Prediabetes is a condition where blood sugar levels are higher than normal but not high enough to be diagnosed with type 2 diabetes. It is estimated that 81% of people with prediabetes are unaware that they have it because it has no obvious symptoms, and the blood sugars rise slowly where someone may not notice any overt changes. Being aware if you have prediabetes is important because it is the stage where you can focus on lifestyle changes to prevent the development of type 2 diabetes.

According to the Centers for Disease Control and Prevention (CDC), prediabetes is a widespread health concern as 1 in 3 American adults has prediabetes or about 98 million people. Around 80% of these individuals are unaware they meet the criteria for a diagnosis. Without intervention it is estimated that many of these people will develop type 2 diabetes within 5 years. About half of the population over the age of 65 is currently living with prediabetes.

Understanding risk factors, symptoms, and getting the right screenings can help you learn if you have prediabetes and are at high risk for type 2 diabetes. Catching it early gives you the power to take control and improve your health.

Key Risk Factors for Prediabetes

The risk for prediabetes can be increased if you have any of the following risk factors:

• Overweight or obese
• 45 years old or older
• Family history of type 2 diabetes
• Physically inactive
• History of gestational diabetes or giving birth to a baby weighing more than 9 pounds
• Are African American, Hispanic/Latino American, American Indian, Pacific Islander, or Asian American

It is recommended by the American Diabetes Association to get your blood sugar evaluated if you have any of these.

How It’s Diagnosed

A simple blood test that measures your blood sugar levels is the only way to be sure if you have prediabetes. You may be asked to complete one of the following tests:

1. Hemoglobin A1c (A1c)

This test shows the average blood sugar level over the last 2-3 months. A result between 5.7-6.5% indicates prediabetes. This is considered the gold standard for diabetes testing. 

2. Fasting Plasma Glucose (FPG)

This is a simple blood test that is taken after an overnight fast. If your result is between 100-125 mg/dL you would fall into the prediabetes category. A single elevated fasting blood sugar may not be the best indicator of diabetes and should be repeated to determine prediabetes or diabetes. 

3. Oral Glucose Tolerance Test (OGTT)

This test is often given to pregnant women to assess for gestational diabetes. Blood sugar is tested two hours after drinking a sugary solution to see how the body is reacting to sugar. If the result is between 140-199 mg/dL it would indicate a diagnosis of prediabetes.

Reviewing your results with your healthcare provider is important to interpret these results and develop an individualized plan to improve your glucose levels. If you meet the criteria for prediabetes with any of these tests and lifestyle changes are not targeted, then the blood sugars may continue to rise and result in a diagnosis of type 2 diabetes.

Simple Steps to Prevent Diabetes

If you’ve found out that you have prediabetes or are at risk, don’t get discouraged. There are many steps you can take to help bring your blood sugar back into the normal range and significantly reduce the risk of developing diabetes.

Lose Weight

Studies have shown that people with prediabetes who are overweight or obese and lose as little 5-7% of their body weight through healthier eating and 150 minutes of physical activity per week can cut their risk of developing type 2 diabetes by 58%. This percentage increases to 71% for people over 60 years old. Weight loss (if you have weight to lose) is the most impactful change one can make to reduce their risk of diabetes.

When focusing on losing weight, it is important to make changes you can stick to for the long-term! Maintaining a healthy weight is just as important as getting there! Not sure what a healthy weight for you is, check out this website to see what an ideal weight for you would be. When working towards weight loss, a healthy goal is to focus on losing an average of 1-2 pounds a week.

Get Moving

Going for a walk or any other activity will get your blood pumping. Your body uses glucose as fuel when you are exercising which naturally brings down high blood sugar. Regular exercise also helps to boost your sensitivity to insulin which helps keep your blood sugar within the normal range. The key here is to find an activity you enjoy and can stick to! Aim for 30 minutes of moderate physical activity every day or at least 150 minutes a week.

Eat More Fiber

Focus on choosing whole, unprocessed foods as much as possible. Fresh fruits, vegetables, beans/legumes, nuts/seeds, and whole grains should make up most of your diet. The fiber in these foods can improve your blood sugar, reduce your risk of heart disease, and promote a healthy weight. Food with fiber, particularly soluble fiber, can slow the absorption of sugar and may also reduce the risk of developing type 2 diabetes. Examples of foods with soluble fiber include oat bran, barley, nuts, seeds, beans, and peas. High fiber foods also tend to be more filling, so may help you eat less and stay satisfied longer.

Say No to Sugary Drinks

Sugary drinks such as soda, sweetened teas, fruit punch, lemonade, energy drinks, and sports drinks account for the largest source of added sugars in the U.S. diet. There are between 7 and 10 teaspoons of sugar in a typical can of soda!! Sugary drinks provide no nutrition to the diet with many calories, making them some of the worst things you can drink for your health. Drinking 1-2 cans or more of a sugary drink per day increases the risk of developing diabetes by 26%. In the Framingham Heart Study, men and women who had one or more soft drinks per day were 25% more likely to have trouble managing their blood sugar.

Eat Consistent Meals

Scheduling meals to be around the same time each day can help with blood glucose control. Eating consistently throughout the day helps keep blood glucose and hunger steadier, which can help control portions and overeating. Having smaller portions, a few times a day, also allows the body to have more constant energy without such large swings in blood sugar.

Studies have shown that people with prediabetes who take part in a structured lifestyle change program and lose 5-7% of their body weight through healthier eating and 150 minutes of physical activity per week can cut their risk of developing type 2 diabetes by 58%. This percentage increases to 71% for people over 60 years old.

When focusing on losing weight, it is important to make changes you can stick to for the long-term! Maintaining a healthy weight is just as important as getting there! Not sure what a healthy weight for you is, check out this website to see what an ideal weight for you would be. When working towards weight loss, a healthy goal is to focus on losing an average of 1-2 pounds a week.

Quitting smoking and following up with your healthcare provider is also recommended to help reduce your chances of developing diabetes and monitor your progress.

Newer Diet Recommendations

Recent research demonstrated that adhering to a Mediterranean diet and regularly eating yogurt may lower the likelihood of diabetes diagnosis. In March 2024, the U.S. Food and Drug Administration (FDA) approved a qualified health claim that eating at least two cups of yogurt per week may reduce the risk of type 2 diabetes.

A study from Harvard of over 100,000 people found that eating dairy-based yogurt daily was associated with an 18% lower risk of type 2 diabetes. The study's authors hypothesized that yogurt's probiotics may improve insulin sensitivity and reduce inflammation. There have been multiple meta-analyses which have also shown the same thing. This does not prove that eating yogurt guarantees you won't develop diabetes. It is important to focus on your overall diet and lifestyle and include other nutritious plant-based foods.

The Mediterranean Diet was ranked as the #1 Diet for Diabetes in 2024 (and the Best Diet Overall). Numerous studies have found that following this diet reduces the risk for certain chronic conditions, including Type 2 Diabetes. It focuses on a whole food diet and including more plants helps to reduce blood sugar, lower weight, and may improve insulin sensitivity.

Find Out Your Risk

If you are curious if you may have prediabetes visit www.doihaveprediabetes.org, to take an online assessment powered by the American Diabetes Association to determine your risk and determine if you need an assessment by your healthcare provider. This assessment can also point you towards lifestyle changes that are unique to you that you need to tackle.

The American Diabetes Association has offered risk tests since 1993. It is a simple 7 question test which is adapted from a published study and validated with data from the Centers for Disease Control and Prevention (CDC).

A high score on the online risk test (five or higher) means you have a significant risk for having undiagnosed prediabetes or type 2 diabetes. If you find out you are at high risk it is recommended to follow up with a healthcare provider and have a blood test to properly diagnose and develop a treatment plan.

Prediabetes Support

Finding out you have prediabetes and developing a successful plan can be overwhelming. Seattle Sutton’s Healthy Eating has been helping people manage their blood sugar and weight for almost 40 years with simple, convenient healthy meals. Their meal plans are designed by Registered Dietitians and Diabetes Educators and follow guidelines from the American Diabetes Association and American Heart Association. In addition, Seattle Sutton’s offers complimentary support from our healthcare team to help you determine which plan is best for you for your goals and needs. Our hope is to provide you with a program to support long-term health.

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We encourage you to take the risk test and learn your risk for prediabetes. Once you know your risk, you are in the driver seat to take your health in your hands through simple lifestyle choices and we are here to help!