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Prediabetes

You may have heard the word prediabetes in the news, or been told by your doctor that you have prediabetes.

Prediabetes is not a clinical term recognised by the World Health Organisation. But it’s used regularly in the media to describe people who are at high risk of type 2 diabetes and by some healthcare professionals or organisations. Diabetes UK will not refer to people as having prediabetes but instead will talk about their risk of developing type 2 diabetes

Here we talk through what prediabetes means, if there are any symptoms of prediabetes and what you can do to reduce your risk of type 2 diabetes.

What is prediabetes?

Prediabetes means that your blood sugars are higher than usual, but not high enough for you to be diagnosed with type 2 diabetes. It also means that you are at high risk of developing type 2 diabetes. You are unlikely to be experiencing any symptoms with prediabetes.

Prediabetes is also sometimes called borderline diabetes. Higher than normal blood sugars can be detected via blood tests. The medical terms for higher-than-normal blood sugars are:

  • Impaired Fasting Glucose (IFG)
  • Impaired Glucose Tolerance (IGT)
  • Impaired Glucose Regulation (IGR)
  • Non-diabetic hyperglycaemia 

These tests are a mix of fasting or non-fasting and they all help your healthcare team to understand your risk of developing type 2 diabetes. So, if you’ve been told you have any of these, knowing this is the first step to being able to do something about it. And for many people there are things you can do to reduce your risk of type 2 diabetes.

Diagnosing prediabetes

If you’re worried about prediabetes you could call your GP surgery and ask for a blood test. The most common test will be checking your HbA1c levels which is your average blood glucose (sugar) levels for the last two to three months. If your HbA1c level is between 42mmol/mol (6%) – 47mmol/mol (6.4%) this means it is higher than normal and you are at risk of developing type 2 diabetes. 

Causes of prediabetes

At the moment 13.6 million people are at increased risk of type 2 diabetes in the UK. If you’ve been told you have prediabetes this is a warning sign that you are at high risk of developing type 2 diabetes. The good news is you don’t have it yet, and with the right support up to 50% of cases of type 2 diabetes can be prevented or delayed.

Type 2 diabetes happens because insulin can’t work properly, so your blood sugar levels keep rising. This means more insulin is released. For some people with type 2 diabetes this can eventually tire the pancreas out, meaning their body makes less and less insulin. This can lead to even higher blood sugar levels.

Type 2 diabetes can come on slowly, usually over the age of 40. The signs may not be obvious, or there may be no signs at all, therefore it might be up to 10 years before you find out you have it.

That’s why it’s very important to know the risk factors:

  • You’re more at risk if you’re white and over 40 or over 25 if you’re African-Caribbean, Black African, or South Asian.
  • You’re two to six times more likely to get type 2 diabetes if you have a parent, brother, sister or child with diabetes.
  • Type 2 diabetes is two to four times more likely in people of South Asian descent and African-Caribbean or Black African descent.
  • You’re more at risk if you’ve ever had high blood pressure.
  • You’re more at risk of type 2 diabetes if you’re carrying extra weight, especially if this weight is around your middle.

You are more at risk of developing type 2 diabetes if some or all of the risk factors apply to you. Our Know Your Risk online tool only takes a couple of minutes to complete. If your results show that you are at moderate or high risk, you could be eligible for a free place on the Healthier You: NHS Diabetes Prevention Programme in England.

You may also be eligible for a free NHS Health Check which will check for health conditions including type 2 diabetes.

“Because I had a family history of diabetes I knew I was potentially at risk. So, I thought I’d better complete the survey and find out. When I found out I was potentially at risk, I wasn’t shocked. Both of my parents have type 2 and, as they are first cousins, I guessed I would be at risk at some time in my life.

I honestly think that everyone is aware of the “right” things to do, but we need that push sometimes to make things happen. I knew it was time to do something about my situation but it wasn’t until I came across the Know Your Risk tool that I actually decided to take action. The Know Your Risk tool gave me that push I needed and I’m so glad I did it because it’s proving to be a very healthy choice for me.

Knowing if you are at risk of anything that deadly has to be a good thing for you to do something about it. And this is why using the Know Your Risk tool is so important.”

Having history of type 2 in her family, Deborah Goodman wasn’t shocked to find out she was potentially at risk. But knowing how dangerous diabetes can be she decided to join the Diabetes Prevention Programme and make changes to her life.

Symptoms of prediabetes

Prediabetes doesn’t have any symptoms. If you start to have any of the symptoms of type 2 diabetes it means you have probably already developed it. So it’s important to know the risk factors and what support is available to help you prevent or delay type 2 diabetes.

Prediabetes and the risk of type 2 diabetes

"Your first question might be ‘does this mean I have type 2 diabetes?’, ‘does this mean I’ll definitely get type 2 diabetes?’ or even ‘does this mean I’m in the clear?’ The answer to all of these is no. You don’t have type 2 diabetes at the moment, but you do need to act now if you want to try and avoid it." 

Simon O’Neill, Diabetes UK’s Director of Healthcare and Professional Liaison

Preventing type 2 diabetes

By making changes to diet, increasing physical activity and losing weight, about half of type 2 diabetes cases can be prevented or delayed in some people. 

Being at risk doesn’t mean you will definitely develop type 2 diabetes. Now is a great time to start making healthy changes to your lifestyle to reduce your risk of type 2 diabetes. Your healthcare team can support you in making these changes.

You can also call our helpline if you have any worries about being at risk of type 2 diabetes or for help with what to do next. And you could join our online forum to share your experiences with others who are at risk or have type 2 diabetes.

Here are some steps you can take to reduce the risk of developing type 2 diabetes in the future.

Manage your weight

If you are living with overweight or obesity and are at high risk of type 2 diabetes, losing just 5% of your body weight can significantly reduce your risk. There are lots of ways you can lose weight and it’s about finding what works best for you.

Making healthier food choices and being more active are both positive ways to start making these changes. If you need help with managing your weight, a dietitian can help you. Your GP surgery may also be able to help you find weight management services in your local area. 

Eat a healthy and balanced diet 

There’s no one special diet for all people at high risk of developing type 2 diabetes. Everyone is individual, so there isn’t a one size fits all way of eating for everyone. But, the food and drink we have in our overall diet is linked to our risk of developing type 2 diabetes.

For example, if your overall diet is made up of food and drinks that are in high fat, have a high GI (short for glycaemic index) and low fibre content, this is linked to an increased risk of type 2 diabetes. But the good news is that by changing some of your food and drink choices, you can reduce your risk of type 2 diabetes.

But what is a healthy and balanced diet anyway? All of these ways of eating have been linked with a decreased risk of type 2 diabetes:

  • Mediterranean diet — check out our handy Mediterranean meal plans
  • Dietary Approaches to Stop Hypertension (DASH) diet
  • vegetarian and vegan diets
  • the Nordic diet
  • moderately cutting down on carbohydrates.

This is because they are made up of healthy foods like fruits, vegetables, wholegrains and lean proteins and it’s the overall balance of our diet that is important in keeping us healthy. 

So, to reduce your risk, aim to eat more of the foods linked with a decreased risk. Research has shown us that the following foods and drinks can be associated with a decreased risk; 

  • total fruit and veg intake (including specifically green leafy veg, blueberries, grapes and apples) 
  • wholegrains 
  • yogurt and cheese
  • unsweetened tea and coffee

Additionally, there are some foods we recommend reducing your intake of, as these have been associated with an increased risk. These foods include:

  • sugar sweetened drinks
  • red and processed meats
  • refined carbohydrates (like sugary snacks, white bread, sugary cereals) 
  • potatoes (particularly French fries)

Be more active

If you spend a lot of time sitting down, this is known as a sedentary lifestyle. Being sedentary is linked with an increased risk of type 2 diabetes.

So being active in your daily life can help to reduce your risk of type 2 diabetes. This doesn’t mean you need to take up a new sport or join the gym. You could make small changes so that you are being more active every day. Think about taking phone calls standing up, using stairs instead of the lift, and going for a walk on your lunch break. Take a look at Sarah’s tips on getting active.

“I think I have come a long way. I have cut down on the snacking and swapped my breakfast so instead of having my regular sugary cereal bar I now have rolled porridge oats. I am now drinking more water (2 litres a day on average) and my alcohol intake has halved. I’m also doing more exercise.

For me it’s always been about making small changes as they’ll eventually add up. I knew this programme was going to benefit me in the long run and making small changes makes me feel confident that I can continue to keep up with these lifestyle changes in the future as they are sustainable. What I’m aiming for is a healthy lifestyle.” Deborah Goodman

 

We’ve got lots of information on where to start with moving more to reduce your risk.

 

 

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