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Understanding Prediabetes: What You Can Do Now
Dr. Michael Zimmer

Dr. Michael A. Zimmer

Understanding Prediabetes: What You Can Do Now

Post Summary

Prediabetes is a warning sign that type 2 diabetes may be in your future—but it's not inevitable. Learn what prediabetes means, who's at risk, and the proven lifestyle changes that can reverse it before it progresses.

The Wake-Up Call: Understanding Prediabetes and Taking Action Now

Imagine being told you're on the path to a serious chronic disease—but that you have the power to change course. That's exactly what a prediabetes diagnosis represents. It's not a life sentence; it's an opportunity.

An estimated 98 million American adults—more than 1 in 3—have prediabetes, yet over 80% don't know they have it. This silent condition rarely causes symptoms, quietly damaging blood vessels and setting the stage for type 2 diabetes, heart disease, and stroke. The good news? Prediabetes can be reversed with lifestyle changes, and catching it early gives you the best chance of avoiding diabetes altogether.

What Is Prediabetes?

Prediabetes means your blood sugar levels are higher than normal but not yet high enough to be classified as type 2 diabetes. It indicates that your body is becoming resistant to insulin, the hormone that moves sugar from your blood into your cells for energy.

Here's how the numbers break down:

| Test | Normal | Prediabetes | Diabetes | |------|--------|-------------|----------| | Fasting Blood Sugar | Below 100 mg/dL | 100-125 mg/dL | 126+ mg/dL | | A1C | Below 5.7% | 5.7-6.4% | 6.5%+ | | Oral Glucose Tolerance | Below 140 mg/dL | 140-199 mg/dL | 200+ mg/dL |

If your numbers fall in the prediabetes range, your body is sending a clear message: it's time to make changes.

Why Prediabetes Matters

Without intervention, 15-30% of people with prediabetes will develop type 2 diabetes within 5 years. But the risks don't stop there. Even before diabetes develops, prediabetes increases your risk of:

  • Heart disease and stroke: Elevated blood sugar damages blood vessels
  • Kidney disease: The kidneys work harder to filter excess sugar
  • Nerve damage: High blood sugar can affect nerve function
  • Vision problems: Blood vessel damage can affect the eyes

This is why catching prediabetes early—and acting on it—is so important.

Who Is at Risk?

Several factors increase your likelihood of developing prediabetes:

  • Being overweight: Especially carrying excess weight around the abdomen
  • Age 45 or older: Risk increases with age
  • Family history: Having a parent or sibling with type 2 diabetes
  • Physical inactivity: Less than 3 times per week of physical activity
  • Race and ethnicity: Higher risk in African American, Hispanic, Native American, Asian American, and Pacific Islander populations
  • History of gestational diabetes: Diabetes during pregnancy increases future risk
  • Polycystic ovary syndrome (PCOS): Linked to insulin resistance
  • Sleep disorders: Sleep apnea is strongly associated with insulin resistance

If you have multiple risk factors, screening is especially important.

The Lifestyle Changes That Work

Here's the empowering truth: research shows that lifestyle intervention can reduce the risk of developing diabetes by 58%—and by 71% in people over 60. That's more effective than medication.

The landmark Diabetes Prevention Program study identified the key changes that make the difference:

1. Lose a Modest Amount of Weight

You don't need to reach your "ideal" weight to see benefits. Losing just 5-7% of your body weight significantly improves insulin sensitivity. For someone weighing 200 pounds, that's only 10-14 pounds.

Focus on sustainable weight loss through:

  • Reducing portion sizes
  • Choosing whole foods over processed foods
  • Limiting sugary beverages and snacks
  • Eating more vegetables and lean proteins

2. Get Moving

Physical activity helps your cells use insulin more effectively, even without weight loss. Aim for:

  • 150 minutes per week of moderate activity (brisk walking, swimming, cycling)
  • That's just 30 minutes, 5 days a week
  • Break it up if needed—three 10-minute walks count

In St. Pete, take advantage of our beautiful weather. Walk the trails at Fort De Soto, swim at one of our beaches, or join a water aerobics class. Find movement you enjoy, and you'll stick with it.

3. Choose the Right Foods

You don't need a restrictive diet—just smarter choices:

Emphasize:

  • Non-starchy vegetables (leafy greens, broccoli, peppers, tomatoes)
  • Lean proteins (fish, chicken, beans, eggs)
  • Whole grains (brown rice, quinoa, oats)
  • Healthy fats (olive oil, avocados, nuts)

Limit:

  • Sugary drinks (soda, sweet tea, fruit juice)
  • Refined carbohydrates (white bread, white rice, pastries)
  • Processed foods high in added sugars
  • Large portion sizes

Focus on fiber: High-fiber foods slow sugar absorption and help you feel full longer.

4. Improve Sleep Quality

Poor sleep worsens insulin resistance. If you have sleep apnea, getting treatment can significantly improve blood sugar control. Aim for 7-9 hours of quality sleep nightly.

5. Manage Stress

Chronic stress raises cortisol levels, which increases blood sugar. Incorporate stress-reduction techniques like deep breathing, meditation, or regular physical activity.

Should You Consider Medication?

For some people at very high risk, doctors may recommend metformin alongside lifestyle changes. This is typically considered if:

  • You have a BMI over 35
  • You're under 60 years old
  • You have a history of gestational diabetes
  • Your A1C is at the higher end of the prediabetes range

However, lifestyle changes remain the foundation of treatment and are more effective than medication alone.

Monitoring Your Progress

If you have prediabetes, regular monitoring helps track your progress and catch any changes early:

  • A1C test: Every 6-12 months
  • Fasting blood sugar: As recommended by your doctor
  • Annual check-ups: To monitor overall health and risk factors

Celebrate improvements, even small ones. Seeing your numbers move in the right direction is powerful motivation.

Taking the First Step

A prediabetes diagnosis can feel scary, but it's actually a gift—advance warning that gives you time to act. The changes required aren't extreme or impossible. They're the same healthy habits that improve energy, mood, and overall quality of life.

If you haven't been screened for prediabetes, or if you've been diagnosed and aren't sure where to start, make an appointment. We can help you understand your numbers, identify your personal risk factors, and create a realistic plan that fits your life.

The path from prediabetes to diabetes isn't inevitable. The next step you take is up to you.