not, right?

Why are we bothering with this concept at all? And is it really possible to reverse this condition if someone is headed to be a diabetic? I thought that both diabetes type 1 and 2 is mostly genetic.

By turquoise — On Feb 21, 2012

I absolutely agree that people who are over 45 and who have weight problems should find out if they're pre-diabetic. But people with diabetes history in their family should have it checked out even before.

I'm 25 and I have type 2 diabetes. Both of my parents have type 2 diabetes but they developed it after they were 45. Mine came about much earlier, probably because I've been consuming too much sugar until now.

I also agree with the earlier comment that Americans are eating less healthy now. During our grandparents' time, there weren't so many unhealhty and processed foods available. People were more active than too, but times have changed. Looking at my example, it seems like pre-diabetes and diabetes is going to show up earlier and earlier in future generations.

By fify — On Feb 20, 2012

I was told that I had pre-diabetes in my late 20s. After that, I tried to make sure I didn't gain weight and stayed away from sweets and processed foods in general. I have been diagnosed with diabetes (type 2) this year but I am 50 years old now. I was able to delay it for over 20 years thanks to my healthy eating and exercise habits.

Considering how overweight America has become in the last couple of years and how much sugar is added to foods, I think everyone needs to have their blood sugar levels checked. If people realize that they are pre-diabetes, they can at least take the precautions that are necessary to delay it. It might even be possible to prevent it altogether in some cases.

Unfortunately, most people I know have never been tested for it. I think this is a problem because the later you realize that you have pre-diabetes or diabetes, the more damage that has been done to your system already.

A.E. Freeman
A.E. Freeman
Amy Freeman, a freelance copywriter and content creator, makes engaging copy that drives customer acquisition and...
Learn more
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