Quick summary
- Prediabetes is the name given to the condition when your blood sugar levels are very high but not high enough to be diagnosed as type 2 diabetes
- Luckily, prediabetes can be reversed and this greatly reduces your chances of developing type 2 diabetes later on
- Symptoms of prediabetes include feeling the need to go to the toilet more often, feeling very thirsty, fatigue, blurred vision, and tingling sensations in your hands and feet
- You might be at an increased risk of having prediabetes if you’re overweight, have high levels of cholesterol, have high blood pressure, have a family history of the condition, or had gestational diabetes during a pregnancy
- Luckily, there are things you can do to help reverse prediabetes such as following a healthy, balanced diet, getting plenty of exercise, and losing weight
Prediabetes is a condition where blood sugar levels are higher than normal but not high enough to be diagnosed as type 2 diabetes. It’s a condition that affects approximately 7 million people in the UK;[1] a number that could be far higher as prediabetes isn’t always easy to detect. Because of this, it’s important to make yourself aware of the potential risk factors and signs associated with the condition.
It’s thought that prediabetes affects at least 7 million people in the UK
As well as developing type 2 diabetes, prediabetes can also increase your chance of suffering from other health conditions such as heart disease or stroke. However, the good news is prediabetes can be reserved, which greatly reduces the chance of developing type 2 diabetes later in life.
What are the warning signs of prediabetes?
Feeling hungry
In a healthy body, food is broken down in the digestive process and turned into glucose. This glucose is then carried via the bloodstream to cells around the body, providing them with energy. In people with prediabetes, this glucose never makes it to the cells and instead stays in the bloodstream, so the cells become weak and struggle to function properly. As a result, these cells send warning signals to the rest of the body that they’re starving and need more food, so even if you’ve just eaten, your body will still think it’s hungry.
Frequent need to urinate
Another warning sign of prediabetes is needing to go to the toilet more frequently. When there is too much glucose in the blood, the kidneys will try and clean the blood by absorbing as much of this excess glucose as they can. If there’s too much glucose for the kidneys alone to absorb, the bladder will take over and try to expel this excess glucose through urination, meaning you’ll need to go to the toilet more often than usual.[2] This can be tough going on the kidneys and can eventually lead to chronic kidney problems.
Feeling thirsty
As the bladder works to flush out any excess glucose through urination, this leaves insufficient water in the body to perform other functions so the body becomes dehydrated. Much like the cells that need more food to function, the body sends signals that it needs more fluids to replenish those that have been lost, making you feel thirsty.[3] Drinking more fluids means you need to urinate more often so these two symptoms tend to go hand in hand or compound one another. Many people attempt to quench their thirst with things like sugary drinks which can lead to higher spikes in blood sugar which can eventually lead to type 2 diabetes.
Feeling tired
Feeling tired is another early warning sign of prediabetes. This one can be trickier to diagnose as general feelings of tiredness and fatigue can be the result of lots of different factors, including poor sleep patterns and busy lifestyles. In prediabetes, if glucose isn’t making it to the cells and providing them with energy they can’t function properly so you’ll start to feel tired and lethargic. It’s also common to find you’re also suffering from headaches, dizzy spells, or finding it hard to concentrate. High blood glucose levels can also cause inflammation in cells around the body and when this happens the natural response is to want to rest and recuperate.
Tingling or numbness in your hands and feet
Feeling pins and needles or a numb sensation in your fingers and toes is an early indicator of prediabetes.[4] As blood sugar levels begin to rise this causes damage to the various small nerves that are found throughout our bodies; this is called ‘diabetic neuropathy.’ If action isn’t taken, diabetic neuropathy can eventually lead to more serious conditions such as ulcers or Charcot foot and, in extreme cases, the damage caused can be so severe that it requires the amputation of a limb.
Blurred vision
As well as affecting the nerve endings, high amounts of glucose in the blood can affect the tissue around your eyes causing the small capillaries and nerve endings to burst into microaneurysms. When this happens it distorts the lens making things appear blurred or out of focus; this is called diabetic retinopathy. Although diabetic retinopathy can be easily reversed in prediabetic patients, if left untreated it can eventually lead to loss of sight for some people with type 2 diabetes.[5]
What are the risk factors for prediabetes?
Weight
Carrying extra weight can increase your chances of developing prediabetes. Research suggests that internal fat deposits impact our body’s ability to regulate blood sugar, causing blood sugar levels to remain high—it’s this continued elevation of blood sugar levels that eventually leads to a type 2 diabetes diagnosis.[6] General guidance is that you may need to lose weight if your waist measures 31.5 inches or more as a woman, or 37 inches or more as a man.[1] If you want to seriously start thinking about losing weight, start small—the most effective weight loss approaches are ones that help you build a positive relationship with food and healthy habits for long-term weight management.
Activity levels
Exercise is important for everyone but a sedentary lifestyle is also a risk factor for developing prediabetes. Lack of exercise can contribute to weight gain, which can go on to affect how the body regulates blood sugar. Exercise is also a great way to keep blood sugar levels healthy (more on that later!) by naturally lowering them. If we’re not moving enough it can affect how our bodies process and react to insulin, increasing the chances of developing prediabetes.
High blood pressure
Blood vessels such as our veins and arteries have the important job of pumping blood around the body. Sometimes the elasticity of these blood vessels can become constricted meaning they’re unable to stretch properly and struggle to move blood around the body—this results in high blood pressure. Having high blood pressure can be a risk factor for developing prediabetes, especially as high blood sugar levels can affect the elasticity of our blood vessels. Most people with prediabetes will find that high blood pressure goes hand in hand with other risk factors such as being overweight and not getting enough exercise. High blood pressure can also increase your chances of having a stroke or a heart attack so it’s important it stays at a healthy level.
Gestational diabetes in an earlier pregnancy
If you’ve been diagnosed with gestational diabetes in a previous pregnancy you might also be at risk of developing prediabetes. Gestational diabetes usually goes away after pregnancy but it can increase your chances of getting gestational diabetes in future pregnancies or being diagnosed with prediabetes or type 2 diabetes after the birth of your baby.
Family history and ethnicity
Ethnicity and family background have been linked to an increased chance of developing prediabetes. Studies show that South Asian communities are six times more likely to be diagnosed with diabetes while the chances of prediabetes developing into type 2 diabetes are up to three times greater in South Asians than their white European counterparts.[7] The chance of developing prediabetes is also greater if diabetes runs in your family so it’s important to advise your doctor of your family history so they can monitor any changes to your health.
High cholesterol and high triglycerides
Cholesterol and triglycerides are both a type of fat that is found in your blood. Drinking too much alcohol, smoking, being overweight, and eating poorly are all lifestyle factors that can affect the cholesterol and triglyceride levels in your body. When these levels are too high, it can cause fatty plaque to build up in your arteries which in turn raises your blood pressure. As we know, a poor diet and high blood pressure are both risk factors that could lead to prediabetes.
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How to reverse prediabetes
The good news is, prediabetes is easy to reverse and by making small, manageable changes to your lifestyle, you will greatly reduce the chance of developing type 2 diabetes in the future.
Eat a balanced diet
One of the quickest ways to reverse prediabetes is by making changes to your diet. Start by cutting down on the amount of fatty and sugary foods you eat, swapping these for healthy alternatives. Aim to eat a balanced diet rich in fruit, vegetables, and lean proteins, and keep an eye on how much of each food group you’re eating as well as general portion sizes.
The positive effect of exercise on blood sugar levels may last for up 48 hours after the activity
Get active
Exercise is a great way to lower blood glucose levels and just 30 minutes of aerobic activity per day is enough to improve insulin sensitivity and blood sugar control.[9] Exercise, alongside a healthy diet, is a great way to help lose weight and things like walking and swimming are great places to start if you’re looking to start with something gentle. Getting active doesn’t have to be intense either; things like taking the stairs, getting off the bus a stop earlier or walking short distances instead of driving all help improve your overall fitness. Exercise also plays an active role in lowering blood sugar levels by increasing insulin resistance, helping muscles to use any available insulin to take up glucose from the blood—it’s even been reported that these effects can last for up to 48 hours after the activity.[10] As well as keeping your blood sugar at a healthy level, insulin also helps the cells in our muscles to grow and develop.[9] Introducing regular activity into your everyday life can go a long way to keeping prediabetes and type 2 diabetes at bay, while also supporting muscle function.
Changes to your lifestyle
As well as adopting healthy eating habits and getting active, it's important to consider how healthy your overall lifestyle is. Smoking is a habit that not only increases the risk of certain cancers and heart disease but is also likely to lead to type 2 diabetes. The NHS offers lots of advice and support to help quit.[10]
It’s also important to make sure you’re getting plenty of rest by implementing a good sleep schedule. Lack of sleep can not only affect your mood but it can also make it harder for you to stay motivated and lose weight. A recent study has shown that lack of sleep can affect insulin resistance, making it harder for our bodies to control our blood sugar levels.[11]
Prediabetes—final thoughts
The early warning signs of prediabetes might not always be clear so it’s important to arm yourself with the facts when it comes to recognising the signs and risk factors associated with the condition. If you think you might have prediabetes, or if you fall into any of the risk categories, then speak to your doctor or a healthcare professional who can test you for prediabetes. Adopting healthy, long-lasting changes to your lifestyle can help reverse any symptoms and help you to live a happier, healthier life.
References
[1] Seven million in the UK have prediabetes. Diabetes UK. Retrieved 22 April 2022. Accessible here.
[2] Polyuria—Frequent Urination. Diabetes.co.uk. Retrieved 22 April 2022. Accessible here.
[3] Polydipsia. Diabetes.co.uk. Retrieved 22 April 2022. Accessible here.
[4] Peripheral Neuropathy (Nerve Damage). Diabetes UK. Retrieved 22 April 2022. Accessible here.
[5] Diabetic retinopathy. NHS. Retrieved 22 April 2022. Accessible here.
[6] Hady, O.T., Czech, M.P., Corvera, S. (2012). What causes the insulin resistance underlying obesity? Curr Opin Endocrinol Diabetes Obes 19(2): 81–87. Accessible here.
[7] Diabetes in South Asians. Diabetes.co.uk. Retrieved 22 April 2022. Accessible here.
[8] Colberg,S.R., Sigal, R.J., Fernhall, B., et al.(2010). Exercise and Type 2 Diabetes. Diabetes Care 33(12): e147–e167. Accessible here.
[9] How diabetes causes muscle loss. Science Daily. Retrieved 22 April 2022. Accessible here.
[10] NHS stop smoking services help you quit. NHS. Retrieved 22 April 2022. Accessible here.
[11] Arora, T., Chen, M.Z., Omar, O.M., et al. (2016). An investigation of the associations among sleep duration and quality, body mass index and insulin resistance in newly diagnosed type 2 diabetes mellitus patients. Ther Adv Endocrinol Metab 7(1): 3–11. Accessible here.
