Prediabetes Is Not Pre-Problem

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Statistically speaking, there’s a pretty good chance that you or someone you care a lot about has prediabetes. About 1/3 of adults in the U.S. have it. And very unfortunately, statistically speaking, you might have prediabetes and not even know it! A whopping 84 million American adults have prediabetes and only about 12 percent are aware that they have it.

Prediabetes must be taken seriously. I think it’s frequently ignored because of what it’s called: prediabetes. “Pre” sounds harmless — like before something happens or before the problem. But prediabetes isn’t harmless. It’s actually a sign that a problem has been going on for some time. Before blood sugar levels rose to the threshold of prediabetes, insulin resistance or loss of insulin production or both were going on for some time.

Here’s the typical progression.

  1. Normal blood sugar levels in an abnormal state. In this earliest stage of the problem, no one is the wiser because blood tests are normal. But because certain cells of the body are resistant to the effects of insulin, the beta cells of the pancreas send out extra insulin to move sugar out of the blood and into the cells. The result is higher-than-normal insulin levels with normal blood sugar levels. There’s more insulin secreted, so it gets the job done. This extra insulin tamps blood sugar down to the normal level, but this is not a normal, healthy state.
  2. Prediabetes. The beta-cells of the pancreas aren’t able to release enough insulin to maintain normal blood sugar levels. For many people, their genetics cause the beta-cells to break down.
  3. Type 2 diabetes. The beta-cells continue to fail, and the pancreas can’t keep up with the demands. The amount of insulin available isn’t enough to keep blood sugar levels down, so they rise even higher.

So now you see that prediabetes didn’t just come out of the blue. It’s actually a sign that a problem has been going on for some time. Prediabetes likely developed gradually over years because of beta-cell failure and insulin resistance. Prediabetes is your wake-up call that type 2 diabetes is on the horizon — unless you make changes.

Without lifestyle changes, 37 percent of people with prediabetes are likely to progress to full blown type 2 diabetes within 4 years and most will have the diagnosis within 10 years.

Prediabetes is More Than a Blood Sugar Problem

Like diabetes, prediabetes is defined by blood sugar levels. And because of this, many people aren’t aware that both prediabetes and type 2 diabetes are metabolic disorders that affect organs throughout the body. Measuring blood sugar levels is how we identify the problem and watch the progression. But there’s a lot more going on. Other problems associated with insulin resistance include blood vessel dysfunction, fatty liver, chronic inflammation and increased risks for heart disease, stroke and certain types of cancer.

Prediabetes Can be Stopped

Your greatest opportunity for a reversal is today. Every day that window of opportunity closes ever so slightly because of progressive loss of beta-cell function. There are lots of things you can do to halt the progression of prediabetes and possibly even reverse it. Prediabetes Is Not Pre-Problem - Here are six strategies to get you started.

  1. Clean up your diet. According to the American Diabetes Association (ADA), higher intakes of nuts, berries, yogurt, coffee and tea are associated with reduced diabetes risk. But red meats and sugar-sweetened beverages are associated with an increased risk of type 2 diabetes. So that sounds like a good place to start: get rid of sugary drinks, cut back on red meats (yes, you still get to enjoy them) and include nuts, berries, yogurt, tea and coffee regularly.
  2. Trade up on carb-rich foods. It’s very common for people with prediabetes to jump to the conclusion that they need to avoid carbohydrates. But the very foods that fight disease are often the ones rich in carbohydrates. Don’t give up carb-containing foods. Instead trade in toaster pastries for whole wheat toast with peanut butter. Swap snack crackers for fruit. Replace breakfast bars with oatmeal. A few carb-rich foods that are especially good choices are oats, barley, fruit, lentils and beans.
  3. Trim calories. Not everyone with prediabetes carries extra weight. But if you do, cutting back even a little can make a difference. At the very least, aim to prevent further weight gain.
  4. Get to bed on time. Studies suggest that sleep deprivation reduces insulin sensitivity. I know from personal experience that short sleeping makes me cranky and less motivated to use my time and energy for self care.
  5. Be active. Every single time you exercise, you improve insulin sensitivity. Yes, I mean that. Every Single Time!!
  6. Get up. The ADA tells us to break up long periods of sitting with 3-minute activity breaks every 30 minutes. Stand up from your desk each time you sip your water or coffee. Do some push ups against the wall. Walk while talking on the phone. You’ll be able to come up with a lot of suitable ideas once you put some thought to it.

Like I said, there’s a lot more to discuss than these six strategies. And there’s lots more to say about these six. The important thing is that you recognize that you have some power here. You do not need to simply wait for your next blood sugar test and hope for the best. Get started now on your own lifestyle reset.

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Jill Weisenberger
Jill Weisenberger, MS, RDN, CDE, CHWC, FAND, is a writer, nutrition consultant and speaker with a private practice in Newport News, VA, and is the author of four books, including the bestselling Diabetes Weight Loss – Week by Week and her newest title, Prediabetes: A Complete Guide. Follow her on social media and learn more at