Prediabetes – What is Prediabetes?

Natalie Stein
July 18, 2018
Prediabetes – What is Prediabetes?

What does the term mean to you? Is it a pronouncement from your doctor that comes with the threat of diabetes? Is it something you think does not affect your life? Is it a warning sign to pay attention to your health signs?

Prediabetes” can mean something else: hope! While prediabetes is a risk factor for diabetes, prediabetes is not diabetes. Prediabetes, rather, is a condition that can mostly be managed with lifestyle changes. With simple changes, such as weight loss, a healthier diet, and getting more active, you can dramatically lower your risk for type 2 diabetes, and improve your health and quality of life at the same time!

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Take heart if you are balking at the thought of these “healthy changes.” Few things are more rewarding than taking charge of your health and life, and you can get help in moving in the right direction. This article will help you learn how to recognize prediabetes and what to do about it, and where you can get help becoming the healthiest “you” you can be.

What Is Prediabetes?

Prediabetes, also known as borderline diabetes, is a condition with higher-than-normal blood sugar (blood glucose) levels, but levels that are lower than in diabetes. As the National Institute for Diabetes and Digestive and Kidney Diseases (NIDDK) explains, it results from a disruption in how your body regulates glucose (sugar) in your blood. The sugar can come from food, as your body digests and metabolizes the foods you eat. Glucose can also come from your liver when you need it, such as if you have not eaten for several hours.[i]

Normally, your body is very good at regulating blood glucose, or keeping your levels within healthy ranges. When your blood sugar rises, such as after you eat a meal, beta cells within your pancreas secrete a hormone called insulin. Insulin enables blood glucose to leave the bloodstream and enter fat, muscle, and liver cells that need it for energy.

How Prediabetes Develops

Prediabetes develops when insulin resistance does. With insulin resistance, or lowered insulin sensitivity, the cells of your body are resistant (less sensitive) to the effects of insulin.

  • More insulin is required for your cells to take up the glucose they need from your blood.

  • Your pancreas must produce and secrete more insulin to keep up with demand.

  • Eventually, your pancreatic beta cells get fatigued, and cannot keep up with demand.

At this point, which can be years after the insulin resistance started, your blood sugar levels rise.

What Is Type 2 Diabetes?

Type 2 diabetes happens when your blood sugar levels rise quite a bit. This happens when you have significant insulin resistance, and your body is unable to produce enough insulin to remove enough glucose from the bloodstream.

Type 2 diabetes is not only the seventh-leading cause of death in the United States, but it is also a risk factor for the leading causes – heart disease – as well as for the fifth-leading cause – stroke. It is linked to Alzheimer’s disease, the sixth-leading cause of death, as well as kidney disease, the ninth-leading cause of death.[ii]

You may or may not have symptoms of diabetes even if you have high blood sugar levels. The most common diabetes symptoms include:

  • Increased thirst and urination, which result from excess sugar in your blood.

  • Feeling tired and losing weight, as the result of sugar in your blood being excreted rather than used normally by cells in your body.

  • Numbness or tingling in your fingers or feet, poor vision, or slow wound healing, due to nerve damage from high amounts of sugar in contact with your blood vessels.

When your blood glucose levels are too high or symptoms of diabetes are not controlled, there is a risk for diabetes complications. These can include the following.[iii]

  • Heart disease.

  • Stroke.

  • Kidney disease.

  • Neuropathy, or nerve damage.

  • Blindness.

  • Foot problems, sometimes leading to amputations.

  • Gum disease.

Prediabetes is a step that happens before type 2 diabetes develops. Most people who develop prediabetes will eventually develop type 2 diabetes, but it does not have to happen soon or at all. Proper management of your prediabetes can delay or even prevent type 2 diabetes. In some cases, you can completely reverse prediabetes with some healthy lifestyle changes.

Who Gets Prediabetes? Hint: Maybe You!

Prediabetes is not a distant condition for “other” people. A full 1 out of every 3 American adults were estimated to have prediabetes in 2015, according to the Centers for Disease Control and Prevention (CDC) National Diabetes Statistics Report.[iv] Men are at slightly higher risk, with 36.9 of men versus 31.1% of women estimated to have prediabetes. 

Prediabetes Risk Factors

Your risk for prediabetes increases with these characteristics.

  • Older age: 48.3% of adults over 65
    years have prediabetes, compared to 23.7% of adults 18 to 44 years.[v]

  • Extra pounds: one study found the risk of insulin resistance to be 14 times higher in obese compared to normal-weight women.[vi]

  • Being of a minority group such as black or Asian.

  • Individuals with a family history of diabetes, or a personal history of gestational diabetes.

  • Being physically inactive.

Hint: It Could Be You

Do you have prediabetes? No?

Are you sure?

Shockingly, only about 1 in 10 people with prediabetes know they have it. That includes only 1 in 11 men, and fewer than 1 in 13 Hispanics.[vii]


Know Your Risk

Protect yourself by knowing your risk and getting tested if you have risk factors. The National Institutes of Diabetes and Digestive and Kidney Diseases, or NIDDK, recommends that you get tested for type 2 diabetes if you are 45 years or older, are overweight or obese or have another risk factor, or had gestational diabetes.[viii]

Diagnosing Prediabetes

You are unlikely to have symptoms of prediabetes, but it is easy to get a prediabetes test. You can find out whether you have prediabetes with a simple blood test. Your doctor might order one of the following test.

Prediabetes Weight Loss Diet

One of the most effective ways to control blood sugar is to lose extra pounds. Losing 50 or 100 lb can be daunting, but you can benefit by losing as little as 5 to 7% of your body weight – that is 10 to 14 lb. if you weigh 200 lb. One study found that people who were overweight and had prediabetes lowered their risk for diabetes by 16% for each kilogram (2.2 lb.) of weight loss![1]

Calories and Weight Loss

Losing weight is about taking in fewer calories than you use. You can use, or burn, more calories by upping your activity levels. You can cut the calories you take in with simple substitutions and swaps. Consider these examples.

  • Have 1 packet of plain oatmeal instead of flavored oatmeal (save 50 calories).

  • Have 1 cup of cheerios instead of ¾ cup of granola (save 150 calories).

  • Choose 1 cup of plain, fat-free yogurt instead of sugar-sweetened, low-fat flavored yogurt (save 120 calories).

  • Choose chicken vegetable soup instead of broccoli cheese soup (save 120 calories).

  • Have two hard-boiled eggs instead of a protein bar (save 90 calories).

A fad diet is not necessary to get effective and lasting weight loss results. You need only reduce your intake by extra 500 calories per day to lose 1 lb. a week, so there is no need to cut out healthy foods or worry that you will “never be able to eat the foods you love again.”

Foods to Choose: nutrients for prediabetes Examples
Non-Starchy Vegetables: fiber, potassium, low-calorie
Fresh lettuce and salad greens; tomatoes; celery; cucumbers; onions; snow peas; mushrooms; broccoli; spinach; brussels sprout; eggplant; zucchini; bell peppers…etc.!; frozen vegetables (no salt added)
Seafood: protein, healthy fats, potassium
Salmon; shrimp; tuna; crab; clams; mackerel; herring; tilapia; pollock
Legumes: * fiber, protein, potassium
Split and black-eyed peas; lentils; beans such as kidney, black, garbanzo, and pinto beans; soybeans and soy products, such as tofu, edamame, and soy milk; meat substitutes
Whole Grains:* fiber
Whole-grain bread, cereal, and pasta; oatmeal; brown rice; whole-grain barley, farro, and quinoa; air-popped popcorn
Starchy Vegetables: * fiber, potassium
Sweet potatoes; potatoes; winter squash; green peas; corn; pumpkin
Plant-based fats/oils: healthy fats, fiber (except oil), protein (in peanuts, nuts, and seeds)
Olive oil; avocado; natural peanut and nut butters; peanuts; nuts; seeds; flaxseed; vegetable oils
Reduced-fat dairy: protein, calcium, potassium, vitamin D
Plain yogurt; skim milk; fat-free cottage cheese; low-fat cheese
Fruit: * fiber, potassium
Peaches; cantaloupe; berries; apples; pears; oranges; tangerines; watermelon; frozen fruit (no sugar added)
Hydrating beverages: water, low-calorie
Water; decaffeinated black coffee and unsweetened tea without cream; water with mint, lime, lemon, or cucumber

Weight Loss Strategies

Taking small steps and getting the support you need can help you lose weight. These are some ideas.

  • Cut portions of higher-calorie foods.

  • Snack on vegetables and lean proteins instead of fatty, sugary, or high-starch foods.

  • Limit restaurant eating or have only half of your order.

  • Use an app, such as Lark DPP, that tracks your weight loss while providing feedback on your eating.

Healthy Prediabetes Diet

What you eat affects your blood sugar. Choosing your foods carefully can help you lower blood sugar and control prediabetes. Carbohydrates are important, but so are other nutrients in the foods you eat.

Carbs and Your Blood Sugar

Sugars and starches are types of carbohydrates in some of the foods you eat, such as bread, pasta, crackers, and cereal; potatoes and other starchy vegetables; beans and other legumes; fruit; and sugar-sweetened foods. Your body breaks down sugars and starches, and turns them into glucose that enters your blood. That is why it is important to be aware of the carbohydrates you eat when you have prediabetes.

A low-carb diet helps keep blood sugar levels from spiking, but it can eliminate healthy foods, such as beans and whole grains, and can lead to an increase in unhealthy foods, such as fatty red meat and butter.

A controlled-carb diet is a more moderate approach, focusing on portion control and quality of carbohydrates.

  • Choose 1 to 3 small servings of carbohydrates at each meal.

  • Focus on high-fiber options, such as fruit, whole grains, beans, and starchy vegetables.

  • Limit sugary foods and refined starches, such as white bread and pasta, since these spike blood sugar.

Balanced Prediabetes Diet

Sugars and starches may directly affect your blood sugar levels, but other factors are important in prediabetes management. You can support lower blood sugar levels by making the following choices whenever possible.

  • Choosing lean proteins, such as seafood, eggs, reduced-fat dairy products, beans, tofu, and skinless chicken, instead of fatty red or processed meat.

  • Including healthy fat sources, such as nuts, avocados, and olive oil.

  • Limiting added sugars, which are in foods such as candies, baked goods, ice cream, and flavored foods such as flavored yogurt, sugary cereals, and sweetened condiments.

  • Limiting fried foods and foods with partially or fully hydrogenated oils.


Help with Diet

Staying on track is a lot easier when you have help. Lark health coach guides you in your quest to eat a healthy prediabetes diet. Food logging is just one tool that Lark offers, but the support goes beyond that. Lark provides information on healthy choices for prediabetes, and offers customized feedback based on what you eat.

Prediabetes Lifestyle: Physical Activity and More

While what you eat and how much you eat are critical in managing prediabetes and preventing diabetes, the prediabetes lifestyle includes more. You can lower blood sugar, along with your risk for type 2 diabetes, by increasing physical activity. The Centers for Disease Control and Prevention recommend working up to 150 minutes per week of moderate to vigorous activity.

Exercise has all kinds of benefits for diabetes and other health conditions.

  • It burns calories, which helps you control your weight, which lowers blood sugar.

  • It increases insulin sensitivity, so your cells are better able to use insulin, which lowers blood sugar.

  • It lowers blood pressure, total and “bad” LDL cholesterol, and triglycerides.

  • Additional healthy behavior choices that can lower or help control blood sugar include:

  • Reducing stress.

  • Getting enough sleep.

  • Staying positive.


Motivation from Other Benefits

It can be hard to make healthy choices day in and day out, but remembering the other benefits of these choices can increase motivation. The same diet, exercise, and other lifestyle factors that improve prediabetes can:

  • Lower risk for heart disease, hypertension, Alzheimer’s disease, and more conditions.

  • Improve mood.

  • Increase energy on a daily basis.


More Motivation and Support

While you are getting all the help you can can improve your success, consider a health coach such as Lark. You can receive information as well as support and encouragement in a text-based setting over your phone. Your personal nurse is available 24/7, including weekends, to be your partner in your health journey.

Prediabetes Treatment

Lifestyle changes that you do on a daily basis have the most impact on your prediabetes, but managing prediabetes also includes your medical care. These are some factors to consider when you have prediabetes and are thinking about your healthcare. [2]

  • Your medical team. Along with your doctor, your care team might include a dietitian and other members who are knowledgeable in prediabetes management.

  • Blood sugar tests. The American Association of Clinical Endocrinologists (AACE) suggest getting a fasting blood glucose or OGTT at least every year, with A1c tests if you are not hitting your management goals.

  • Additional lab tests. The AACE recommends testing blood lipids (cholesterol and triglycerides) annually.

Diabetes Prevention Program

Do lifestyle changes really matter when you have prediabetes? Yes! The National Diabetes Prevention Program (DPP) is recognized by the Centers for Disease Control and Prevention as a “proven way to prevent or delay type 2 diabetes.”[3] In landmark research among people with prediabetes who followed the lifestyle program in the DPP, risk for developing diabetes decreased by 58%!

How the Diabetes Prevention Program Works

The DPP has a curriculum designed to help you learn which healthy lifestyle changes can help you lower blood sugar levels, and how to implement them in your own life. The lessons cover topics such as weight loss, healthy eating, and exercising, and they include strategies for overcoming special situations and barriers, such as the following:

  • Eating healthily at restaurants

  • Choosing healthy carbohydrates

  • Getting back on track
  • Staying motivated

The program is designed to take a year to complete. With an in-person DPP, you attend meetings as often as every week to get the coaching you need.

Free Health Kit to Lower Your Risk of Diabetes

Weight 150lbs
Height 60
low Risk
How do you lower your risk?
Free Health Kit

Lark DPP

An online DPP program, such as Lark, can have some advantages over an in-person one.  more convenient

  • Convenience, since you access your lessons whenever you want from your smartphone rather than attending meetings in specific times and locations.
  • Extra coaching, since the program offers not only the DPP curriculum, but holistic coaching surrounding lifestyle behaviors and weight loss.
  • 24/7 availability

You may be eligible for Lark DPP plus a Free Fitbit and Weight Scale to assist with your journey. Let’s get started! 

Written by Natalie Stein on July 18, 2018
Exercise, Fitness & Nutrition Expert | Lark Health
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