What Should You Do When the Diagnosis is Prediabetes?

An increase in your blood glucose levels, even if it doesnt signal full-blown type 2 diabetes, should be considered a warning that changes are needed.


Watching your blood glucose (sugar) levels is critical if you’re trying to avoid type 2 diabetes and the cardiovascular complications that can accompany it. But if your levels rise to the point your doctor informs you that you have prediabetes, what’s your next move?

“Move” is actually the key word, according to Cleveland Clinic endocrinologist Betul Hatipoglu, MD.

“Exercise. This is the most important intervention you can do to start the fight,” she says. “Getting 150 minutes a week of moderate exercise, with possible weight training twice a week, would make a huge difference in your future, and whether you become diabetic or go back to normal.”

Diagnosing Prediabetes

There are two main tests that can determine whether you have prediabetes or diabetes. The first is a fasting plasma glucose test. It is a blood test done after you have gone eight or more hours without eating.

A fasting blood glucose score of less than 100 milligrams per deciliter (mg/dL) is considered healthy or normal. If your numbers are between 100 and 125 mg/dL, the diagnosis is prediabetes. Type 2 diabetes is considered anything from 126 mg/dL onup.

The second test is known as the A1C test. Your doctor also may refer to as the hemoglobin A1C or HbA1C. The test measures your blood glucose levels over the previous three months. An A1C of 5.6 or lower is considered normal. A level of 5.7 to 6.4 means prediabetes. A level of 6.5 or higher, scored on two separate tests, indicates type 2 diabetes.

Prediabetes Diagnosis

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Taking Your Score Seriously

The complications of diabetes are quite serious. It can exacerbate cardiovascular disease and injure your blood vessels. It can damage nerves in the kidneys, eyes, feet and elsewhere in the body. It’s also associated with skin, vision, and hearing problems, as well as issues with brainfunction.

If you have been diagnosed with prediabetes, know that some complications may already be developing.

“Yes, damage has been shown to start as early as the prediabetes stage,” Dr. Hatipoglu says. “Kidney damage or even nerve damage linked to blood sugar can start during this time.”

However, with lifestyle changes, and in some cases with medication help, you may be able to reversecourse.

Positive Changes

In addition to regular exercise, controlling your weight and following a healthier diet are two other necessary steps in preventing prediabetes from progressing to type 2 diabetes.

“You will probably have to change your eating and drinking habits,” Dr. Hatipoglu says. “Getting rid of sugary drinks (soda, sweetened juices and sports drinks) and foods with a high-carbohydrate load is as important as exercise. We have great food plans, such as the Mediterranean diet, with less processed, high-carb foods and instead good fats (unsaturated fats, such as those in olive oil), fiber, whole grains, fruits and vegetables. Do that and cut out greasy and fried foods, and it should be enough to put you on a good track. Weight management and weight loss are very important. Follow a plan by working with a dietitian or alone.”

Do You Need Medications?

Most people who are diagnosed as prediabetic are not prescribed medications. But there is some debate on this subject. Some experts believe that more people with prediabetes should be on medications to help stave off type 2 diabetes. Other doctors suggest that lifestyle changes can be sufficient for most people.

Typically, diabetes medications such as metformin are prescribed to people with prediabetes if their doctor believes they are at high risk for developing type 2 diabetes.

“Sometimes medications are advised to help patients follow the plan recommended to them,” Dr. Hatipoglu says. “At this stage, medications are usually not a must, but rather a support to their effort of beatingdiabetes.”

Heed the Warning

So if you fall into the prediabetes category, understand the risks as well as the steps you can take to preserve your health. Don’t get discouraged.

“It is upsetting news, but I advise my patients to see this as an opportunity, a second chance,” Dr. Hatipoglu says. “Now they have the warning and they have the opportunity to act on it, and defeating the diabetes before it gets even closer to them. They are not helpless or hopeless at this stage. They should go after the diagnosis with full force, instead of getting upset and ignoring it.”


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