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What Is Borderline Diabetes (Prediabetes)?

February 16, 2020
borderline diabetic

What is Borderline Diabetes?

Borderline diabetes, also known as prediabetes, is a condition in which blood sugar is higher than normal, but not as high as it is in diabetes. It is the result of insulin resistance, or reduced effect of insulin on certain cells in your body. 

Borderline diabetes often progresses to diabetes as insulin resistance increases, but knowing that you have it gives you an opportunity to take steps to lower your risk for developing diabetes.

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How to Know if You Are at Risk of Borderline Diabetes


Nearly 1 in 3 American adults have prediabetes, but only a fraction of them know it. If you are unsure if you have borderline diabetes or you have risk factors for it, your doctor can order blood tests. There are a few that can determine prediabetes.

If your first test comes back in the prediabetes or diabetes range, your doctor may order a repeat test before making a diagnosis.

What Is A Borderline A1C Level?


Your doctor can use the results of an A1C test to diagnose borderline diabetes. A “normal” A1C level is under 5.7%. In prediabetes, A1C is higher than normal (5.7 to 6.4%). You can be diagnosed with diabetes if your A1C is higher than than 6.5%. 

Your A1C results can also be used to monitor prediabetes or diabetes if you have already been diagnosed. Your goal might be to reverse prediabetes and lower your A1C to under 5.7%. For otherwise healthy individuals with diabetes, a common goal to lower the risk for complications is to keep A1C under 7%. For some people with diabetes, such as older adults or people with complications, reducing or maintaining A1C under 8% may be safer. In general, your risk for diabetes complications rises when A1C is higher.

Borderline Diabetes Signs and Complications


Most people with borderline diabetes do not have any signs or symptoms. However, some people have darkening of the skin on the back of the neck or armpits. If prediabetes progresses to diabetes, signs can include excessive hunger and thirst, weight loss, increased frequency of urination, and fatigue.

If untreated, borderline diabetes is likely to progress to type 2 diabetes, and complications can include loss of vision, diabetic neuropathy, and kidney disease. Prediabetes is also a risk factor for high blood pressure and cholesterol.

What Causes Borderline Diabetes?


Genetics and lifestyle both affect risk for prediabetes and diabetes. These are some non-modifiable risk factors, or risk factors that you cannot do anything about.

  • Older age
  • Family history
  • Being African-American, Hispanic, Native American, Asian-American, or Pacific Islander

There are many modifiable risk factors, or risk factors that your own choices can affect. They include the following.

  • Being overweight
  • Not being physically active
  • Having a diet high in red meat and added sugars
  • Having a diet low in vegetables, whole grains, and healthy fats such as olive oil and nuts

Lark DPP can help you address the modifiable risk factors for diabetes to keep your risk as low as possible.

Treatment for Borderline Diabetes


While a diagnosis of borderline diabetes can be jarring, the condition is usually very treatable. In most cases, lifestyle changes can lower risk for diabetes by well over 50%. Steps to take include:

  1. Losing weight
  2. Increasing physical activity
  3. Improving diet
  4. Managing stress
  5. Getting more sleep

A small proportion of patients with prediabetes may be prescribed a medication, such as metformin, to improve insulin sensitivity.

Diet for Borderline Diabetes


If you are overweight and have borderline diabetes, losing weight can be the best way to lower risk for developing diabetes. Losing a lot of weight is good, but so is losing just a few pounds. Losing 5 to 10% of your body weight (say, 10 to 20 pounds) can cut risk by over half, and losing just over 2 pounds can cut risk by 16%.

Lark DPP can help you set and work towards weight loss goals without making dramatic changes to your lifestyle. Instead, small changes can help you lose weight and keep it off. These include:

  • Serving smaller portions of higher-calorie foods, such as refined carbs, fatty meats, desserts, and fried foods
  • Choosing water, tea, or coffee instead of beverages with calories
  • Cutting restaurant meals in half and saving the rest for later
  • Eat slowly, enjoy your food, and stop eating when you are barely full
  • Fill up on vegetables and lean proteins before moving to calorie-dense foods

The types of foods you eat also affect your risk for diabetes. These tips can help you choose a good prediabetes diet.

  • Have plenty of non-starchy vegetables, such as greens, eggplant, zucchini, onions, beets, broccoli, cabbage, cauliflower, bell peppers, mushrooms, cucumbers, and tomatoes.
  • Choose whole-grains instead of refined grains. Examples include whole-grain bread and pasta instead of white, brown rice instead of white rice, whole-grain cereal instead of refined, and whole-grain crackers instead of white.
  • Include fresh fruits.
  • Eat more fish and plant-based proteins such as beans, lentils, soy products, and nuts, instead of fatty meats and processed meats.
  • Limit sugar-sweetened foods and beverages.
  • Bake, broil, steam, grill, and roast instead of fry.
  • Select nuts, olive oil, and vegetable oil rather than butter, lard, and shortening.

Physical Activity and Borderline Diabetes


Along with losing weight, getting physically active is one of the most effective things you can do to reverse insulin resistance. The general goal is to get at least 150 minutes per week of moderate to vigorous-intensity physical activity. This can be in any combination, such as 30 minutes, 5 days a week, or 10 minutes, 3 times a day, 5 days a week. 

Almost any activity that gets your heart pumping faster and makes you breathe hard counts. This includes:

  • Brisk walking
  • Hiking
  • Doing the elliptical trainer or stepper
  • Stationary biking
  • Taking a group fitness class (e.g. aerobics, zumba)
  • Playing tennis or basketball
  • Housework such as gardening, raking leaves, and shoveling snow


A Diabetes Prevention Program, such as Lark DPP, is designed to help people with prediabetes prevent or delay progression to type 2 diabetes. A DPP has a specially-designed curriculum to help you learn about weight loss, increasing physical activity, and lifestyle tips to help you stay as healthy as possible.

Lark DPP is a health coach available 24/7 via your smartphone. Lark DPP is fully recognized by the Centers for Disease Control and Prevention (CDC) within the National Diabetes Prevention Recognition Program. The personalized program includes help with weight loss, nutrition, and increasing physical activity through small behavior changes and establishing habits. In addition to offering the CDC curriculum, features of Lark include real-time feedback when you log meals or snacks, tracking of weight, physical activity, and food intake, and insights around diet, exercise, sleep, and stress management.

Free Diabetes Prevention Diet and Program

* Required