I have prediabetes. Now what?

Sara Mae Delaney Henriques, MD

Family Medicine

Finding out you have prediabetes can be a shock. Does this mean diabetes is next? Will you have to take medicine for the rest of your life? What can you eat? Family medicine physician Sara Henriques, MD, explained what prediabetes is and what you can do about it.

What is prediabetes?

Prediabetes is the stage before diabetes. It means your blood sugar levels are higher than normal, but not high enough to be Type 2 diabetes. A hemoglobin A1c blood test is used when diagnosing this condition. If your hemoglobin A1c is between 5.7% and 6.4%, you have prediabetes. If you have an A1c of 6.5% or higher, you have diabetes.

What can affect your blood sugar?

“It’s important to know that sweets aren’t the only foods that can affect your blood sugar,” Dr. Henriques said. “When we talk about sugars, we’re referring to carbohydrates, which can include foods such as rice, pasta, bread, potatoes and beans. The body processes all of those as sugars.”

Why should we care about prediabetes?

While it’s not precisely a disorder in and of itself, it is a risk factor for diabetes, which is associated with health complications such as heart disease, as well as:

• Kidney failure. Diabetes is the main reason people are on dialysis.
• Blindness. Diabetes can damage the vessels in the back of your eyes.
• Neuropathy. High blood sugar levels can damage the nerves in your body to the point where you have numbness in your extremities.
• Problems with wound healing. Numbness paired with the inability to fight infection can lead to amputation.

Can prediabetes be reversed?

A diagnosis doesn’t mean diabetes is a done deal. Knowing you have prediabetes allows you the time you need to make some changes to prevent the progression to diabetes.

“A lot of people get upset, even depressed, when they’re diagnosed, because they feel like it’s going to be a chronic thing that they must live with forever,” Dr. Henriques said. “But there are many people who have successfully reversed their prediabetes.”

The cure for prediabetes is weight loss, and the first step is changing your diet.

“I always tell people, abs are made in the kitchen, not the gym, so you want to take those comfort foods you’re eating and just cut them back by at least 50%. You’ll see a big difference in your A1c numbers as well as your weight.”

Dr. Henriques also recommended the 45/15 rule, which means consuming no more than 45 grams of carbohydrates per meal and no more than 15 grams of carbs per snack.

According to the Centers for Disease Control and Prevention, losing just 5–7% of your body weight and getting at least 150 minutes of exercise a week can prevent Type 2 diabetes.

Can you develop prediabetes if you’re thin?

There’s an association between obesity and prediabetes, but there are individuals who are normal weight and still, unfortunately, develop diabetes. People who eat a lot of carbs, even if they are normal weight, are still at risk.

When can prediabetes turn into diabetes?

There’s no guaranteed timeline as to when prediabetes will turn into diabetes. “Some individuals have lived with prediabetes for five or ten years and never progressed to diabetes,” Dr. Henriques said.

Are there any signs and symptoms of prediabetes?

Unfortunately, prediabetes has no symptoms. Most people do not know they have prediabetes, which is why screening for it is important.

When should you get screened for diabetes?

Somebody at normal risk should start yearly screenings at age 45. For those who are overweight, obese or have a family history, screenings are recommended as early as age 18.

“Just know this: If you get this diagnosis, it’s not the end of the world. It’s an opportunity to make the changes needed to improve your health,” Dr. Henriques said.