Understanding the early warning signs of potential health issues is crucial. One condition that often goes unnoticed until it reaches more advanced stages is prediabetes. This silent precursor to diabetes can be a wake-up call for anyone aiming to maintain a healthy lifestyle. In my experience working in nutrition and diabetes, this condition is diagnosed a lot and there seems to be a misconception around what prediabetes is and what it means for many patients.

In this blog post, lets discuss the subtle signs and symptoms of prediabetes, emphasising the utmost importance of early intervention in preventing its progression to type 2 diabetes.

What is prediabetes?

Prediabetes is a medical condition characterised by elevated blood glucose (sugar) levels that are higher than normal but not yet high enough to be classified as diabetes. It is considered an intermediate stage between normal blood sugar levels and the diagnosis of type 2 diabetes.

People with prediabetes have an increased risk of developing diabetes, but with lifestyle changes, it’s often possible to prevent or delay the progression to diabetes.

The term “borderline diabetes” is sometimes used colloquially to describe prediabetes. This term may be used because individuals with prediabetes have blood glucose levels that are higher than normal but not quite at the threshold for a diabetes diagnosis, therefore considered at the ‘border’. It’s important to note that “borderline diabetes” is not a clinical or medical term. The preferred terminology is “prediabetes,” which accurately reflects the intermediate nature of the condition.

When can prediabetes occur?

Prediabetes occurs when the body becomes resistant to the effects of insulin, a hormone that helps cells absorb glucose from the bloodstream. As a result, blood glucose levels rise, but they don’t reach the levels seen in diabetes. Pre-diabetes often precedes the development of type 2 diabetes, which is a chronic condition where the body either doesn’t produce enough insulin or doesn’t use insulin effectively.

What are your risk factors?

• Family history
A family history of diabetes can increase the risk of prediabetes.

• Lifestyle factors
Having sedentary lifestyles, poor dietary habits, and holding excess weight are significant risk factors.

• Age
The risk of prediabetes increases with age, particularly after 45.

• Ethnicity
Certain ethnic groups, such as being from an Aboriginal or Torres Strait Islander background, being from a Pacific Islander, South Asian, Middle Eastern or North African background.

• Gestational diabetes
Women who had gestational diabetes during pregnancy are at an increased risk.

• Medical conditions
Conditions like polycystic ovary syndrome (PCOS) can contribute to insulin resistance.

You can check your risk of getting type 2 diabetes by using these free tools:

1. Diabetes Australia risk calculator. Click here
2. Australian Type 2 Diabetes Risk Assessment Tool (AUSDRISK). Click here

The subtle warning signs

 One of the first signs of prediabetes may be unexpected weight fluctuations, particularly around the abdominal region. This happens because the body’s insulin response becomes less efficient, leading to imbalances in blood glucose levels.

 Frequent thirst and urination can be indicative of prediabetes. As blood sugar levels rise, the kidneys work overtime to filter and absorb excess glucose, leading to increased fluid intake and subsequently, more trips to the bathroom.

 Feeling constantly tired or fatigued, even after a full night’s sleep, may be linked to prediabetes. The body’s inability to effectively utilise glucose for energy can leave you feeling drained and lethargic.

 Prediabetes can impact the eyes, causing fluctuations in vision. High blood glucose levels can lead to changes in the shape of the eye lens, resulting in blurred or distorted vision.

 A condition known as acanthosis nigricans can manifest as darkened, velvety patches of skin, often appearing in body folds and creases. This skin discoloration is closely associated with insulin resistance and may be an early sign of prediabetes.

How do I get checked?

Your health care provider will send you for a blood test collection. Common tests include:

1. Fasting plasma glucose (FPG) test
This test involves fasting (not eating or drinking anything except water) for at least 8 hours before having blood drawn. An FPG level between 5.6 to 6.9 mmol/L indicates prediabetes.

2. Oral Glucose Tolerance Test (OGTT)
For this test, an individual fasts overnight and then drinks a solution containing a specific amount of glucose. Blood samples are taken before and two hours after drinking the solution. A 2-hour glucose level between 7.8 to 11.0 mmol/L is indicative of prediabetes.

3. Glycated haemoglobin (HbA1c) test:
The HbA1c test provides an average of blood glucose levels over the past 2-3 months. An HbA1c level of 5.7% to 6.4% is considered indicative of prediabetes.

What can you do to intervene?

Identifying and addressing prediabetes early on provides a crucial window of opportunity to implement lifestyle changes. A balanced diet, regular exercise, and weight management can significantly reduce the risk of progressing to diabetes. Prediabetes is not only a precursor to diabetes but also a risk factor for cardiovascular diseases.

To sum up, being aware about the signs and symptoms of prediabetes is a proactive approach to maintaining good health. Early intervention not only prevents the progression to diabetes but also lays the foundation for a healthier, and longer life.