Prediabetes: signs, risks & how to take action early

Prediabetes is a serious health concern that often goes unnoticed because it typically presents no clear symptoms. This condition occurs when blood sugar levels are higher than normal, but not high enough to be diagnosed as diabetes. However, prediabetes is an important warning sign and offers a crucial opportunity to take action and prevent the development of type 2 diabetes. Read on to learn more about the risks associated with prediabetes and what you can do to protect yourself.

Table of Contents

• What is prediabetes?
• What are risk factors for prediabetes?
• What symptoms occur with prediabetes?
• What complications can prediabetes cause?
• How is prediabetes diagnosed?
• How can prediabetes be prevented?
• Summary

What is prediabetes?

Prediabetes is a condition in which blood sugar levels are higher than normal but not high enough to be classified as type 2 diabetes. It is often a precursor to the development of type 2 diabetes. Type 2 diabetes is a chronic disease in which the body either does not produce enough insulin or does not respond effectively to the insulin it produces, leading to consistently elevated blood glucose levels.

In healthy bodies, the hormone insulin—produced by the pancreas—regulates blood sugar levels by allowing the body’s cells to absorb glucose (sugar) from the bloodstream and use it for energy. When someone has prediabetes, this process begins to function less efficiently. The body’s cells become more resistant to the effects of insulin, which means they are less efficient at absorbing and using glucose. This leads to an increase in blood glucose concentration. In addition to insulin resistance, the pancreas may also produce less insulin in people with prediabetes. This means there is not enough insulin to effectively regulate glucose in the body, further increasing blood sugar levels.

Prediabetes is often asymptomatic, meaning that many people do not realize they have it. If left untreated, it can increase the risk of cardiovascular disease and other health problems (MedlinePlus, 2021). 

What are risk factors for prediabetes?

In principle, anyone can develop prediabetes, but some people are more at risk than others. Here are some factors that may increase the risk of prediabetes:

• Age: The risk of prediabetes increases with age, especially after age 45.
• Overweight or obesity: Excess weight—especially abdominal fat—is the most significant risk factor for prediabetes. The more body fat someone has, the more resistant their cells become to insulin, leading to increased blood sugar levels.
• Lack of physical activity: A sedentary lifestyle increases the risk of prediabetes by reducing insulin sensitivity and promoting weight gain, both of which can contribute to insulin resistance.
• Family history of diabetes: People with a parent or sibling with type 2 diabetes have a higher risk of developing prediabetes themselves. The exact cause is unknown, but a genetic predisposition may influence insulin production or function.
• Polycystic ovary syndrome (PCOS): Women with PCOS are at higher risk of developing prediabetes. PCOS is a hormonal disorder often associated with insulin resistance.
• Gestational diabetes: Women who had high blood sugar during pregnancy (gestational diabetes) have an increased risk of developing prediabetes or type 2 diabetes later in life.
• Unhealthy diet: Diets high in sugary foods, processed products, and red or processed meat—but low in fiber, fruits, and vegetables—can raise the risk of prediabetes. These dietary patterns can lead to blood sugar spikes, insulin resistance, and ultimately prediabetes.
• High cholesterol levels: Elevated cholesterol levels—especially high LDL ("bad") cholesterol and low HDL ("good") cholesterol—have been linked to insulin resistance and an increased risk of prediabetes.
• High triglyceride levels: Triglycerides are the most common type of fat in the body, derived from food and produced by the body. High levels of triglycerides can increase the risk of prediabetes as they are often associated with other conditions such as obesity and insulin resistance.

Source: Mayo Clinic, 2022

It’s important to understand that the presence of one or more of these risk factors does not mean you will definitely develop prediabetes—but it does increase your chances. If you are at higher risk, regular testing is recommended.

Want to check your levels yourself?

The Homed-IQ blood sugar test measures your HbA1c value. HbA1c is an important indicator of long-term blood sugar control, as it reflects your average blood sugar level over the past two to three months. Identifying an elevated HbA1c level may indicate the presence of prediabetes. The test is therefore a valuable tool for early detection and prevention of diabetes. However, if abnormal values are found, you should always consult a doctor for a full diagnosis and treatment plan.

What symptoms occur with prediabetes?

Prediabetes usually causes no symptoms. Many people are unaware they have this condition until they take a blood sugar test. However, some people with prediabetes may show signs or symptoms of diabetes or related conditions, such as:

• Increased thirst and frequent urination: These are classic symptoms of high blood sugar. When there is too much sugar in the bloodstream, the kidneys work harder to filter and excrete it, leading to more frequent urination and, as a result, increased thirst.
• Fatigue: High blood sugar levels can make you feel constantly tired and low on energy. This happens because the body cannot efficiently use glucose for energy. Difficulty concentrating may also occur.
• Blurred vision: Excess sugar in the blood can cause the lenses in your eyes to swell, leading to blurred vision.
• Dark patches of skin: Some people with prediabetes develop darkened areas of skin, often in the armpits, neck, or body folds. This condition is called acanthosis nigricans.

If you notice one or more of these symptoms, you should consult a doctor (Cleveland Clinic, 2021).

What complications can prediabetes cause?

Prediabetes is more than just a warning sign; it carries its own health risks that are often underestimated. These include:

• Development of type 2 diabetes: The greatest risk of prediabetes is progression to type 2 diabetes. According to studies, 5–10% of people with prediabetes develop the condition each year.
• Cardiovascular disease: People with prediabetes are at higher risk for heart and blood vessel diseases. Elevated blood sugar can lead to plaque buildup along the artery walls, which may obstruct blood flow. This narrowing of the arteries, also known as atherosclerosis, is a major cause of cardiovascular disease. Prediabetes also increases the risk of high cholesterol and high blood pressure, both of which contribute to heart disease.
• Damage to organs and blood vessels: High blood sugar levels can damage the heart, eyes, and nervous system. Kidney damage, known as diabetic nephropathy, may also occur.
• Metabolic syndrome: Prediabetes is often associated with other conditions, such as high blood pressure and high cholesterol, which together are known as metabolic syndrome.

Sources: Tabak et al., 2012; Brannick et al. 2016

It is important to note that not everyone with prediabetes develops these health problems. Timely lifestyle changes such as healthy eating, regular physical activity, and weight loss can significantly reduce these risks.

How is prediabetes diagnosed?

The diagnosis of prediabetes is usually based on blood sugar levels. In addition to reviewing possible symptoms, several tests may be used:

• A1C test: This blood test measures your average blood sugar level over the past two to three months. An A1C value between 5.7% and 6.4% is usually considered prediabetes.
• Fasting plasma glucose test (FPG): This test measures your blood sugar after fasting overnight. A result between 100 mg/dL and 125 mg/dL indicates prediabetes.
• Oral glucose tolerance test (OGTT): For this test, you drink a special glucose solution, and your blood sugar is measured before and two hours after drinking. A two-hour result between 140 mg/dL and 199 mg/dL indicates prediabetes.
• Random plasma glucose test (RPG): This test measures blood sugar at a random time, regardless of when you last ate. An RPG level of 200 mg/dL or higher may indicate diabetes if it occurs alongside diabetes symptoms.

Source: NIDDK, 2022

How can prediabetes be prevented?

The number of people with diabetes increased from 108 million in 1980 to 422 million in 2014. Since diabetes is a leading cause of blindness, kidney failure, heart attacks, strokes, and lower-limb amputations, diagnosing and preventing prediabetes is of the utmost importance (WHO, 2023). Preventing prediabetes means addressing the underlying risk factors and includes:

• Healthy eating: A balanced diet rich in nutrients and vitamins is key to preventing prediabetes. Focus on foods with a low glycemic index, such as whole grains, fruits, vegetables, and lean proteins. Avoid pro-inflammatory foods high in sugar and processed carbohydrates, as they promote insulin resistance by triggering chronic inflammation. High-fat foods should also be limited.
• Regular physical activity: It is generally recommended to get at least 30 minutes of brisk walking five days a week to reduce the risk of prediabetes and type 2 diabetes.
• Weight management: When people are overweight, their fat cells enlarge and release substances that impair insulin function, leading to increased insulin resistance. Losing weight improves insulin sensitivity and reduces the risk of prediabetes and type 2 diabetes.
• Smoking cessation: Smoking increases the risk of prediabetes and type 2 diabetes. Quitting smoking can reduce this risk. Smokers are 30–40% more likely to develop type 2 diabetes than nonsmokers. The more you smoke, the greater the risk (CDC, 2022).
• Regular health checkups: Routine medical checkups can help detect and treat prediabetes early.
• Moderate alcohol consumption: Excessive alcohol intake can promote prediabetes by lowering insulin sensitivity, promoting weight gain, and raising blood sugar levels due to the sugar content in alcoholic beverages.
• Stress management: Chronic stress can increase the risk of prediabetes. Stress reduction techniques such as meditation, yoga, or breathing exercises may help lower this risk.

Sources: CDC, 2022; Cleveland Clinic, 2021

By following these preventive strategies, you can significantly reduce your risk of developing prediabetes and its associated health problems. If lifestyle changes are not enough to control blood sugar levels, medications such as metformin may be considered. Regular diabetes screenings are also important to enable early treatment if prediabetes progresses to diabetes.

Summary

Prediabetes is a serious health condition that increases the risk of type 2 diabetes, heart disease, and stroke. However, there are many actions you can take to prevent or delay its progression. Healthy eating, regular physical activity, weight management, and routine medical checkups can help you control your blood sugar levels and improve your overall health.