What Are the Warning Signs of Prediabetes?
Recognizing the signs of prediabetes can make a major difference in preventing its progression to type 2 diabetes, a metabolic disorder that impacts up to 95% of the 37 million people living with diabetes in the United States, according to the Centers for Disease Control and Prevention (CDC). Like many chronic conditions, type 2 diabetes is much easier to treat in its earliest stages, which is why being able to possibly prevent it or at least minimize its impact on the body is huge.
"Once you have prediabetes, the chances of progressing to diabetes is quite high if you continue to maintain the same lifestyle habits," Hien Tran, M.D., an endocrinologist with Texas Diabetes and Endocrinology, tells SELF. "Not only can that lead to developing type 2 diabetes, but it can also raise your risk of heart disease, stroke, and kidney disease. Lifestyle changes that address your prediabetes are crucial for overall health."
That means identifying prediabetes symptoms could, quite literally, be a lifesaver if your diagnosis is followed with a targeted prediabetes treatment plan. Here's what you need to know, including whether or not prediabetes can be reversed.
What is prediabetes, exactly?
To ensure you have the steady energy you need to function, your body regulates your blood glucose, more commonly known as blood sugar, via insulin, a hormone made by your pancreas (a long, flat gland located behind and below your stomach). Insulin's main job is to help guide blood sugar into your cells, which is then used as fuel for all sorts of processes.
If you have prediabetes, your cells don't respond to insulin as they should-this is known as insulin resistance. Your pancreas goes into overdrive, pumping out more insulin to try to encourage your cells to respond, the CDC explains. Eventually, though, the pancreas also stops responding due to the rise in blood sugar, which sets the stage for the early signs of diabetes. Having prediabetes means your blood sugar stays consistently higher than normal but it is not yet elevated enough to be considered type 2 diabetes.
This window of warning signs is incredibly common: 1 in 3 American adults has prediabetes, and more than 80% of them don't even know it, the CDC says.
According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), those with prediabetes have up to a 50% chance of developing type 2 diabetes within five to 10 years of their initial diagnosis, but Dr. Tran adds it can happen faster than that without intervention, especially if you are unaware of the problem.
What are some common prediabetes risk factors?
There are factors that are associated with a higher risk of developing prediabetes, but according to the CDC and U.S. National Library of Medicine, the most common ones include:
Being overweight or having obesity
Being 45 years or older
Having a family history of type 2 diabetes
Exercising less than three times per week
Having a history of heart disease or stroke
Having high cholesterol or high blood pressure
Having metabolic syndrome
Having polycystic ovary syndrome (PCOS)
Having a history of gestational diabetes (diabetes during pregnancy)
Giving birth to a baby who weighs more than nine pounds
Being Black, Hispanic/Latinx, Native American or Alaskan Native, Asian American, or Pacific Islander
The biggest red flag to note is having a family history of diabetes, Kathleen Wyne, Ph.D., M.D., an endocrinologist at The Ohio State University Wexner Medical Center, tells SELF.
In fact, in one 2018 study published in Genetics in Medicine of Americans 20 years or older, roughly 9% of them had been diagnosed with diabetes. Almost half of those people-more than 10 million-could attribute their diabetes to a family history of the condition. The researchers also found that 40% of people without diabetes had prediabetes-and 4 million of them (roughly 5%) could also attribute their diagnosis to their family history.
What are the warning signs of prediabetes?
You can have prediabetes for years without noticeable symptoms. However, as your blood sugar stays high over time, you may start to experience symptoms as you edge closer to type 2 diabetes, which presents with similar warning signs.
That's why it's important to talk with your health care provider if you have prediabetes risk factors or notice any of the following symptoms, most of which signify being closer to type 2 diabetes, especially if they are persistent or can't be explained. According to the experts SELF talked with, those include:
Darkened skin patches
This is one of the few telltale prediabetes symptoms, according the American Academy Of Dermatology Association. Darkened skin (which presents differently depending on your skin tone) can develop on areas like the elbows, knees, knuckles, neck, and armpits and is caused by skin cells reproducing too quickly due to higher levels of insulin. You may also notice tiny skin growths in similar areas.
Overwhelming fatigue
Stable blood sugar changes throughout the day help keep your energy on track. When blood sugar is not controlled, you might experience heavy fatigue, especially after you eat a high-carb meal (since the glucose spike can't be processed effectively). Your sleep quality might take a nosedive, too.
Weight fluctuations
Unexplained weight gain or loss can happen despite eating a consistent amount of calories and getting the same amount of exercise and is typically due to blood sugar fluctuations, per the Mayo Clinic.
Immune system issues
High blood sugar that isn't controlled can weaken your immune system, making you more susceptible to issues like catching colds frequently or having recurring yeast infections. High glucose levels can also lead to poor circulation and cause sores or wounds to heal slowly, the Mayo Clinic says.
Frequent urination
Too much sugar in the blood is tough on the kidneys since they have to process that glucose. As a result, they work overtime to eliminate it from the body, so you may feel like you need to pee a lot more than usual.
Increased thirst
As you pee more often, your chances of getting dehydrated also go up as your body releases all the fluid, which will often kick off your thirst response.
Lightheadedness
With dehydration, you may notice other changes like feeling dizzy or lightheaded.
Irritability
Blood sugar fluctuations can also lead to mood fluctuations. That can increase stress, which can cause blood sugar to spike even more, setting off a vicious cycle.
When should you see a doctor about prediabetes symptoms?
Even if you have risk factors, your doctor may not automatically screen for prediabetes during check-ups, Dr. Wyne says, which is why it's crucial to speak up if you're noticing any unusual symptoms.
If you're concerned, you can ask about any tests you might need, which can include an A1C test to measure average blood sugar over three months and a fasting plasma glucose test to look at your blood sugar at a single point in time, per the U.S. National Library of Medicine. This will also alert your health care provider to stay on top of the issue.
"When a patient asks for a test like that, your doctor will be more tuned in to watching for signs of diabetes," Dr. Wyne notes. "Also, it shows you're being more proactive about your health, and that can lead to some good discussions about lifestyle changes that can help."
Can prediabetes be reversed?
If your doctor confirms you have prediabetes, you may understandably feel a bit overwhelmed. But it is indeed possible to reverse prediabetes, depending on what you do next, says Dr. Wyne. At the very least, you may be able to significantly slow the progression toward the more serious diagnosis of type 2 diabetes, which requires taking insulin injections.
"Prediabetes isn't an official medical condition or disease," Dr. Wyne adds. "Think of it instead as a warning sign. If you take action now, you can change where you're headed."
With prediabetes, overhauling your lifestyle habits is nearly always the first step, says Dr. Tran. There are many factors that can lead to higher blood sugar, including poor sleep and increased stress, but the biggest switch will come down to what eat and how much you move. "Control of blood sugars is 80% dietary," she says. "Just by cutting down portions of carbohydrates by a quarter or a half will help."
If there's one diet change to make right away, it's eliminating sweetened drinks, Karen Graham, R.D., certified diabetes educator and co-author of Diabetes Meals for Good Health, tells SELF. She says examples include soft drinks, sports drinks, sweetened smoothies, sweetened tea, and sweetened coffee drinks. With the exception of some types of smoothies, these drinks often don't contain much fiber-which is needed to help slow down digestion and regulate blood sugar levels. That means you'll be getting a blood sugar spike with every drink.
Choices like fried foods or sugary desserts should be punted into the "occasional" category while your blood sugar remains elevated. You might also need to cut back on certain beneficial carbohydrates until your blood sugar levels stabilize, including some fruits and whole-grain bread, Dr. Tran says.
In general, it's helpful to track the foods you eat-there are several apps that can help you do this-to understand how many carbohydrates you're eating, at least when you first receive a confirmation of prediabetes. Working closely with your doctor or a registered dietitian who is also a certified diabetes educator can help you figure out how to navigate these diet changes, so you're making adjustments safely with your body and personal needs in mind.
Getting more active is also important if you're trying to reverse prediabetes, and that's true even if you already take walks or do other activities like yoga, says Graham. That's because consistently exercising increases your sensitivity to insulin, which can help lower and stabilize your blood sugar levels over time, according to the American Diabetes Association.
"If you do aerobic exercise or walk for about 15 minutes a day, try to increase it to 30 minutes," Graham suggests as one tip. "You can either do one long walk or add in a second walk."
In general, noticing the signs of prediabetes is a pivot toward becoming more aware of your body and your health, according to Dr. Wyne. As you make changes to try to help lower your blood sugar levels, you'll likely notice other shifts as well. That can include better sleep, less stress, more energy, and a better mood, she adds.
"Prediabetes can actually be a good thing because it helps you to see the importance of taking care of yourself," Dr. Wyne says. "It shouldn't be seen as a condition on its own that you manage, but rather as a red flag that prompts changes."
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