Pre Diabetes: Symptoms, Causes and Treatment

Pre diabetes, a condition prior to type 2 diabetes, affects millions globally. What makes this condition particularly concerning is that most people with pre diabetes are unaware that they have it. The warning signs of pre diabetes often go unnoticed, as many individuals do not experience obvious symptoms. 

This comprehensive guide examines the essential signs of pre diabetes, its risk factors, and the steps individuals can take to prevent its progression to type 2 diabetes. Understanding these symptoms is necessary, as early detection and lifestyle changes can diminish the risk of developing Type 2 diabetes.

Symptoms of Pre Diabetes

Doctors refer to this condition as "silent" because most individuals with pre diabetes feel perfectly normal.

The absence of obvious warning signs makes regular medical check-ups essential. Only blood tests can definitively identify pre diabetes, as these reveal elevated blood sugar levels that haven't yet reached diabetic thresholds.

While most people remain symptom-free, a small percentage may experience subtle signs. The following are some common pre diabetes symptoms:

• Increased thirst
• Frequent urination
• Blurry vision
• Unusual fatigue
• Darkened skin in the armpit or neck (acanthosis nigricans)
• Small skin growths or skin tags

Doctors actively look for specific clinical indicators when assessing pre diabetes risk. These include:

• Waistline measurements exceeding 40 inches in males and 35 inches in females
• Blood pressure readings of 130/80 or higher
• Fasting plasma glucose levels equal to or above 100 mg/dL but <126 mg/dL
• Post-glucose 75 g load test results equal to or above 140 mg/dL but <200 mg/dL
• A1C levels between 5.7% and 6.4%
• Fasting triglycerides over 150 mg/dL
• HDL cholesterol under 40 mg/dL in men and under 50 mg/dL in women

Causes and Risk Factors of Pre Diabetes

Insulin resistance stands at the core of pre diabetes development. This condition occurs when cells in muscles, fat, and the liver fail to respond correctly to insulin, preventing efficient glucose utilization in body. The body consequently produces more insulin to compensate, but eventually, it cannot keep up with demand.

Several factors promote the development of insulin resistance:

• Excess weight: Particularly abdominal fat (visceral fat) increases risk significantly
• Physical inactivity: Lack of regular exercise reduces the body's ability to utilize glucose
• Poor dietary habits: Frequent consumption of highly processed, high-carbohydrate foods and saturated fats
• Genetic predilection: Family history of type 2 diabetes, especially in parents or siblings
• Age: Being 45 years or older increases susceptibility
• Ethnicity: Higher risk among Black, Hispanic/Latino, Native American, Pacific Islander, and Asian American populations
• Chronic stress: Prolonged stress coupled with inadequate sleep quality
• Medical Ailments: Medical conditions that raise pre diabetes risk include obstructive sleep apnea, non-alcoholic fatty liver disease, polycystic ovarian syndrome (PCOS), Cushing's syndrome, and lipodystrophy syndromes (conditions causing abnormal fat distribution). Notably, people with metabolic syndrome—a combination of high blood pressure, abnormal cholesterol levels, and large waist size—face increased risk.
• Medications: Certain medications may also trigger insulin resistance, including glucocorticoids, some antipsychotics, HIV medications, and long-term steroid use.
• Other Factors: 
  • A waist measurement exceeding 40 inches for men and 35 inches for women often signals potential insulin resistance. 
  • Women with a history of gestational diabetes or who delivered babies weighing over 9 pounds face heightened risk.

Complications

Many people view pre diabetes as merely a warning stage, yet this condition carries serious health risks beyond just progressing to full-blown diabetes. If left untreated, pre diabetes increases the likelihood of developing numerous health complications that can significantly reduce quality of life. These include:

• The most immediate concern is progression to type 2 diabetes. 
• Pre diabetes increases the risk of cardiovascular problems, with heart disease being particularly concerning. People with pre diabetes face higher chances of experiencing strokes, heart attacks, heart failure, and atrial fibrillation.
• Kidney function often suffers as well. 
• Pre diabetes boosts the risk of chronic kidney disease, which can gradually impair this vital organ's filtering capabilities. 
• Pre diabetes can trigger early changes in the eyes that may eventually lead to diabetic retinopathy—a leading cause of vision loss. 
• Nerve damage (neuropathy) begins earlier than many realise.
• Other concerning links include:
  • Increased risk of all-cause dementia and specifically Alzheimer's disease
  • Higher likelihood of certain cancers, including liver and breast cancer
  • Greater risk of hepatocellular carcinoma (up to 101% increased risk)
  • Doubled risk of depression if progression to diabetes occurs

Diagnosis

Doctors rely on three primary tests to diagnose pre diabetes:

• Glycated Haemoglobin (A1C) Test: This blood test reveals average blood glucose levels over the past 2-3 months. Results are interpreted as:
  • Below 5.7% - Normal
  • 5.7% to 6.4% - Pre diabetes
  • 6.5% or higher on two successive tests - Diabetes
• Fasting Plasma Glucose Test: This requires fasting for at least eight hours before blood is drawn:
  • Less than 100 mg/dL: Normal
  • 100 to 125 mg/dL: Pre diabetes
  • 126 mg/dL or higher levels on two separate tests: Diabetes
• Oral Glucose Tolerance Test: Though less commonly used except during pregnancy, this test requires:
  • Overnight fasting
  • Normal diet prior 3 days of tests
  • Blood testing over two hours post-75 g glucose.
  • Results between 140-199 mg/dL (7.8-11.0 mmol/L) indicate pre diabetes

Pre Diabetes Treatment

Reversing pre diabetes remains possible through targeted interventions that focus on normalising blood sugar levels. 

First and foremost, losing excess weight makes a significant difference in blood sugar management. Shedding just 5% to 7% of body weight can substantially diminish the risk of developing type 2 diabetes. 

Regular exercise plays a crucial role in treatment by:

• Helping control weight
• Using sugar for energy
• Improving insulin sustainability
• Increasing glucose uptake into muscles by at least 40%

Dietary changes are another pillar of pre diabetes treatment. A diet enriched in fruits, vegetables, whole grains, and low oil helps lower the risk of developing the disease. Equally important is reducing refined carbohydrates, added sugars, and unhealthy fats while increasing fibre intake.

Other lifestyle adjustments that support pre diabetes treatment include:

• Quitting smoking to improve insulin function
• Managing stress levels effectively
• Ensuring adequate sleep quality
• Drinking water instead of sugary beverages

If blood sugar remains elevated despite lifestyle changes, physicians may prescribe medications. 

When to See a Doctor

Certain individuals should consider seeing a doctor sooner, including those who:

• Have unusual blood sugar readings
• Show skin changes like darkened areas or skin tags
• Experience unexplained fatigue or increased thirst
• Have heart disease/obesity
• Possess multiple risk factors for diabetes

Prevention

The power of prevention begins with getting tested. More than 80% of individuals with pre diabetes remain unaware of their condition since symptoms rarely appear apparent. Regular screening becomes essential, particularly for those with risk factors like excess weight or a family history of diabetes.

• Diet: Adopting healthy dietary habits is a cornerstone of prevention. A diet abundant in fruits, vegetables, whole grains, and low oil significantly lowers the risk of pre diabetes. Decreasing the consumption of processed foods and sugary items and limiting alcohol intake supports stabilised blood glucose levels.
• Work out: Exercise improves insulin sensitivity and reduces blood sugar levels. Health authorities recommend at least 30 min/day minutes of moderate-intensity exercise (brisk walking, cycling, swimming, or dancing) or 75 minutes of vigorous-intensity activities (running, swimming laps, aerobics, or strength training) weekly. Even simple activities like daily walks or bike rides offer substantial benefits. Losing just 5-7% of total body weight can decrease the possibility of developing type 2 diabetes. 
• Additional prevention strategies:
  • Getting sufficient sleep (at least 7 hours nightly) to avoid increased insulin resistance
  • Managing stress through relaxation practices like meditation or yoga
  • Quitting smoking, which can improve insulin function within eight weeks
  • Monitoring key health metrics (A1C, blood pressure, cholesterol)

Pre Diabetes Diet Plan 

Doctors recommend a balanced approach rather than eliminating entire food groups, as gradual behaviour changes often lead to sustainable results.

The Mediterranean diet is the gold standard for pre diabetes management, with its emphasis on whole grains, lean protein, and healthy fats. For practical meal planning, doctors suggest following a simple proportion guideline: fill 50% of your plate with non-starchy vegetables (like leafy greens), 25% with healthy carbohydrates (such as brown rice, farro, or quinoa), and 25% with lean protein (chicken, fish, or tofu). Water or zero-calorie beverages are preferred companions to meals.

To effectively manage pre diabetes through diet, focus on these key strategies:

• Choose low glycemic index food items that release glucose slowly, preventing blood sugar spikes
• Increase fibre intake to 25-30 grams daily through fruits, vegetables and whole grains
• Limit added sugars by reducing sugary beverages, cakes, sweets and processed snacks
• Restrict portion sizes of refined carbohydrates like white bread, rice and pasta
• Incorporate healthy fats from seeds, low oil and avocados
• Maintain regular eating times to prevent sudden blood sugar fluctuations. Divide meals in 3-4 times/ day.

Conclusion

Pre diabetes stands as a serious health condition that requires immediate attention and action. Though it often shows no apparent symptoms, blood tests can detect this condition early, allowing people to make vital lifestyle changes before it progresses to type 2 diabetes.

Whether through dietary changes, increased physical activity, or regular medical check-ups, taking action today helps secure better health outcomes for tomorrow.

FAQs

1. Should I be worried if I am pre diabetic?

Pre diabetes warrants attention but not panic. This condition signals that your blood sugar levels are higher than normal levels but not yet high enough to be diagnosed as type 2 diabetes. 

2. Can pre diabetes be reversed?

Yes, you can reverse pre diabetes with appropriate lifestyle changes. Research shows that making strategic modifications to diet and physical activity can effectively lower blood sugar levels. 

3. Is pre diabetes curable?

Pre diabetes can often be reversed with timely lifestyle changes. A lifelong commitment to healthy dietary and lifestyle habits is essential to prevent 
the condition from returning and to maintain long-term blood sugar control.

4. How long before pre diabetes turns into diabetes?

The progression rate varies individually. Altogether, research indicates that about 5% to 10% of people with pre diabetes develop type 2 diabetes annually. Without intervention, approximately 70% of individuals with pre diabetes will eventually develop diabetes during their lifetime.

5. Can pre diabetics eat rice?

People with pre diabetes can include rice in their diet. The key is to choose higher-fibre types of rice and control portion sizes.

6. Can pre diabetics eat bananas?

To minimise blood sugar spikes:

• Choose slightly under-ripe bananas with some green on the peel
• Eat smaller portions (medium or small bananas)
• Pair bananas with healthy fats or protein like yoghurt or nuts
• Spread fruit intake throughout the day