Prediabetes (Impaired Fasting Glucose/Impaired Glucose Tolerance)

What is Prediabetes (Impaired Fasting Glucose/Impaired Glucose Tolerance)?

Prediabetes is a condition where your blood sugar levels are higher than normal but not yet high enough to be diagnosed as type 2 diabetes. It happens when your body becomes less responsive to insulin, a hormone that helps sugar move from your blood into your cells for energy. Your pancreas tries to compensate by making more insulin, but eventually it cannot keep up.

About 96 million American adults have prediabetes. That is more than 1 in 3 people. The concerning part is that more than 8 in 10 people with prediabetes do not know they have it. Without intervention, 70% of people with prediabetes will develop type 2 diabetes within 10 years.

The good news is that prediabetes is reversible. Making changes to your diet, exercise routine, and lifestyle can bring your blood sugar back to normal levels. Catching it early gives you the power to prevent type 2 diabetes and the serious health problems that come with it, including heart disease, nerve damage, and kidney disease.

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Symptoms

Increased thirst and frequent urination
Extreme hunger even after eating
Unusual fatigue or tiredness
Blurred vision
Slow healing of cuts and bruises
Tingling or numbness in hands or feet
Darkened skin patches, especially around the neck and armpits
Frequent infections

Most people with prediabetes have no symptoms at all. This is why testing your blood sugar and insulin levels is so important. By the time symptoms appear, you may already have type 2 diabetes.

Causes and risk factors

Prediabetes develops when your cells become resistant to insulin. This is called insulin resistance. Your pancreas responds by producing more insulin to try to get sugar into your cells. For a while, this extra insulin keeps your blood sugar in the normal range. Over time, your pancreas cannot keep up with the demand, and your blood sugar starts to rise.

Several factors increase your risk of developing prediabetes. Being overweight or obese is the biggest risk factor, especially when you carry extra weight around your belly. Physical inactivity, eating too many refined carbohydrates and sugary foods, and having a family history of diabetes also raise your risk. People over age 45, those with polycystic ovary syndrome, and women who had gestational diabetes during pregnancy face higher risk as well. Sleep problems, chronic stress, and smoking can also contribute to insulin resistance.

How it's diagnosed

Prediabetes is diagnosed through blood tests that measure your blood sugar and insulin levels. Standard tests include fasting glucose, hemoglobin A1C, and oral glucose tolerance tests. However, these tests only show a problem after blood sugar has already started to rise. Advanced testing can catch prediabetes much earlier.

Measuring fasting insulin levels reveals insulin resistance years before glucose becomes abnormal. When your body is pumping out high levels of insulin to maintain normal blood sugar, it signals that prediabetes is developing. Testing for small dense LDL particles is also valuable because these dangerous cholesterol particles increase as insulin resistance develops. This helps identify cardiovascular risk in people with prediabetes. Rite Aid offers testing for both fasting insulin and small dense LDL particles at Quest Diagnostics locations nationwide.

Treatment options

Lose 5% to 7% of your body weight if you are overweight
Exercise for at least 150 minutes per week, combining cardio and strength training
Eat more fiber from vegetables, fruits, beans, and whole grains
Cut back on refined carbohydrates, sugary drinks, and processed foods
Choose lean proteins and healthy fats like olive oil, nuts, and avocados
Get 7 to 9 hours of quality sleep each night
Manage stress through meditation, yoga, or other relaxation techniques
Quit smoking and limit alcohol consumption
Consider metformin medication if lifestyle changes are not enough
Work with a doctor or registered dietitian for personalized guidance

Frequently asked questions

Prediabetes means your blood sugar is higher than normal but not high enough to be diagnosed as diabetes. A fasting glucose between 100 and 125 mg/dL indicates prediabetes, while 126 mg/dL or higher means diabetes. Prediabetes can often be reversed with lifestyle changes, while type 2 diabetes requires ongoing management.

Yes, prediabetes is reversible for many people. Losing 5% to 7% of your body weight through diet and exercise can restore normal blood sugar levels. Studies show that lifestyle changes can reduce the risk of progressing to type 2 diabetes by 58%. The key is catching it early and making consistent changes.

Fasting insulin measures how much insulin your pancreas is producing, while glucose testing measures the sugar in your blood. High insulin levels often appear years before glucose becomes abnormal because your body is working overtime to keep blood sugar normal. Testing insulin catches prediabetes much earlier than glucose testing alone.

Small dense LDL particles are a type of cholesterol that is more likely to stick to artery walls and cause heart disease. These particles increase as insulin resistance develops during prediabetes, even when blood sugar is still normal. Testing for them helps identify cardiovascular risk early so you can take action to protect your heart.

Focus on whole foods like vegetables, lean proteins, healthy fats, and high-fiber carbohydrates. Avoid sugary drinks, white bread, white rice, and processed snacks. Choose foods that do not cause big spikes in blood sugar, like leafy greens, beans, nuts, fish, chicken, and berries. Working with a registered dietitian can help you create a sustainable eating plan.

Research shows that losing just 5% to 7% of your body weight can significantly reduce your risk of developing type 2 diabetes. For someone who weighs 200 pounds, that is only 10 to 14 pounds. Even modest weight loss combined with regular physical activity can restore normal blood sugar levels for many people with prediabetes.

Most doctors recommend retesting every 6 to 12 months if you have prediabetes. Regular testing helps you track whether your lifestyle changes are working or if your condition is progressing. Testing fasting insulin and small dense LDL along with glucose gives you a more complete picture of your metabolic health.

Medication is not always necessary for prediabetes. Most people can reverse prediabetes through diet, exercise, and weight loss alone. However, your doctor may prescribe metformin if you have very high blood sugar, cannot lose weight through lifestyle changes, or have other risk factors like polycystic ovary syndrome or a history of gestational diabetes.

Yes, though being overweight is the biggest risk factor, thin people can develop prediabetes too. Genetics, physical inactivity, poor diet quality, stress, and lack of sleep all contribute to insulin resistance. Some people store fat around their internal organs even when they look thin, which increases diabetes risk.

Ignoring prediabetes significantly increases your risk of developing type 2 diabetes within 10 years. Type 2 diabetes can lead to serious complications including heart disease, stroke, kidney failure, nerve damage, vision loss, and amputation. Prediabetes also increases your risk of heart disease even before diabetes develops, which is why early detection and intervention are so important.