Prediabetes vs. Diabetes

Being diagnosed with either prediabetes or diabetes may come as a surprise to many people.  But what exactly is the difference between the two and when does a person go from having prediabetes to having diabetes?

Determining the difference between prediabetes and diabetes

It can be difficult to understand the differences between these two conditions but they are separate from one another.  The main difference that distinguishes them is in how high the blood sugar levels are. 

Prediabetes is when your blood sugar or glucose levels are higher than normal but not high enough to be diagnosed as type 2 diabetes.  It is estimated that about 79 million Americans ages 20 and older have prediabetes and many of them do not know it – yet.

Diabetes is when a person has high blood sugar or glucose levels either because insulin production is inadequate or because the body’s cells do not respond properly to insulin, or both. 

Why is my body developing either prediabetes or diabetes?

A condition called insulin resistance can increase the risk of getting both prediabetes and type 2 diabetes.  Insulin is a hormone produced by the pancreas, a large gland sitting behind the stomach.  When we eat foods containing carbohydrates, the carbohydrates eventually are broken down into their smallest components, one of which is a sugar called glucose.  Our bodies require glucose as it is necessary to provide energy to the cells of our body. 

When the glucose enters into the bloodstream, the pancreas detects a rise in the blood glucose levels and will secrete the hormone insulin into the bloodstream.  Insulin’s job is to help move the glucose from the bloodstream into the cells of the body. 

The problem for people who have either prediabetes or diabetes is insulin resistance.  When a person has insulin resistance, their body still produces insulin but does not use it effectively.  This makes it difficult for the insulin to be able to move the glucose from the bloodstream into the cells of the body, thus blood glucose levels remain elevated leading to prediabetes or diabetes. 

Most people with insulin resistance aren’t aware they have it for many years, until it turns into type 2 diabetes.  The good news is that if people find out early that they have insulin resistance, they may be able to delay progression to type 2 diabetes.

How is prediabetes and diabetes diagnosed?

Both prediabetes and diabetes are found with the following tests:

·        Fasting glucose test (FGT)

This test measures blood sugar when you haven’t eaten anything for at least 8 hours. 

A FGT test to diagnose prediabetes is 100- 125 mg/dl; for type 2 diabetes – 126 mg/dl or higher

·        Glucose tolerance test (GTT)

This test measures blood sugar after you haven’t eaten anything for at least 8 hours and 2 hours after you drink a sugary drink provided by a doctor or laboratory.

A GTT test to diagnose prediabetes is 140-199 mg/dl; for type 2 diabetes – 200 mg/dl or higher

·        A1C

This test measures your average estimated blood sugar over the past 3 months.

An A1C to diagnosis prediabetes is 5.7% - 6.4%; for type 2 diabetes – 6.5% or higher

Ways to lower risk for prediabetes

If you are diagnosed with prediabetes, your blood sugar should be checked for type 2 diabetes every 1 to 2 years.  Prediabetes does not automatically turn into type 2 diabetes and there are steps a person can take to lower their risk:

·        Losing just 5-7% of your current body weight can help to lower blood glucose levels

·        Doing moderate physical activity such as brisk walking for 30 minutes a day, 5 days a week.

·        Controlling the amount of carbohydrates you consume daily – schedule an appointment with a registered dietitian who can help you determine an appropriate carbohydrate level for you to follow.