Borderline diabetes, known as prediabetes, is where a person’s blood sugar levels are higher than normal but not yet high enough for a diagnosis of type 2 diabetes.
Research shows that this progression occurs in about
Doctors may also refer to borderline diabetes as impaired glucose tolerance or impaired fasting glucose.
This article looks at how to recognize risk factors for prediabetes, manage the condition, and prevent type 2 diabetes from developing.
Borderline diabetes does not have clear symptoms. Some people may not be aware that they have it until:
- a doctor performs a blood glucose test and urinalysis
- it has progressed to type 2 diabetes
- a complication occurs, such as a heart attack
If a person’s blood sugar level
However, most people will not know they have prediabetes until they receive testing.
According to the
- obesity, especially when it involves a large waist size
- high blood pressure
- high levels of triglycerides, a type of fat
- low levels of high-density lipoprotein (HDL), or “good,” cholesterol
- low levels of physical activity
People with a family history of type 2 diabetes may also have an increased risk, suggesting that genetics play a role.
According to the
- raised stress levels
- drinking too much alcohol
Regularly consuming high sugar drinks may also increase the risk. A
People who lead an inactive lifestyle also have a higher risk of taking in too many calories without burning them through exercise.
Other people who may be at risk of developing prediabetes include those who have polycystic ovary syndrome (PCOS) or have experienced instances of high blood sugar levels in the past.
Anyone with any of these risk factors may benefit from a prediabetes screening to check whether they have the condition.
A doctor typically uses blood tests to diagnose prediabetes. A glucose tolerance test is particularly useful because it measures how quickly the body can process the sugar in the blood in a 2-hour period.
Other options include a fasting blood test, which measures blood sugar levels after a person has not eaten for a specific period, and an A1C test, which measures the average blood sugar levels over 2–3 months. People do not need to fast or take any special liquids or medications for the A1C test, and it gives reliable results.
The American Diabetes Association states that a doctor will diagnose prediabetes when test results show the following measurements:
- fasting blood sugar levels of 100–125 milligrams per deciliter (mg/dl)
- glucose tolerance levels of 140–199 mg/dl
- an A1C test result of 5.7–6.4%
A doctor will often re-test these levels to confirm that the readings are not due to one-off spikes in blood sugar.
Who should undergo screening for prediabetes?
- an age of 45 years or over
- a body mass index (BMI) of 25 or higher
- a waist circumference larger than 40 inches in males or 35 inches in females
- a close relative with diabetes
- a condition that increases insulin resistance, including PCOS, acanthosis nigricans, and non-alcohol-related steatohepatitis
- certain racial or ethnic backgrounds, including African American, Asian American, Hispanic, Latino, Native American, Alaska Native, and Pacific Islander
- a history of gestational diabetes, which is diabetes during pregnancy
- having given birth to an infant weighing more than 9 pounds
- having a disease that hardens the arteries
- recent treatment with glucocorticoids or atypical antipsychotic medications
If a doctor identifies any of these risk factors, they may recommend that the person has a screening to check their blood glucose levels.
Medical professionals advise repeating screening tests every 1–3 years for people with these risk factors.
The NIDDK has an
However, anyone who is concerned that they may have borderline diabetes should visit a doctor for testing and a diagnosis.
Prediabetes is reversible, but it is often easier to prevent than treat. Lifestyle factors are the primary cause of prediabetes, and making changes in some aspects of life can significantly reduce the risk.
Alongside regular exercise, a balanced, nutritious diet that moderates sugar intake can help reverse borderline diabetes.
According to the American Diabetes Association, many people can improve their diet by:
- increasing the intake of unprocessed high fiber carbohydrates
- increasing fruit and vegetable consumption
- reducing the intake of saturated fats and processed meat
Exercise is also important.
Examples of moderate-intensity exercise are fast dancing and brisk walking.
Regular exercise and a nutritious diet not only help reduce the risk of developing diabetes but also protect the heart against future diseases.
Combining nutrition and exercise
In addition, there is strong evidence for the benefits of combining exercise and dietary interventions in reducing diabetes risk and reversing prediabetes.
This primarily comes from the
All of the participants in the program received advice on how to diet and exercise, and they attended lifestyle change classes for the duration of the study.
After 3 years, in comparison with those who took a placebo, people in the program had a 58% drop in the risk of developing type 2 diabetes regardless of sex or ethnicity. Among those aged 60 years and older, the decrease in risk was 71%.
The researchers held regular follow-up sessions. After 15 years, people in the DPP Lifestyle Change Program continued to see a delay in the onset of diabetes compared with people who took a medication called metformin or a placebo.
Anyone who developed diabetes during the study received extra medical care. However, diet and exercise remained important in managing the symptoms and reducing the risk of complications.
Managing prediabetes also involves continual monitoring of the risk factors and regular testing of blood sugar levels.
In addition to lifestyle changes, doctors may recommend other ways to minimize the risk of developing diabetes. Medical management may include treating related conditions, such as obesity and heart disease.
Prediabetes is the stage before type 2 diabetes develops. By this stage, blood sugar and insulin resistance may start reaching harmful levels.
Prediabetes does not usually cause active symptoms, and most people will not be aware that they have the condition until it progresses to diabetes and starts causing severe health problems.
Therefore, it is advisable for anyone who is at risk of developing diabetes to undergo regular screening. Risk factors include high BMI and waist circumference, an age of 45 years or older, and the presence of other cardiovascular diseases.
Prediabetes is often reversible with a sustained exercise program and a balanced, low sugar diet.
Below, we answer some commonly asked questions about prediabetes.
Which foods should I eat if I have prediabetes?
Fat and fiber tend to slow absorption and lower what is called the glycemic index (GI) of foods. Low GI fruits and vegetables, such as stone-ground whole wheat bread, rolled or steel-cut oatmeal, nonstarchy vegetables, and whole fruits are good choices. Experts consider a low GI food to have a rating of 55 or less. A person can use this database to find the GI of common foods.
What are the complications of prediabetes?
Even if it does not progress to type 2 diabetes, prediabetes
Can children have prediabetes?
Many children who develop type 2 diabetes do not receive a diagnosis until adolescence. This is, in part,
Can prediabetes progress to type 1 diabetes?
Prediabetes refers to a metabolic state that is a precursor to type 2 diabetes. It cannot evolve into type 1 diabetes. However, there is
How long does it take to reverse prediabetes?
With a well-balanced diet, regular exercise, and prescribed medical interventions, a person may be able to reverse prediabetes in about