What is prediabetes?

Prediabetes is defined by a hemoglobin A1c (HgbA1c) level that is above the normal limit but lower than the level to be diagnosed with Type 1 or Type 2 diabetes mellitus (DM). HgbA1c is a three-month snapshot of a person’s blood glucose levels and a better reflection of their blood sugar control over time than a one-time glucose level. Individuals with prediabetes typically have an HgbA1c between 5.7%-6.4%. Providers often order HgbA1c tests routinely as part of annual physicals or if a person has a risk factor for developing diabetes.  

Prediabetes and Type 2 DM have the same route cause of insulin resistance. This is when the body does not recognize insulin secretion correctly, which is required to allow glucose into the cells to be absorbed. The lack of glucose uptake into the cells leads to high amounts of glucose in the blood. Those with insulin resistance, or those whose pancreas is not producing enough insulin, are at risk for developing prediabetes.

The risk factors for prediabetes are similar to those for developing Type 2 DM, and can include: 

• Genetics 
• Being overweight or obese 
• A history of gestational diabetes 
• Being over 45 
• Lack of physical activity and being physically active less than three times a week 

The development of insulin resistance, prediabetes, and eventually Type 2 DM has to do with a combination of lifestyle factors and genetics.  

For individuals who are overweight or obese, weight loss of around 5-7% of a person’s body weight and 150 minutes of exercise weekly may help decrease this risk and support overall health. This exercise goal breaks down to roughly 30 minutes a day, 5x/week, and can include low-intensity cardiovascular exercise such as walking. The Centers for Disease Control (CDC) has created standardized programs with health coaches to help people reverse prediabetes through lifestyle interventions. In the most personalized action plan, individuals with prediabetes can consult a Registered Dietitian for customized nutrition recommendations and goals.  

Evidence indicates that there is no one diet that works best for managing prediabetes but rather an emphasis on lifestyle changes and exercise. Nutrition interventions can be low-cost and often an effective method for the prevention of Type 2 DM, an extremely prevalent disease with severe comorbidities. Consult your medical provider and registered dietitian for personalized interventions to help manage prediabetes and prevent the development of Type 2 DM.  

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References

https://www.cdc.gov/diabetes/prevention-type-2/prediabetes-prevent-type-2.html  

https://diabetes.org/about-diabetes/prediabetes  

https://pubmed.ncbi.nlm.nih.gov/33003593/