Symptoms and Causes of Prediabetes | Endocrinology


What is prediabetes?

Prediabetes means that your blood glucose (also known as blood sugar) levels are higher than normal. When your blood glucose levels reach a certain level, you have diabetes. It is a disease that occurs when your body does not make or use the hormone insulin correctly. It causes the formation of excess glucose in the blood. Too much glucose in the blood is harmful to your body over time.

When your blood glucose levels are very high but not as high as diabetes. People who develop type 2 diabetes often have prediabetes. If you have prediabetes, you are at risk for type 2 diabetes. You are also at risk for developing other health conditions, such as heart disease or stroke.

The good news is that if you have prediabetes, you can prevent or delay the development of type 2 diabetes by making lifestyle changes. These include eating a healthy diet, reaching and maintaining a healthy weight, and exercising regularly.


Prediabetes usually has no signs or symptoms. Blackheads in certain parts of the body are a sign of prediabetes. Affected areas include the neck, armpits, elbows, and knees. Classic signs and symptoms that indicate you’ve changed from prediabetes to type 2 diabetes:

  • Increased thirst
  • Frequent urination
  • High appetite
  • Fatigue
  • Blurry vision

See your doctor if you are concerned about diabetes or if you notice any signs or symptoms of type 2 diabetes. Ask your doctor about testing your blood sugar if you have any risk factors for diabetes.


Prediabetes occurs when the insulin in your body is not working. Insulin helps your body’s cells use glucose from your blood. When insulin doesn’t work properly, more glucose builds up in the blood. Higher than usual levels indicate prediabetes. If the levels get high enough, you will develop type 2 diabetes. High glucose levels can damage your blood vessels and nerves. This increases your risk for heart disease, stroke, and other health problems.

The exact cause of prediabetes is unknown. But family history and genetics play an important role. Lack of regular physical activity and being overweight with excess fat around the abdomen also appear to be important factors. People with prediabetes do not process sugar (glucose) properly. As a result, blood sugar rises without doing the normal work of energizing the cells that makeup muscles and other tissues.

Most of the glucose in your body comes from the food you eat. When food is digested, sugar enters the bloodstream. A hormone called insulin is needed to move sugar from the bloodstream to the cells of your body. Insulin comes from a gland in the back of the stomach called the pancreas. Your pancreas sends insulin into your bloodstream when you eat.

Risk factors

The same factors that increase the risk of developing type 2 diabetes also increase the risk of prediabetes. These factors are:

Weight: Being overweight is a major risk factor for prediabetes. The more fatty tissue you have, especially between the muscles and skin around your abdomen, the more resistant your cells will become to insulin.

Waist measurement: Large waist size indicates insulin resistance. Men with a waist greater than 40 inches and women with a waist greater than 35 inches are at increased risk for insulin resistance.

Food: Eating red meat and processed meat and drinking sugary beverages increases the risk of prediabetes. A diet rich in fruits, vegetables, nuts, whole grains, and olive oil is associated with a lower risk of prediabetes.

Inactivity: If you are less active, your risk of prediabetes is higher. Physical activity helps you control your weight, uses sugar for energy, and allows the body to use insulin more efficiently.

Years: Diabetes can develop at any age, but the risk of prediabetes increases after age 45.

Family history: If you have parents or siblings with type 2 diabetes, your risk of prediabetes increases.

Race or ethnicity: While it’s not clear why, some people, including Black, Hispanic, American Indian, and Asian American people, are more likely to develop prediabetes.

Gestational diabetes: If you have diabetes while you are pregnant (gestational diabetes), you and your baby are at risk for prediabetes. If you have gestational diabetes, your doctor will check your blood sugar levels at least once every three years.

Polycystic ovary syndrome: Women with this common condition (irregular menstruation, high hair growth and is outstanding) have a higher risk of prediabetes.

Sleep: People with obstructive sleep apnea, a condition that repeatedly interferes with sleep, are at increased risk for insulin resistance.

Tobacco smoke: Smoking increases insulin resistance. Smokers also tend to weigh more in the middle.

Other conditions associated with prediabetes include:

  • Hypertension
  • Low-density lipoprotein (HDL) cholesterol, “good” cholesterol
  • High levels of triglycerides, a type of fat in the blood.
  • When these conditions occur with arrhythmias, they are associated with insulin resistance.

A combination of three or more of these conditions is often called metabolic syndrome.


Without treatment, prediabetes can lead to type 2 diabetes or other serious complications:

  • Nephropathy
  • Blindness
  • Hypertension
  • Nerve problems (peripheral neuropathy)
  • Organ damage (amputation)


  • Eat a healthy diet and lose weight. Losing even 5-10% of your weight can make a big difference.
  • Exercise. Choose what you like to walk. Try to do at least 30 minutes a day, 5 days a week. You can start with less time and work up to half an hour if necessary. Consult your doctor before doing more than that.
  • Stop Smoking
  • Keep your blood pressure and cholesterol under control.
  • If you are at high risk for diabetes, take medications such as metformin (Glucophage) to lower your blood sugar.


There is no official diet, but four conversions can reverse prediabetes and reduce the risk of developing type 2 diabetes:

  • Choose whole grains and whole-grain products based on processed carbohydrates like white bread, potatoes, and breakfast cereals
  • Drink coffee, water, and tea instead of sugary drinks
  • Choose vegetable oils, nuts, and seeds that are better fats than those found in margarine, baked goods, and fried foods
  • Swap red and processed meats for grains, cereals, poultry, and fish


If you have prediabetes, making lifestyle changes is the best way to prevent the development of type 2 diabetes.

Lose weight: If you are overweight, losing just 7 percent of your starting weight can help delay or prevent diabetes. That means if you weigh 200 pounds, there is a difference if you lose 14 pounds. Losing weight will also help lower blood pressure and cholesterol levels.

Get regular exercise. Exercise is an important part of preventing diabetes. Your exercise routine should include at least 30 minutes of moderate physical activity 5 times a week. This can include active walking, biking, or swimming. Ask your doctor if any level of exercise is safe for you.

Eat a healthy diet: Eat lean proteins such as vegetables, fruits, whole grains, fish or chicken, and low-fat milk. Don’t overeat processed, fried, or sugary foods. Eat small portions to reduce the number of calories you consume each day. Drink water instead of sugary drinks.

Your doctor can refer you to a dietitian or diabetes educator to help you change your diet and exercise habits. Some people take medicine to prevent or delay diabetes.

When to see a doctor

See your doctor if you are concerned about diabetes or if you notice any signs or symptoms of type 2 diabetes. Ask your doctor about testing your blood sugar if you have any risk factors for diabetes.

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