Prediabetes is a condition where the blood sugar level is higher than normal but not yet in the diabetes range. Prediabetes is a sign of risk of developing type 2 diabetes.

Individuals are considered to have prediabetes when fasting blood sugar or glucose levels are between 100-125 mg/dL; fasting blood sugar/glucose levels above125mg/dL are in the diabetes range and can require treatment. 

Fasting Blood Glucose
Normal Less than 100 mg/dL
Prediabetes 100–125 mg/dL
Diabetes 126 mg/dL or greater

Prediabetes Symptoms & Testing

There are often no signs or symptoms of prediabetes, and in many cases patients are unaware they have prediabetes unless they are screened. 

Screening Guidelines:

Our program screens diabetes or prediabetes in asymptomatic adults in accordance with the ADA Standards of Care 2022. A patient may have diabetes or prediabetes if they have the following:

  • Testing should be considered in adults with overweight or obesity who have one or more of the following risk factors:
    • First-degree relative with diabetes
    • High-risk race/ethnicity such as African American, Latino, Native American, Asian American, Pacific Islander
    • History of cardiovascular disease
    • Hypertension or on therapy for hypertension)
    • HDL cholesterol level
    • Women with polycystic ovary syndrome
    • Physical inactivity
    • Other clinical conditions associated with insulin resistance such as severe obesity, acanthosis nigricans
  • Patients with prediabetes (A1C less than or equal to 5.7%) impaired glucose tolerance, or impaired fasting glucose should be tested yearly
  • Women who were diagnosed with Gestational Diabetes should have lifelong testing at least every 3 years

For all other patients, that do not meet the above criteria, testing should begin at age 35 years.

  • If results are normal, testing should be repeated at a minimum of 3-year intervals, with consideration of more frequent testing depending on initial results and risk status.
  • People with HIV

Providers may use one of the tests or measurements below in order to confirm if a patient have prediabetes or diabetes:

  • Fasting plasma glucose test: Measures glucose levels after a patient you have fasted for at least 8 hours. 
  • Glucose tolerance test: Measures sugar levels after a patient has fasted for at least 8 hours, plus 2 hours after taking a sugar solution provided by the lab.
  • A1C: This test measures the estimated average levels of blood sugar over the past 3 months.

Understanding Your A1C

Your A1C helps determine your blood sugar control and is used to diagnose diabetes.

A1C Result
Normal Less than 5.7%
Prediabetes 5.7%–6.4%
Diabetes 6.5% or higher

The American Diabetes Association recommends an A1C less than 7% to reduce long-term complications of diabetes. Having an uncontrolled A1C or undiagnosed diabetes can lead to the following:

    • Eye problems and loss of vision/blindness
    • Dental problems
  • Nerve damage
  • Kidney damage and disease that can lead to dialysis
  • Slower wound healing and higher risk for infection and amputation
  • Increased risk for heart attack and stroke

Regular follow-ups with your primary care provider and making healthy changes to your lifestyle can help control your A1C.

Diabetes Prevention

While individuals with prediabetes are at risk for developing type 2 diabetes, it is not too late to make lifestyle changes that will help decrease your risk.

You can lower your risk for diabetes by:

  • Increasing your level of physical activity to reach 30-60 minutes of moderate exercise, such as walking four or more days a week 
  • Meal Planning:
    • Balance meals with moderate amounts of carbohydrates, choose lean proteins and add non-starchy vegetables
    • Choose water or sugar-free beverages and limit or avoid sugar sweetened beverages
  • Getting 7–8 hours of uninterrupted sleep most nights
  • Identify healthy coping skills to reduce stress
  • Monitoring your health, taking your medications, and going to all your appointments 

These diet and lifestyle changes can promote healthy weight loss and losing 7% of your body weight has been shown to reduce your risk of developing Type 2 diabetes by up to 58%