Everything You Need to Know About Pre-Diabetes

The CDC and National Institutes of Health estimate that tens of millions of American adults have pre-diabetes, with approximately 80%–85% remaining undiagnosed. This is largely because pre-diabetes typically presents no noticeable symptoms, leading individuals to feel healthy and not seek blood glucose testing. Factors such as limited access to healthcare and infrequent routine check-ups and blood work further contribute to underdiagnosis. 

Why pre-diabetes happens.

There is not one single cause, it usually develops from a combination of genetic predisposition and lifestyle-related factors.

Genetics, you may have a higher risk if:

• You have a parent or sibling with type 2 diabetes

• You are Asian, Black, Hispanic/Latino, Native American, or Pacific Islander

• You experience gestational diabetes

Lifestyle-related factors

            Nutrition & Patterns of eating

• Highly processed foods

• Frequent sugary drinks

• Large portions + irregular meals

• Low fiber intake

Physical Inactivity

• When we move less insulin becomes less effective

• Glucose stays in the bloodstream longer

Stress, Sleep and Hormones- this is often ignored…

• Stress hormones increase glucose and insulin resistance

• Poor sleep affects appetite, cravings, and energy

• Chronic inflammation worsens body feedback loops

What pre-diabetes feels like

May people have no symptoms at all. Others may notice:

·      Fatigue, increased hunger, difficulty losing weight, brain fog, sugar cravings, skin darkening around the neck or armpits.

These are signals—not failures.

 Your A1C Matters

How your body processes glucose is an indicator for pre-diabetes. Pre-diabetes occurs when blood glucose levels are higher than normal but not high enough to be diagnosed with type 2 diabetes. Think of a diagnosis of pre-diabetes as a warning light, your body is telling you to it needs a tune up and to make some changes. A blood test (different from a finger-stick) measures your A1C, showing average blood glucose over 90 days. A1C percentages are utilized because they do not require fasting, provide insight into long-term glycemic patterns, serve as effective predictors of potential complications, and assist in monitoring the impact of lifestyle or medication adjustments.

Your A1C measures how much glucose (sugar) has attached to hemoglobin a protein in red blood cells which carry oxygen. Red blood cells last around three months, which is why the measurement covers a 90-day span. While an A1C test reflects your average glucose levels over that period, a finger stick provides your blood sugar level at that specific moment. The US standard for A1C is important to know as this is how you would be diagnosed with pre-diabetes or diabetes. A normal A1C is 5.7%, pre-diabetes is 5.7%-6.4% and diabetes is 6.5% or higher. Do you know your A1C? When was the last time you had blood work?

With an A1C mildly elevated, 5.7%-5.9% (estimated glucose finger reading is 117 mg/dL) this is considered early pre-diabetes. Your body may be starting to struggle with insulin efficiency. You have the opportunity to reverse your A1C in 3-6 months with lifestyle and diet changes. Moving to moderate risk, 6.0%-6.2% (estimated glucose finger reading is 126 mg/dL) this is where insulin resistance is occurring. You may see post-meal spikes due to the body needing more insulin to regulate glucose. This can also be reduced with a more structure diet, movement and stress reduction exercises. And the high end of pre-diabetes is 6.3%-6.4% (estimated glucose finger reading is 137 mg/dL) this is very close to the type 2 diabetes cutoff number. This can be reduced by active management with the support of medical doctors, diet, sleep, stress management and daily movement.

Some important limitations for A1C percentages

·      You have anemia, low iron, or vitamin B12 deficiency

·      You have kidney disease

·      You’re pregnant

·      You recently had blood loss or transfusion

·      You have hemoglobin variants which are more common in

• African/African American,

• Mediterranean populations including Greeks, Italians and southern Europeans,

• Southeast Asian especially, Thailand, Cambodia, Laos, Vietnam and Myanmar,

• South Asian especially India, Bangladesh, Pakistan and Sri Lanka,

• Middle Eastern especially Arabian Peninsula, Iran, Iraq, Yemen, Lebanon, and Jordan.

• If you have a hemoglobin variant other lab work can be done such as fasting glucose, oral glucose tolerance test,

  SMBG and/or a continuous glucose monitor (CGM) may be used to get an accurate A1C percentage.

If you think you have a hemoglobin variant be sure to talk with your medical doctor.

Truth is Pre-Diabetes is Reversable

Pre-diabetes is a warning to make some changes. Lifestyle, nutrition and movement changes can stop the progression to type 2 diabetes, lower blood glucose, improve energy and insulin sensitivity, and improve mental health. Consistency and small changes are key to positive lifestyle changes. Your journey is personal. Enjoy. Breathe. Be present.