Prediabetes (Borderline Diabetes): Signs, Symptoms, and More
Prediabetes, also known as borderline diabetes, is a condition where your blood sugar is higher than normal, but not high enough to be considered diabetes. It’s estimated that 84 million Americans are living with prediabetes, making it a very common health issue. If left untreated, prediabetes can lead to type 2 diabetes, stroke, and heart disease.
The signs and symptoms of prediabetes can vary from person to person, and many people may not even realize they have it. Common symptoms include increased thirst, frequent urination, fatigue, and blurry vision. Prediabetes can also cause weight gain and increased hunger.
The good news is that prediabetes is treatable. Eating healthier, exercising regularly, and maintaining a healthy weight can help manage the condition. Your doctor may also prescribe medication to help control your blood sugar.
By recognizing the signs and symptoms of prediabetes and taking action, you can reduce your risk of developing type 2 diabetes and other serious health issues. If you’re concerned about prediabetes, talk to your doctor about your risk and what you can do to protect your health.
What is Borderline diabetes or Prediabetes?
Borderline diabetes or Prediabetes is when your blood sugar level is higher than it should be but not high enough for your doctor to diagnose diabetes. They might call it impaired fasting glucose or impaired glucose tolerance.
Having prediabetes doesn’t mean you’ll definitely develop diabetes. But it’s important to make changes to your diet and lifestyle to prevent the condition from progressing.
Prediabetes treatment can prevent more serious health problems, including type 2 diabetes and problems with your heart, blood vessels, eyes, and kidneys.
Borderline diabetes or Prediabetes signs
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 remains high, they may begin to develop some symptoms of type 2 diabetes. These include frequent urination and increased thirst. However, most people will not know they have prediabetes until they receive testing.
The primary indicator of prediabetes is a hemoglobin A1C level of 5.7% or greater. Other risk factors include being overweight, being 45 years or older, smoking, physical inactivity, or having a family history of prediabetes.
What Causes Prediabetes?
Insulin is a hormone made by your pancreas that helps your body convert glucose into fuel. When you eat a meal, the carbohydrates in your food are converted into glucose, otherwise known as blood sugar.
That glucose stays in your bloodstream until your pancreas releases insulin. The insulin acts like a key that opens your cells to allow the glucose to enter, where it’s then used to fuel your body.
Without insulin or when insulin is not working effectively, that glucose stays stuck in your bloodstream and accumulates, causing your blood sugar to rise.
During type 2 diabetes, your pancreas can still produce insulin, but that insulin gradually becomes less effective at helping the glucose into your cells.
Prediabetes is an indicator that your body is beginning to stop using insulin as efficiently as it should. In other words, your body is starting to become resistant to insulin.
When your body resists insulin, the glucose levels in your blood rise, which is how you develop prediabetes and, if that process is not stopped and allowed to progress, type 2 diabetes.
Symptoms of Borderline diabetes or Prediabetes
If prediabetes was easy to detect, you wouldn’t have people go years and years before getting diagnosed with type 2 diabetes.
Typically, adults experience either no symptoms at all, or the insulin resistance symptoms are so gradual or slight they may go unnoticed for years. Sometimes, though, there are warning signs. These include:
- Increased thirst
- Increased hunger
- Unexplained weight loss, even if eating more
- Frequent urination
The last symptom happens because excess sugar in your bloodstream triggers your body to make more urine in order to flush the glucose out. The more you urinate, the more likely you are to become dehydrated, which can lead to a cycle of increased hunger and thirst signals.
Diabetes symptoms men experience can also cause sexual issues such as erectile dysfunction (ED) and decreased sex drive.
Dark Skin on Neck
A dark patch or band of velvety skin on the back of your neck, armpit, groin, or elsewhere could mean that you have too much insulin in your blood.
Other skin issues that could signal prediabetes or ineffective treatment for diabetes include yellowish, reddish, or brown patches of skin that are hard, itchy, or painful; thickening skin on the fingers, toes, or both; sudden blisters; and patches of reddish-yellow bumps that look like pimples, but are itchy.
Prediabetes or Borderline diabetes risk factors
Any of these risk factors can increase your chances of developing prediabetes:
- having overweight or obesity
- being physically inactive
- being age 45 or older
- having high blood pressure or high cholesterol levels
- having a close family member with type 2 diabetes
- having a history of heart disease, stroke, gestational diabetes, or polycystic ovary syndrome
How to Determine if you have Prediabetes or Borderline Diabetes
Prediabetes is a silent condition, so getting a regular wellness checkup is important for early detection. If you think you might have borderline diabetes, it’s best to discuss your concerns with a doctor.
If a doctor suspects you may have prediabetes, they’ll most likely perform a hemoglobin A1c (HbA1c) test or oral glucose tolerance test (OGTT).
HbA1c is an indicator of your blood sugar control over the past 3 months, so it’s often a better overall picture than a single fasting blood sugar check. An HbA1c level between 5.7 and 6.4 indicates prediabetes.
Potential complications of Prediabetes or Borderline diabetes
High blood glucose levels, especially if they’re left untreated, can affect other systems in your body. This can leave you vulnerable to a variety of health risks and chronic health conditions. For example, uncontrolled diabetes can lead to:
- vision loss
- nerve damage
- kidney damage
- cardiovascular disease
The high insulin levels that come with insulin resistance can cause additional problems.
Is Prediabetes Reversible?
You can turn back your prediabetes by adopting lifestyle changes, including:
Evaluating Food Choices
For the best chance at long-term success, work with your dietitian to create a meal plan that still includes your favorite foods with slight alternations if necessary, so you don’t feel deprived and can stick to it long-term.
Some examples of this might include switching out white rice for cauliflower rice as an accompaniment to your usual dishes, or swapping “zoodles” made from squash or other vegetables for pasta so you can still enjoy your favorite recipes with less starch.
Exercise is a great way to reverse prediabetes for a number of reasons. First, a fitness regimen can help you shed the pounds that increase your risk for prediabetes without restrictive dieting.
Additionally, when you exercise, your body uses more glucose, which helps clear it out of your bloodstream. Finally, exercise activates a cell receptor called GLUT-4, which helps absorb glucose out of your bloodstream and move it into your cells. Cardio and weights both are exercises that help activate the GLUT-4 mechanism.
The American Diabetes Association recommends at least 150 minutes of moderate physical activity each week, which most commonly averages out to 30 minutes, five times a week. But you can also divide it up into longer workouts on days when you have more time available if you know you will be too busy to exercise on others.
If your doctor has medically advised weight loss for prediabetes and you don’t know where to begin (or you’ve already tried every diet with no results), ask for help.
Losing just 5% to 10% of your body weight can significantly reduce your risk of developing type 2 diabetes and eliminate your prediabetes, so invest in a nutritionist and trainer if you have found it too challenging to lose weight in the past.
Many health plans pay for diabetes educators and physical therapy, and your doctor can work with you to connect you to services that are available to help you succeed within your budget.
Uninsured? Nutritionist-recommended apps like Cronometer and Mindful Eating Tracker ($2.99) take the focus off of calorie counting and educate you about what you are eating while they help you make better food choices.
If you are at a very high risk of developing type 2 diabetes after being diagnosed with prediabetes because of comorbidities such as obesity, you doctor may recommend a medication such as metformin, which keeps your liver from making more glucose when you don’t need it, so your glucose levels stay within a safer range.
What Are the Treatments for Prediabetes?
If you catch it early, prediabetes can usually be reversed with diet and exercise. Depending on how high your blood sugar is when you’re first diagnosed, your doctor might elect to put you on one medication or a combination in order to get your glucose back down to a healthy level.
Healthy lifestyle choices can help you bring your blood sugar level back to normal, or at least keep it from rising toward the levels seen in type 2 diabetes.
To prevent prediabetes from progressing to type 2 diabetes, try to:
- Eat healthy foods: A diet high in fruits, vegetables, nuts, whole grains and olive oil is associated with a lower risk of prediabetes. Choose foods low in fat and calories and high in fiber. Eat a variety of foods to help you achieve your goals without compromising taste or nutrition.
- Be more active: Physical activity helps you control your weight, uses up sugar for energy and helps the body use insulin more effectively. Aim for at least 150 minutes of moderate or 75 minutes of vigorous aerobic activity a week, or a combination of moderate and vigorous exercise.
- Lose excess weight: If you’re overweight, losing just 5% to 7% of your body weight — about 14 pounds (6.4 kilograms) if you weigh 200 pounds (91 kilograms) — can significantly reduce the risk of type 2 diabetes. To keep your weight in a healthy range, focus on permanent changes to your eating and exercise habits.
- Stop smoking: Stopping smoking can improve the way insulin works, improving your blood sugar level.
- Take medications as needed: If you’re at high risk of diabetes, your health care provider might recommend metformin (Glumetza). Medications to control cholesterol and high blood pressure might also be prescribed.
Children and prediabetes treatment
Children with prediabetes should follow the lifestyle changes recommended for adults with type 2 diabetes, including:
- Losing weight
- Eating fewer refined carbohydrates and fats, and more fiber
- Reducing portion sizes
- Eating out less often
- Spending at least one hour every day in physical activity
Medication generally isn’t recommended for children with prediabetes unless lifestyle changes aren’t improving blood sugar levels. If medication is needed, metformin is usually the recommended drug.
What Is Prediabetes Diet?
A diet for prediabetes looks a lot different than a typical American one. A person with prediabetes should not eat processed carbohydrates that are high in sugar, but instead get carbohydrates from whole grains, fruits, legumes, and starchy vegetables (in moderation).
If you want to cut out carbs, you certainly can, but you don’t have to. They taste good, they give you energy, and usually it’s not sustainable to give them up completely.
Also shoot for 25 to 30 grams of fiber from food each day, as fiber-rich foods such as oatmeal and crunchy vegetables improve insulin resistance and keep you fuller, longer.
Prediabetes is a serious condition that can often go undiagnosed, but it is important to recognize the signs and symptoms so that it can be addressed in a timely manner. While it is not as severe as Type 2 diabetes, it can still lead to serious health complications if left untreated. By making lifestyle changes such as exercising and eating a healthy diet, individuals can reduce their risk of developing Type 2 diabetes.
Additionally, regular check–ups with your healthcare provider can help detect this condition early and help to prevent it from progressing into a more serious form of diabetes. Prediabetes is a serious condition, but it can be managed and treated with lifestyle changes and regular monitoring.