Here at Salt Lake NutriCoaching, many of our patients often come to us after having learned they have “prediabetes.” But what is prediabetes? And what can you do about it? These are just a few of the questions our dietitians are trained to answer — before helping you create a plan for what to do next. So, today, let’s demystify the word and the condition by answering eight frequently asked questions about prediabetes.
We’ll start with:
What is prediabetes?
Prediabetes is a condition that is diagnosed prior to diabetes. A diagnosis of prediabetes is a warning that without changes, you may eventually progress to a diagnosis of diabetes. You are also at greater risk for heart disease or stroke. There are no clear symptoms associated with diabetes, so you may have prediabetes and not even know it.
Who is at risk for prediabetes?
Everyone is at risk for prediabetes. In fact, one in three people have prediabetes, but most do not know it. People with prediabetes have higher than normal blood glucose (sugar) levels but these levels are not high enough yet to be considered type 2 diabetes. The current guidelines state that anyone age 35 and older should be screened for prediabetes and diabetes. Additionally, screening should be done for people who are at even higher risk including people with a BMI greater or equal to 25 or Asian-American individuals with a BMI of greater than or equal to 23 with one or more risk factors (see below).
What are some of the factors that put people at risk for prediabetes?
There are many risk factors that make you susceptible to prediabetes or diabetes. These include the following:
- A history of heart disease
- Having a close relative with diabetes
- Having other conditions associated with insulin resistance (PCOS, Acanthosis Nigricans)
- African American, Latino, Native American, Asian American, Pacific Islander ethnicity
- Physical inactivity
- History of gestational diabetes
- Hypertension or being on a hypertension medication
How is prediabetes diagnosed?
Prediabetes is diagnosed in three ways:
- Hemoglobin A1c Test
- Fasting Plasma Glucose (FPG)
- Oral Glucose Tolerance Test (OGTT)
The table below shows a breakdown of the criteria used to assess normal, prediabetes, and diabetes test results.
| Stage | A1c | Fasting Plasma Glucose (FPG) | Oral Glucose Tolerance Test (OGTT) |
| Normal | A1c less than 5.7% | FPG less than 100 | 2-hour plasma glucose less than 140 mg/dl |
| Prediabetes | A1c 5.7%-6.4% | FPG 100-125 mg/dl | 2-hour plasma glucose 140-199 mg/dl |
| Diabetes | A1c greater or equal to 6.5% | FPG greater than or equal to 126 mg/dl | 2- hour plasma glucose greater than 200 mg/dl |
I have been diagnosed with prediabetes, do I need to worry?
Even when diagnosed with prediabetes, many people believe the condition is not worth worrying about. Unfortunately, if you are diagnosed with prediabetes and do nothing about it, you are at increased risk for many health conditions including chronic kidney disease, heart disease, stroke, retinopathy, and/or neuropathy in the hands and feet. Having an elevated blood glucose level also puts you at risk for a compromised immune system, increased time for wound healing, and a greater chance of hypertension.
In short, prediabetes isn’t something to stress about — so long as you do something about it!
Can I prevent/delay progression to diabetes?
Yes. A diagnosis of prediabetes is helpful because knowing this means you can take action to prevent or delay progression to diabetes. This is GOOD NEWS! Weight loss, regular physical activity, and making healthy food choices are all changes that you can make to reduce your chance of progressing to diabetes.
I have been told I have “borderline diabetes?” What does this mean?
Borderline diabetes is another name for prediabetes. But, some people use this term even when they have diabetes. Whether you have prediabetes or diabetes depends on the test results mentioned in the diagnosis section of this post. If your A1c is greater than or equal to 6.5%, you may have been diagnosed with diabetes. If your A1c is between 5.7% and 6.4% or less, you may have been diagnosed with prediabetes. In either case, making changes now will help improve your long-term health outcomes.
Can prediabetes be reversed?
Yes! For some people it is possible that making healthy lifestyle changes now will reduce your sugar level to a range that you will no longer have prediabetes.
The Take-Away
Prediabetes is a serious condition, but it is possible to make changes now that will help you delay or prevent progression to diabetes. To get started, become more physically active, lose weight (if needed), and make more healthy food choices throughout your day. Small changes can go a long way in creating a more healthy you! If you need help in getting started on this journey, please give us a call. Our dietitians can help you manage your weight, reduce your risk of serious disease, and deal with full-blown diabetes if necessary. We are currently accepting new patients and always happy to be of service!
– JaNae Kinikin
American Diabetes Association. Prediabetes: What is it and what can I do? Diabetes Advisor.
Centers for Disease Control and Prevention. Prediabetes – Your Chance to Prevent Type 2 Diabetes. https://www.cdc.gov/diabetes/basics/prediabetes.html. Accessed August 2, 2023.
VenHuizen, Danielle. Prediabetes—Diagnostic Criteria and Health Risks. Today’s Dietitian. Vol. 21, No. 1, P. 44.