I’ve Got Prediabetes. Now What?
Maybe you felt like there was something wrong with your body or noticed dark spots on your neck, armpits, knees, or elbows. Maybe at a routine check-up, your doctor noticed that your blood glucose levels were higher than normal and made you wonder if you had diabetes. Instead, your doctor said you have prediabetes. It’s relieving to have the answer to why you’ve been having those experiences, but you may be wondering: I have prediabetes, what does that mean and what do I do?
What is Prediabetes?
Prediabetes indicates that your blood glucose is slightly higher than normal, but not high enough to be considered type 2 diabetes. Prediabetes is a red flag that indicates that something is not working properly in the way you metabolize glucose. But if you make certain lifestyle changes in your habits and lifestyle, you can prevent or delay the progression to type 2 diabetes.
Thinking of Your Pancreas as a ‘Sponge’
As a diabetes educator, I usually use a sponge full of water as an example to model how the pancreas produces insulin. In this example, the sponge represents the pancreas and the water represents insulin. We’re all born with the sponge to keep us from running out of water, but when we have a diet of mostly high in processed foods with high fat, sodium and refined sugar content, we squeeze that sponge a little more than usual and reduce the amount of water within it.
If we also add factors such as a sedentary lifestyle, stress and not eating enough fruits and vegetables that provide us with many nutrients, then the day comes when the sponge has very little water. These factors cause insulin resistance, which I explain more below.
Insulin Resistance
Insulin resistance occurs when muscle, fat and liver cells don’t respond well to insulin. Imagine your cells as a lock and the insulin as a key. The key is slightly crooked and it is unable to open the lock so that blood glucose can enter the cell. Because the cells can’t easily absorb glucose from the blood causing the pancreas to produce more insulin. While the pancreas can produce enough insulin to overcome the weak response the cells have to insulin, blood glucose levels will remain at an adequate level. But if it cannot produce enough, you’ll begin to see some elevation in blood glucose that indicates that something is wrong.
Now, how did the doctor know you had prediabetes? The tests I mentioned earlier probably included some of these:
- Glycated hemoglobin (A1c) test. This test tells us what the average blood glucose was for the past three months.
- Fasting blood sugar test. A blood sample is taken after fasting for eight hours.
- Oral glucose tolerance test. A blood sample is taken after fasting for eight hours, you drink a sugar solution, and your blood glucose is tested two hours later.
| Glycated Hemoglobin (A1C) | Fasting glucose | Glucose tolerance test | |
| Normal range | 5.7 % | <5.5 mmol/L100 mg/dL | <7.8 mmol/L140 mg/dL |
| Prediabetes | 5.7-6.4 % | 5.5-6.9 mmol/L100-125 mg/dL | 7.8-11.1 mmol/L140-199 mg/dL |
| Diabetes | >6.5 % | >6.9 mmol/L125 mg/dL | >11.1 mmol/L200 mg/dL |
You Have Prediabetes, Now What?
Well, we already know that prediabetes is a state you are in before you get diabetes, but after your diagnosis, you have a lot of control over the factors that can keep it from progressing to type 2 diabetes. One of the keys is assessing your environment, eating habits and exercise habits. The National Diabetes Prevention Program focuses on the latter two. By maintaining a healthy diet low in processed foods and consisting mostly of fruits, vegetables, lean meats and seafood, legumes and more, along with daily exercise up to 150 minutes per week, you can prevent or delay the onset of type 2 diabetes and return your blood glucose levels back to normal.
However, if you are still diagnosed with type 2 diabetes, you can still use those same behaviors to maintain healthy blood glucose levels and live a full, healthy life with diabetes. There is no shame in living with type 2 diabetes or prediabetes.
