Sofie Wise

Mark Spera

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About Author — Mark grew up in a family of healthcare providers and has always been fascinated by preventative medicine, infectious diseases and the intersection of big data and healthcare.

Most PlushCare articles are reviewed by M.D.s, Ph.Ds, N.P.s, nutritionists and other healthcare professionals. Click here to learn more and meet some of the professionals behind our blog.

Have you been told that you have prediabetes?

Maybe you just suspect that you might, or you’re wondering what to watch out for. Maybe you have a family history of type 2 diabetes and want to know what you can do to reduce your risk of developing it yourself.

It’s an important thing to worry about: approximately 86 million people in the United States have prediabetes, and 22% of them don’t even know it. A further 28.9 million people (15.5 million men and 13.4 million women) have type 2 diabetes.

The good news is that prediabetes can be reversed before it becomes type 2 diabetes, which can be controlled but is not as reversible as prediabetes.

If you have prediabetes and act now, you can prevent the onset of type 2 diabetes.

This article will address:

  • What is prediabetes?
  • Are there any symptoms?
  • What’s the difference between type 1 and type 2 diabetes? What are those symptoms?
  • And what can you do to reverse your prediabetes before it becomes type 2 diabetes?

If you would like to speak to a doctor about your condition, click below:

doctor_on_phone

What is prediabetes?

Prediabetes is a warning that your blood sugar is higher than it should be and you are on a path toward type 2 diabetes unless you make some lifestyle changes.

Your blood sugar levels are not quite elevated enough to be diagnosed with type 2 diabetes, but the long-term damage of diabetes may already be starting inside your body.

As our nation struggles with an obesity epidemic, more children and teenagers are being diagnosed with prediabetes than ever before. What used to be referred to as “juvenile diabetes” and “adult-onset diabetes” are now referred to as type 1 and type 2 diabetes to reduce confusion and enforce the notion that even children are susceptible to prediabetes and type 2 diabetes.

Prediabetes is occasionally referred to as impaired glucose tolerance (IGT) or impaired fasting glucose (IFG), depending on what type of test was used to make the diagnosis.

Along with a higher risk of developing diabetes, prediabetes puts you at a greater risk of developing cardiovascular disease.

What is the difference between type 1 and type 2 diabetes?

Both types of diabetes are serious, long-term diseases that affect the way your body handles blood sugar, which is known as glucose.

The two types of diabetes cause different problems regulating glucose. Glucose helps to fuel your body’s cells, but it needs the help of insulin, which is produced by the pancreas, to move from the bloodstream into the body’s cells.

Type 1 diabetes

Previously referred to as juvenile diabetes because it is commonly diagnosed in childhood and adolescence, is a condition where a person’s body doesn’t produce insulin because the body’s immune cells attack insulin-producing cells called beta cells.

Since the body needs insulin to get energy from glucose, people with type 1 diabetes need regular injections of insulin to manage the levels of glucose in their blood and use it for energy.

Type 2 diabetes

Previously referred to as adult-onset diabetes, refers to people whose bodies don’t respond to insulin the way it should. Eventually, their body doesn’t make enough insulin to manage the glucose levels in their blood.

Signs of prediabetes

Prediabetes may not cause any signs or symptoms at all. As it progresses toward type 2 diabetes, it may cause symptoms of diabetes.

Many people live with prediabetes for years without knowing it because they aren’t experiencing any symptoms – the only clue lies in their blood.

Those who do experience signs of prediabetes will often notice symptoms such as:

  • Increased thirst
  • Feeling hungrier than usual
  • Increased urination
  • Unexplained weight loss or gain
  • More urge to urinate
  • Being more tired than usual

If you would like to speak to a doctor about your condition, click below:

doctor_on_phone

Signs of diabetes

Approximately 8 million people in the United States who have type 2 diabetes aren’t even aware of it because they aren’t experiencing any symptoms yet.

General signs of diabetes include:

  • Being very thirsty
  • Being hungrier than usual
  • Peeing a lot
  • Breath odor that is fruity, sweet, or an acetone odor
  • Nausea
  • Blurry vision
  • Being irritable
  • Unexplained weight loss or gain
  • Tingling or numbness in your hands or feet
  • Darkening of skin in areas of body creases (acanthosis nigricans), such as the neck, armpits, elbows, knees, and knuckles
  • Feeling worn out
  • Wounds that don’t heal
  • Skin infections that keep coming back

Risk factors for diabetes

A number of factors increase your odds of developing type 2 diabetes. Men are at increased risk of developing type 2 diabetes compared to women. Other risk factors for diabetes include:

  • Prediabetes
  • A sibling or parent with diabetes
  • Ethnicity: increased risk for Asians, Hispanics, Native American, Alaska Natives, and African Americans
  • Over age 45
  • Obesity
  • Depression
  • Excess fat around the middle (a waist larger than 40” around for men or 35” around for women)
  • High blood pressure
  • High levels of triglycerides, a form of cholesterol
  • Low levels of high-density lipoprotein (LDL) cholesterol, the “good cholesterol”
  • Metabolic syndrome, which is a combination of high blood glucose, extra fat around the waist, high blood pressure, and high cholesterol and triglycerides
  • Your liver produces too much glucose
  • Not getting any or enough exercise
  • Smoking
  • Excess alcohol intake
  • Lack of sleep (especially due to sleep apnea or working overnight or irregular shifts)
  • Having had gestational diabetes, which is diabetes during pregnancy
  • Giving birth to a baby weighing more than 9 pounds
  • Polycystic ovarian syndrome
  • Low testosterone in men
  • Unhealthy diet such as too much red or processed meat and highly-processed carbohydrates as well as drinking sugary beverages. A diet full of fruits, vegetables, nuts, whole grains, and olive oil can reduce the risk of developing diabetes.

Diabetes symptoms in men

Men display some different signs and symptoms of diabetes than women. These include:

  • Erectile dysfunction (also referred to as ED, or impotence)
  • Retrograde ejaculation (when semen reaches the bladder instead of leaving the penis, also called a dry orgasm)
  • Low testosterone (also referred to as low-T)
  • Decreased sex drive (libido) and sexual dysfunction

Diabetes symptoms in women

Some symptoms affect only women instead of men.

They include:

  • Vaginal and oral yeast infections and vaginal thrush. High levels of glucose in the blood can lead to elevated levels of the candida fungus, which causes yeast infections and thrush.
  • Vaginal symptoms include itching, soreness, discharge, and painful sex.
  • Oral symptoms include a coating on the tongue and inside of the mouth that resembles cottage cheese.
  • Urinary Tract Infections (UTI).
  • Diabetes causes poor circulation and makes it harder for white blood cells to travel through the bloodstream and kill infections. This can lead to bacteria entering the urinary tract, which causes a UTI. Symptoms of a UTI include painful urination, a burning sensation, and bloody or cloudy urine. Untreated UTIs can lead to kidney infections.
  • Female sexual dysfunction. High levels of blood glucose can damage your nerve fibers. It’s called diabetic neuropathy, and it can cause tingling and loss of feeling. While it typically affects the hands, feet, or legs, it can also affect sensation in the vaginal area and lower a woman’s sex drive.
    Polycystic Ovary Syndrome (PCOS). PCOS is not necessarily a symptom of diabetes, but it does increase a woman’s risk of developing diabetes because it can cause elevated blood sugar levels. PCOS is a result of too much male hormone being produced by the adrenal glands. Symptoms include irregular periods, weight gain, acne, and depression. It may also cause infertility and insulin resistance.

Pregnancy and diabetes

It is possible to have a healthy pregnancy if you have diabetes, but it is critically important to manage your blood sugar levels before and during your pregnancy, as high glucose levels can lead to congenital disabilities such as cognitive impairments, developmental delays, and high blood pressure.

Before trying to get pregnant, you will want to get your blood glucose levels as close to your target range as possible first. Your doctor may suggest a different target range once you become pregnant.

You should talk to your doctor before and during your pregnancy about how to manage you and your baby’s health during your pregnancy. Your doctor will likely want to track your general health and blood glucose levels before and during your pregnancy.

How does diabetes affect men and women differently?

While some problems with diabetes affect men and women differently, some problems are unique to men. Men with type 2 diabetes are twice as likely as men without diabetes to have low levels of testosterone (low-T). Low testosterone level can cause symptoms that women with diabetes do not experience.

Low testosterone can lead to symptoms such as a reduced sex drive, depression, lack of energy, and decreased muscle mass as well as sexual and urological problems that are specific to men.

One common symptom of diabetes in men is erectile dysfunction (also known as ED or impotence), which is the inability to get or keep an erection. Erectile dysfunction strikes men with diabetes at a younger age than men who don’t have diabetes.

Retrograde ejaculation, which is reduced amounts of ejaculation as the result of semen traveling up to the bladder, is another sexual dysfunction symptom related to diabetes. Retrograde ejaculation is the result of diabetes causing damage to the blood vessels and nerve damage that affects the muscles that control the bladder and urethra.

Men are actually at higher risk of developing type 2 diabetes than women are.

The good news for men is that death rates for men with diabetes dropped between 1971 and 2000.

Unfortunately, the death rate for women not only didn’t drop for women during this same period, but the difference in the death rate between women with diabetes and those without it more than doubled.

The differences in death rates between men and women may be related to factors such as:

  • Women typically receive less-aggressive treatment for complications of diabetes such as cardiovascular risk factors.
  • It’s more difficult to recognize and diagnose some complications of diabetes in women.
  • Women are prone to different kinds of heart disease.
  • Inflammation and hormones affect women’s bodies differently.

Long-term health complications of diabetes

Diabetes causes a wide variety of complications, some of which can be life-threatening. Some of those complications include:

  • High blood pressure
  • Heart disease
  • Stroke
  • Nerve damage and neuropathy (nerve pain)
  • Kidney disease
  • Retinopathy (nerve damage in the eye which may lead to blindness)
  • Hearing impairment
  • Foot damage potentially leading to amputations
  • Skin infections
  • Peripheral vascular disease
  • Yeast infections
  • Alzheimer’s disease

What tests are done to test for prediabetes and diabetes?

There are several tests that your doctor may choose to run to test for diabetes or prediabetes. Some tests may be run two days in a row to get an even more accurate picture of your blood glucose levels. Some of those tests include:

  • The A1C test measures an average of your blood glucose levels over the last 2-3 months. It’s a blood test that does not require fasting like the fasting plasma glucose (FPG) test or drinking a sweetened liquid and returning for more testing after 2 hours like the oral glucose tolerance test (OGTT).
  • A normal blood glucose level is less than 5.7%.
  • A glucose level between 5.7-6.4% indicates prediabetes.
  • A glucose level higher than 6.4% indicates diabetes.
  • The fasting plasma glucose (FPG) test must be done after 8 hours of fasting and is usually performed first thing in the morning. You can’t eat or drink anything except water for 8 hours before the test in order to see what your blood glucose level is without the recent addition of more glucose from food or drink.A normal FPG reading is less than 100 mg/dl. A reading between 100-125 mg/dl indicates prediabetes. A reading of 126 mg/dl or higher indicates diabetes.
  • The oral glucose tolerance test (OGTT) tests your blood after 8 hours of fasting, then has you drink a special sweetened liquid and tests your blood two hours later so that your doctor can see how well your body is processing glucose. A normal OGTT reading is less than 140 mg/dl.A reading between 140-199 mg/dl indicates prediabetes. A reading that is 200 mg/dl or higher indicates diabetes.
  • A random or casual plasma glucose test can be taken any time you are experiencing symptoms of diabetes. A reading of 200 mg/dl or higher indicates diabetes.

Prediabetes treatment

Luckily, leading a healthier lifestyle can help reverse prediabetes and prevent the onset of type 2 diabetes. Your doctor will recommend a plan specific to your health and situation, but some general guidelines include:

Improving your diet

Talking to a registered dietitian (RD) or a certified diabetes educator (CDE) can help you create a meal plan that takes into account your overall health, the amount of exercise you get, and what you like to eat.

This meal plan will be designed to be beneficial for both your overall health and your blood glucose level, with the goal of keeping your glucose levels within normal ranges.

Exercising more

Exercise can lower your blood glucose level because it causes your body to use glucose to feed your muscles. During exercise, your body also doesn’t need as much insulin to use the glucose, which can help your body to become less insulin resistant.

Since one of the problems with prediabetes is that it causes insulin resistance, reducing that insulin resistance through exercise is a great way to get your health back on track.

You’re certainly already aware of the other benefits of exercise. It keeps your heart healthy, helps you reach and maintain a healthy weight, and it can even improve your sleep and mood.

According to the American Diabetes Association, you should aim for at least 150 minutes of moderate exercise each week, or 30 minutes five times a week. Moderate exercise includes activities like walking, swimming, or riding a bike.

Losing weight

Losing even 5-10% of your body weight can greatly reduce your odds of developing type 2 diabetes. For a 200-pound person, that’s only 10-20 pounds (although you should eventually aim for a weight that your doctor thinks would be beneficial for your overall health).

The best way to lose weight is to exercise more and eat better. Implementing new healthy habits into your daily routine can help you not only lose weight in the short term but keep it off in the long term.

Taking metformin

If your doctor decides that you are at high risk of having your prediabetes develop into type 2 diabetes, your doctor may recommend a medication called metformin. It’s the only medication that the American Diabetes Association recommends for preventing type 2 diabetes in those who have prediabetes and are at increased risk of developing diabetes.

Metformin prevents your liver from making more glucose when your body doesn’t need it, which helps to keep your blood glucose levels in a better range. Your doctor will want to carefully monitor your blood glucose levels to see whether or not they are improving.

They may suggest adding exercise for tweaking your diet to see further improvement in your glucose levels.

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