6 signs of prediabetes and how to lower your risk

Prediabetes is an increasingly common condition that can sneak up on you without much warning. This condition happens when blood sugar (blood glucose) levels are higher than normal, but not high enough to be diagnosed as diabetes 1

About 1 in 3 adults in the United States has prediabetes.1 Understanding the possible signs and risk factors of prediabetes can help you take steps to improve your health.

Understanding the differences between prediabetes and type 2 diabetes

With prediabetes, your blood sugar levels are higher than normal. Prediabetes can lead to heart disease, stroke and type 2 diabetes (the most common form of diabetes). The good news? Prediabetes can often be turned around with lifestyle changes.2

Type 2 diabetes is a chronic condition where the body can’t properly use or produce a hormone called insulin. High blood sugar levels can cause longer-term problems like heart disease and vision loss.2

3 surprising signs you may have prediabetes

“Prediabetes is a silent condition and usually has no symptoms,” explains Kevin Peterson, M.D., vice president of primary care and quality at the American Diabetes Association. “Even though a person feels good, over time prediabetes can cause damage inside the body. Most prediabetes is found by a screening test in people who feel normal.” In some cases, though, a person may have early symptoms of diabetes.3

1. Darkened skin or skin tags

This is a condition where the skin on the armpits, or on the back or sides of the neck darkens. Skin tags (small benign growths) may often appear in those same areas.4

2. Unexplained weight loss or gain

Unexplained weight loss or gain, along with increased appetite, may be a symptom of both prediabetes and type 2 diabetes.5

3. Fatigue or weakness

Are you feeling more tired than usual in your daily life, despite getting more sleep? This may be a sign of prediabetes. You may also experience an overall feeling of weakness.5

If you have any of these signs, reach out to your health care provider to get your blood glucose levels checked.

Risk factors of prediabetes

Having one or more of the following risk factors, may increase the chances of prediabetes.  

Being overweight

Weighing more than what’s recommended for your age, gender and height increases the likelihood of having abnormal blood sugar levels.1

Being 45 or older

While anyone can develop prediabetes (including children), adults 45 or older have a higher risk.1

Having a parent or sibling with type 2 diabetes

If you have a family history of diabetes, you’re at higher risk.1

Not being as physically active as you’d like

Exercising fewer than 3 times a week may increase your risk of prediabetes and type 2 diabetes.1 Getting at least 150 minutes of weekly exercise — broken up into smaller blocks of time throughout the week — is recommended to reduce blood sugar levels.6

Having gestational diabetes

Women who have/had diabetes during pregnancy — known as gestational diabetes — are more likely to develop prediabetes and type 2 diabetes when they’re not pregnant. Women who give birth to babies weighing more than 9 pounds are also at higher risk.1

Being of a certain ethnicity

African Americans, Hispanic and Latino Americans, American Indians, Pacific Islanders and some Asian Americans are at higher risk of both prediabetes and type 2 diabetes.1

Having polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is one of the most common causes of female infertility. It’s a condition where a woman’s body produces more male hormones than usual. According to the Centers for Disease Control and Prevention, more than half of women with PCOS develop type 2 diabetes by the age of 40.7

How to lower your risk of prediabetes

Managing prediabetes and preventing it from progressing into type 2 diabetes may be possible through lifestyle changes.1 “If you commit to living a healthier lifestyle, you may substantially reduce your risk of diabetes and feel better,” says Dr. Peterson. Here are some strategies that may help.

Eat non-starchy vegetables, lean proteins and whole grains — and avoid sugary drinks

Having a balanced diet can help manage blood sugar levels.  If you’re prediabetic, you may want to try eating fruits like berries and citrus fruits.8

You may also want to try non-starchy vegetables, like broccoli, carrots or green beans. Lean proteins include fish like salmon and cod, chicken, turkey, lean beef and lean pork. Some healthy carbohydrates include brown rice, oatmeal, beans and whole grain pasta.9

There’s also a place in your diet for starchy vegetables, like plantains and sweet potatoes. No matter what healthy carbohydrate you choose, the American Diabetes Association recommends limiting them to one-quarter to half of your plate.9

Sugary beverages can cause your blood sugar to spike. It’s best to limit these in your diet.9

Aim for 30 minutes of activity at least 5 days a week

“Moderate-intensity physical activity of 150 minutes per week is one of the most sustainable lifestyle changes you can make — with the greatest overall impact,” says Dr. Peterson. “It’s important to get up and walk or be physically active for at least 30 minutes, 5 days a week.” Exercising can help lower blood sugar levels and reduce your risk of heart disease.6

Take steps to get to and stay at a healthy weight

Maintaining a healthy weight is key to lowering your risk of prediabetes and type 2 diabetes.4 Setting a small, doable goal is often the best way to get started — and stick with it.10

Manage or reduce stress

Regular stress has been associated with higher blood sugar levels.11 It may not always be easy to reduce stress, but taking small steps during the day to become more relaxed can help. Try setting a timer every hour or couple of hours to remind yourself to take a few slow, deep breaths. Or take a break and do some simple stretching while slowing your breathing.

Aim to get at least 7 hours of sleep each night

Not getting enough sleep can increase your risk of type 2 diabetes. It may also lead to weight gain — a risk factor for both prediabetes and diabetes — and make it harder to shed pounds.12

How to determine if you have prediabetes

Regularly monitoring your blood sugar levels is important for managing prediabetes — and reducing your risk of developing type 2 diabetes. There are 3 tests that can help diagnose prediabetes.13

A1C test

The A1C test measures the average blood sugar level over the course of 2 or 3 months. Levels between 5.7% to 6.4% is a sign of prediabetes.13

Fasting blood glucose test

This is a blood test that measures blood sugar levels after fasting. If your fasting blood sugar level is between 100 mg/dL and 125 mg/dL, it’s an indication that you’re prediabetic.13

Glucose tolerance test

This test also requires a fast. After you fast, your blood is drawn to establish your fasting blood sugar level. Then you’ll drink a sugary beverage and have your blood taken again, 1, 2 or 3 hours later. A blood sugar level between 140 mg/dL and 199 mg/dL after the drink indicates prediabetes.13

There are a number of factors to consider and actions you can take that may help lower your blood sugar levels. Talk to your doctor about your risk factors for prediabetes and get advice on lifestyle changes or treatment options that may work for you.

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