What Is Prediabetes?

“As we age and enter our early-to-mid 40s, our chances of developing prediabetes increase,” said Beth Freedman, Manager of Outpatient Nutrition at the Catholic Health Diabetes Education Center at Mercy Hospital. “That age group is more likely to have risk factors like high blood pressure, high cholesterol and being overweight.”

What causes prediabetes?

Prediabetes is a precursor to Type 2 diabetes.

“It is a ‘warning sign’ that you could be looking at a diabetes diagnosis in the future,” explained Freedman.

Like Type 2 diabetes, prediabetes is caused by insulin resistance. Insulin regulates blood glucose levels (sugar).

Although it is unknown precisely what causes insulin resistance, similar to Type 2 diabetes, certain factors contribute to prediabetes, including:

• Age 45 and older
• Chronic stress
• Cholesterol: high cholesterol; high triglycerides; high “bad cholesterol”; low “good” cholesterol
• A diet that is not well-balanced with fruits, vegetables, whole grains and healthy fats
• Drinking sugary beverages like soda
• Eating foods that are high in carbohydrates, high in saturated fats and highly processed
• Genetics
• Hormonal disorders (including hypothyroidism and Cushing’s syndrome)
• Medications (including long-term steroid use)
• Overweight (especially excessive fat around the belly and organs)
• Poor sleep habits and sleep apnea
• Waist size larger than 40 inches for a male; larger than 35 inches for a female
• Sedentary lifestyle/lack of exercise

How is prediabetes diagnosed?

Prediabetes is diagnosed as part of your routine bloodwork. Your primary care physician (PCP) will order a bloodwork panel during your yearly physical exam, including an A1C test. This simple hemoglobin test measures your three-month blood sugar levels.

A1C results can fall into one of three categories:

• Normal range: A1C is below 5.7
• Prediabetes: A1C is between 5.7 - 6.4
• Type 2 diabetes: A1C of 6.5 or higher on two separate tests

“An A1C in the prediabetes range is reversible; however, it is a red flag to take action,” explained Freedman.

Prediabetes can lead to a Type 2 diabetes diagnosis, which is not reversible and must be managed daily throughout your lifetime.

What does a prediabetes diagnosis mean?

A1C is a three-month cumulative measure of blood glucose, so your physician will repeat the bloodwork in three months. That means you have time to make changes that can impact the following A1C number.

When you retake your A1C test three months later:

• If A1C is still in the prediabetes range: Your PCP will continue to monitor your A1C approximately every three months as you work on lifestyle changes.
• If A1C has lowered below the prediabetes range: You are no longer classified as prediabetic if your A1C has gone down, and your A1C will likely be rechecked at your annual exam.
• If A1C goes up but is still in the prediabetic range: Your PCP will continue to monitor your A1C approximately every three months and recommend taking action on more lifestyle changes.
• If A1C rises to the Type 2 diabetes level: If your A1C is above the 6.5 threshold, it does not mean you are immediately diagnosed with Type 2 diabetes. Your PCP will recheck your A1C. It takes two tests equal to or above the A1C of the 6.5 threshold for a diagnosis of Type 2 diabetes.

“Your PCP manages prediabetes,” said Freedman. “In complex cases, they may refer you to an endocrinologist, an expert in managing metabolic diseases like diabetes.”

How can I manage prediabetes?

“A higher-than-expected A1C result in the prediabetes range can be a shock,” said Freedman. “But do not panic. Instead, take action.”

She emphasized that if A1C results indicate prediabetes, there is still time to make lifestyle changes to prevent it from becoming Type 2 diabetes.

She recommends the following prediabetes action plan.

Change your diet. This is a hard one for all of us. But remember, it does not have to be a complete overhaul. Add more fresh foods and cut back on processed white grains instead of whole grains. Eliminate sugary drinks, increase your water intake and monitor your portion size.

Most adult-size carbohydrate portions are fist-sized, not full-plate-sized. Work with a dietician if you’d like in-depth training on meal planning, grocery shopping and carbohydrate counting.

Create a workout schedule. Your goal should be to move your body for at least 150 minutes each week, which can be broken up into six daily 25-minute sessions. (With one rest day!)

Find an activity that works for you. Schedule a consultation with a trainer at a local gym, book an exercise class or recruit a friend to be your daily walking buddy. Even taking a ten-minute walk on your lunch break at work can make a difference.

Inspire your family to join you. If you are working to get healthier, bring your entire family along. As the obesity epidemic worsens, even children can be at risk of developing prediabetes and Type 2 diabetes. Make it a fun family effort to discover new healthy recipes and fitness activities together.

Lose a few pounds: Did you know the location of your weight can increase your chances of prediabetes? Extra weight around the stomach plays a significant role in prediabetes and diabetes risk, as does family history and genetics. Losing weight around your middle is a great place to start your fitness journey.

Seek out helpful resources: Ask your PCP for a referral to a prediabetes lifestyle change program. You can also find free at-home workout options, prediabetes-specific recipe options, and meal plans online.

Prediabetes is a warning sign for your health and an opportunity to change. You are more likely to achieve a healthy weight and enjoy a more active lifestyle with diet and exercise.

“Small changes can make a big difference when you are prediabetic—it does not have to lead to Type 2 diabetes,” said Freedman. “So, start making changes today for better health.”

Manage Your Diabetes at Catholic Health Diabetes Education Centers

Catholic Health Diabetes Education Centers in Nassau and Suffolk Counties provide tools and resources to help you manage your diabetes. Our Registered Dietitians and Certified Diabetes Care and Education Specialists help you make small changes that significantly impact your daily life. Our patient-centered programs teach you how to manage your insulin, count carbohydrates, and create healthy daily lifestyle adjustments. 

Find a Catholic Health Diabetes Education Center near you. Or call 855-908-8989. 

View our diabetes services.