Prediabetes

What is prediabetes?

From: MedlinePlus, National Library of Medicine

Prediabetes means that your blood glucose, or blood sugar, levels are higher than normal but not high enough to be called diabetes. Glucose comes from the foods you eat. Too much glucose in your blood can damage your body over time.

If you have prediabetes, you are more likely to develop type 2 diabetes, heart disease, and stroke. But if you make some lifestyle changes now, you may be able to delay or prevent type 2 diabetes.

What causes prediabetes?

From: MedlinePlus, National Library of Medicine

Prediabetes usually happens when your body has a problem with insulin. Insulin is a hormone that helps the glucose get into your cells to give them energy. A problem with insulin could be:

• Insulin resistance, a condition in which the body can't use its insulin properly. It makes it hard for your cells to get glucose from your blood. This can cause your blood sugar levels to rise.
• Your body can't make enough insulin to keep your blood sugar levels at a healthy level

Researchers think that being overweight and not getting regular physical activity are major factors in causing prediabetes.

Who is at risk for prediabetes?

From: MedlinePlus, National Library of Medicine

About 1 out of every 3 adults has prediabetes. It is more common in people who:

• Are overweight or have obesity
• Are age 45 or older
• Have a parent, brother, or sister with diabetes
• Are not physically active
• Have health conditions such as high blood pressure and high cholesterol
• Have had gestational diabetes (diabetes in pregnancy)
• Have a history of heart disease or stroke
• Have metabolic syndrome
• Have polycystic ovary syndrome (PCOS)

What are the symptoms of prediabetes?

From: MedlinePlus, National Library of Medicine

Most people don't know they have prediabetes because usually there are no symptoms.

Some people with prediabetes may have darkened skin in the armpit or on the back and sides of the neck. They may also have many small skin growths in those same areas.

How is prediabetes diagnosed?

From: MedlinePlus, National Library of Medicine

There are a few different blood tests that can diagnose prediabetes. The most common ones are:

• Fasting plasma glucose (FPG) test, which measures your blood sugar at a single point in time. You need to fast (not eat or drink) for at least 8 hours before the test. The results of the test are given in mg/dL (milligrams per deciliter): A normal level is 99 or below Prediabetes is 100 to 125 Type 2 diabetes is 126 and above
• A1C test, which measures your average blood sugar over the past 3 months. The results of an A1C test are given as a percentage. The higher the percentage, the higher your blood sugar levels have been. A normal level is below 5.7% Prediabetes is between 5.7 to 6.4% Type 2 diabetes is above 6.5%

If I have prediabetes, will I get diabetes?

From: MedlinePlus, National Library of Medicine

If you have prediabetes, you may be able to delay or prevent type 2 diabetes through lifestyle changes:

• Losing weight, if you are overweight
• Getting regular physical activity
• Following a healthy, reduced-calorie eating plan

In some cases, your health care provider may also recommend taking diabetes medicines.

Can prediabetes be prevented?

From: MedlinePlus, National Library of Medicine

If you are at risk for prediabetes, those same lifestyle changes (losing weight, regular physical activity, and a healthy eating plan) may prevent you from getting it.

Which doctor should you see?

The suggested department for discussing Prediabetes is Diabetology, with a endocrinologist / diabetologist as the relevant type of clinician. General physician / Family Medicine; paediatrician for children. Referral depends on symptoms.

This is an editorial referral starting point. The appropriate clinic depends on the person’s age, symptoms, previous diagnosis and local services. The first clinician can decide whether another specialty or a team is needed; a department label does not confirm the diagnosis.

How to prepare for an assessment

Bring a short timeline of the main symptoms: when they first appeared, whether they are constant or episodic, what seems to change them, and how they affect daily activities. Include previous reports, discharge summaries, current medicines and supplements, allergies, and any relevant family history. A dated record is more useful than trying to match every feature in an online article.

Ask the clinician what is already established and what remains uncertain. If a test is suggested, ask what question it answers, what its limitations are and how the result would change the next step. The information here is not an instruction to arrange every possible test. In children, bring growth, developmental and school information if it is relevant to the concern.

• What type of glucose problem has been confirmed?
• What are the individual monitoring and follow-up goals?
• If treatment can cause low glucose, what response plan should be taught?

Treatment discussions and follow-up

The material gathered for this draft does not provide a complete condition-specific treatment pathway for Prediabetes. That gap does not mean that treatment is unavailable. A clinician needs to establish the diagnosis and review current guidance before recommending medicines, procedures, rehabilitation or other support.

Before leaving the appointment, clarify the next review date, who will communicate results, and whom to contact if the situation changes. Discuss difficulties with sleep, work, school, mobility, eating or emotional wellbeing when these are relevant. Practical support may require coordination between the treating clinician and other services.

The collected references do not establish a complete prevention or long-term outlook section for this entry. Missing information should not be interpreted as proof that prevention is impossible or that a particular outcome is inevitable. Ask what is known for the exact subtype, stage and personal circumstances, and which uncertainties remain.

When to seek emergency help

Severe breathing difficulty, collapse, new stroke-like symptoms, a seizure that is prolonged or repeated without recovery, uncontrolled major bleeding, or an immediate risk of self-harm require emergency help. In India, call 112 or reach the nearest emergency department. This is a general, non-exhaustive warning list; it is not a condition-specific triage tool.