Medically reviewed by Dr. George Kosco, DO on October 26, 2021
Prediabetes is a common condition that is marked by higher-than-normal blood sugar levels. According to the CDC, more than one in three Americans have the condition (1).
If it is allowed to progress, it puts you at risk for developing type 2 diabetes. In this post, I explain how to tell if you have prediabetes and what you can do to prevent it from progressing.
Prediabetes – At-A-Glance
- Prediabetes is a condition where your blood sugar levels are higher than normal but not yet high enough to be diagnosed as diabetes.
- When you have prediabetes, your cells do not respond to insulin properly. This abnormal response is referred to as insulin resistance.
- The development of prediabetes is linked to diet and lifestyle habits.
- Risk factors include being over 45, leading a sedentary lifestyle, having a BMI > 25, and carrying too much belly fat.
- The A1C test is used to diagnose prediabetes. A person with prediabetes has an A1C between 5.7 and 6.4 percent.
- Steps can be taken to reduce your risk of developing prediabetes and diabetes. These steps include, following a low carb diet, practicing intermittent fasting, getting regular exercise, and losing weight.
Prediabetes: What Is It? Do I Have It? What Can I Do About It? [Video]
In this video, you’ll learn…
- The definition and causes of prediabetes.
- What factors increase your risk of developing prediabetes.
- Ways to reduce your risk!
What is Prediabetes?
Prediabetes can be thought of as a stepping stone to type 2 diabetes. It is defined as a condition where your blood sugar levels are higher than normal but not yet high enough to be diagnosed as diabetes.
The onset of prediabetes is closely related to how the cells of your body respond to insulin. That response is strongly influenced by diet and lifestyle habits.
Insulin is a pancreatic hormone that is secreted into your bloodstream when you eat. Its job is to move nutrients from your blood to your cells, where they can be used. One of the primary nutrients that insulin helps to transport is sugar or glucose. So, you can think of insulin as the hormone that keeps your blood sugar levels in check.
When you have prediabetes, your cells do not respond to insulin properly. For example, you eat a sandwich, the sugar that is digested out of the meal moves into your blood, insulin comes in to transport the sugar to your cells, but your cells don’t respond. This is often referred to as insulin resistance because your cells resist insulin’s attempt to deliver the sugar.
What Causes Prediabetes?
I mentioned that your body’s response to insulin is strongly influenced by your diet and lifestyle habits. There are three main nutrients that come from the foods you eat. They are carbohydrates, fat, and protein. Of the three, carbohydrates are the ones that impact your blood sugar the most.
But, not all carbohydrates are created equal. Unrefined carbohydrates that we get when we eat whole foods, like vegetables, fruit, beans, nuts, seeds, and unprocessed grains, must be acted upon by enzymes in your digestive tract before the sugar they contain can get into your bloodstream.
These slow-digesting carbs will raise your blood sugar level, but not nearly as quickly as when you eat sugar or refined carbohydrates. When you drink soda or sweetened drinks or eat the 3 C’s: cookies, cakes, and candies, there is very little for your digestive system to break down. Just think about putting a cookie in your mouth. If you simply hold it there, it breaks down to mush without even chewing.
These quick-digesting refined carbohydrates spike your blood sugar, requiring a mass dumping of insulin. If your diet is high in these insulin-spiking foods, your cells begin to resist insulin’s constant deliveries. As a result, the sugar remains in your blood, leading to the hallmark sign of prediabetes, namely the higher-than-normal blood sugar levels.
Diet is not the only factor that influences the onset of prediabetes. Lifestyle factors also play a role, with a sedentary lifestyle being one of the main factors. Exercise improves insulin sensitivity, meaning your cells are more willing to receive the sugar that insulin brings them. Because your cells take the sugar, regular exercise naturally lowers your blood sugar. The opposite is also true, inactivity creates a low demand for energy, so the sugar stays in the blood, contributing to prediabetes.
What are The Symptoms of Prediabetes?
How do you know if you have prediabetes? More than 1 in 3 Americans are thought to have prediabetes. However, despite that high occurrence, the CDC reports that more than 84% of those with prediabetes don’t know they have it (1). The reason that it goes undetected is because there are no overt signs or symptoms to alert you that you have the condition.
However, there are easily seen factors that, when present, increase your risk of developing the condition. These factors include being over the age of 45, leading a sedentary lifestyle, having a body mass index or BMI greater than 25, and carrying too much belly fat, which is loosely defined as a man having a waist circumference of more than 40 inches and a woman having a waist measurement of 35 inches or more.
You can gather more clues about your risk of prediabetes by testing your blood sugar levels at home. You can pick up an inexpensive blood glucose meter at your local pharmacy or online. These devices tell you your current blood sugar level by analyzing a drop of blood. A person without diabetes would expect to see a fasted morning reading of less than 100 mg/dL (5.6 mmol/L). A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes (2).
If your numbers are in the prediabetes range or the other risk factors that I mentioned are present, your doctor can order a blood test referred to as an HbA1c test to diagnose prediabetes.
How is Prediabetes Diagnosed?
HbA1c, which is often simply referred to as the A1C test, is a blood test that shows how well your body is controlling your blood sugar levels over time. It does this by taking a look at how much sugar is attached to your red blood cells. The more sugar that’s attached, the higher your HbA1c.
The sugar is actually sticking to a specific protein in your red blood cells called hemoglobin. In fact, the Hb in HbA1c stands for hemoglobin. Your red blood cells are a good target for this test because they have a lot of hemoglobin but a very short lifespan. During their brief three-or-so-month life, your red blood cells provide a record of how much sugar they encounter, acting as a good indicator of how well you have been controlling your blood sugar over time.
According to the National Institute of Health, a person without diabetes has an A1C level below 5.7 percent. A person with diabetes has an A1C of 6.5 or above. In between those two figures, a person is classified as having prediabetes (3).
What Can I Do About Prediabetes?
If you have been diagnosed with prediabetes or have some of the risk factors, there are diet and lifestyle actions that you can take to get control of your health and prevent prediabetes from progressing to diabetes.
Diet for Prediabetes
Because the onset of the condition is closely related to how your cells respond to insulin, and insulin is secreted in response to blood sugar, the best approach to halt prediabetes is to eat in a way that stabilizes blood sugar. Many studies show that following a low carb diet has this effect, making the diet a viable approach to managing prediabetes (4) (5).
This makes sense when you consider that carbohydrates are the macronutrients that cause the most significant spike in blood sugar and insulin. Protein creates a modest increase, and dietary fats have a minimal impact. If you are new to low carb dieting, you can gradually decrease your carb intake by tracking how many grams of carbs you eat in a day, aiming for no more than 125 grams. For some of you, this can be accomplished by cutting out quick digesting carbs, like soda, sweetened tea, and refined desserts and snacks.
Depending on your body, you may find that you need to reduce your overall carbohydrate intake further to achieve blood sugar stability. However, you’ll likely find that you can keep some slow-digesting carbs in your diet. You’ll be happiest with your results when you focus on foods with the best fiber-to-carb ratios, such as leafy greens, non-starchy vegetables, avocados, nuts, and seeds.
The fiber and nutrients in these foods slow the rate at which they break down and get absorbed. So you don’t need to eliminate all carbs from your diet; just make different choices.
Intermittent Fasting for Prediabetes
Intermittent fasting is another way of disrupting the progression of blood sugar disorders, like prediabetes. It is a timing strategy that, in its most basic form, asks you to split your day between a period of eating and not eating or fasting. During the fasting period, there is no food coming in, so there is no rise in blood sugar or insulin. This downtime has been found to lower your risk of diabetes by reducing chronically high blood sugar levels and improving insulin sensitivity (6) (7).
If you are new to intermittent fasting, you can start by dividing your day in half to perform what is referred to as a 12:12 fast. A 12-hour fast is easiest to do if you include the hours you sleep in the fasting window. For instance, note the time you stop eating in the evening. When you wake up the following day, put breakfast off until 12 hours have passed.
Exercise for Prediabetes
Exercise is also beneficial for reducing the progression of prediabetes because it improves insulin sensitivity. When your cells are more insulin sensitive, they have an easier time pulling sugar out of your blood, so there is less circulating. The exercise does not have to be exhausting to be helpful. Even short, brisk walks after dinner will move you in a positive direction.
Weight Loss for Prediabetes
The great thing about following a low-carb diet, practicing intermittent fasting, and exercising is that they encourage weight loss. Losing weight has been shown to bring down your HbA1c, which, in turn, reduces your risk of diabetes. So, you can feel good that the diet and lifestyle changes you are making to control your blood sugar are having a positive snowball effect on your overall health.
Prediabetes is a common condition in which your body has a hard time regulating your blood sugar levels. If you are over the age of 45, inactive, and overweight, carrying a lot of that weight around your waist, you have the risk factors for prediabetes. However, you’ll need to ask your doctor to run an A1c blood test for a formal diagnosis. Even if that test indicates that you have the condition, you can take diet and lifestyle steps to reduce your risk of developing diabetes.
If you need a place to start, I recommend that you download my 0,1,2,3 strategy. It is already in use by more than 80,000 people, and it will help you get started on a healthy diet by providing you with a plan to replace refined carbs with blood sugar-stabilizing foods. Thanks for watching and have a great rest of your day.
(1) “Prediabetes – Your Chance to Prevent Type 2 Diabetes.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 11 June 2020, www.cdc.gov/diabetes/basics/prediabetes.html.
(2) “Diabetes.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 30 Oct. 2020, www.mayoclinic.org/diseases-conditions/diabetes/diagnosis-treatment/drc-20371451.
(3) “The A1C Test & Diabetes.” National Institute of Diabetes and Digestive and Kidney Diseases, U.S. Department of Health and Human Services, 1 Apr. 2018, www.niddk.nih.gov/health-information/diabetes/overview/tests-diagnosis/a1c-test.
(4) Spritzler, Franziska. “A low-carbohydrate, whole-foods approach to managing diabetes and prediabetes.” Diabetes Spectrum 25.4 (2012): 238-243.
(5) Feinman, Richard D., et al. “Dietary carbohydrate restriction as the first approach in diabetes management: critical review and evidence base.” Nutrition 31.1 (2015): 1-13.
(6) Wilkinson, Michael J., et al. “Ten-hour time-restricted eating reduces weight, blood pressure, and atherogenic lipids in patients with metabolic syndrome.” Cell metabolism 31.1 (2020): 92-104.
(7) Sutton, Elizabeth F., et al. “Early time-restricted feeding improves insulin sensitivity, blood pressure, and oxidative stress even without weight loss in men with prediabetes.” Cell metabolism 27.6 (2018): 1212-1221.
About the Author
Becky Gillaspy, DC graduated Summa Cum Laude with research honors from Palmer College of Chiropractic in 1991.