Understanding Pre-Diabetes

An estimated 79 million Americans have pre-diabetes. Is this you?

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What is Pre-Diabetes?

Pre-diabetes is a condition of elevated blood sugar that is not high enough to be called diabetes.  You have pre-diabetes if:

  • Your fasting blood sugar is between 100-125 mg/dL, or
  • Your A1C reading is between 5.7-6.4 percent, or
  • Your 75 gram oral glucose tolerance test reading is between 140-199 mg/dL after two hours

Why is Pre-Diabetes a Problem?

You may think that medical complications only happen to people with diabetes.  However, people with pre-diabetes are at increased risk for having:

  • heart disease or a stroke
  • neuropathy (nerve damage)
  • retinopathy (damage to the retina in the eye)
  • nephropathy (kidney damage)

Of course, people with pre-diabetes are at increased risk for getting type 2 diabetes!

Are You at Risk?

You are at risk if you:

  • Have a family history of diabetes
  • Are from an ethnic minority group (Native American, African American, Latino, Asian American, Pacific Islander)
  • Have a history of heart disease
  • Are overweight, obese or inactive
  • Have a history of diabetes of pregnancy or a baby weighing more than nine pounds
  • Have high blood pressure (over 140/90), or low HDL cholesterol (40 or lower), or high triglycerides (150 or higher)

The Good News- Diabetes can be Delayed or Prevented!

Landmark research completed in 2002 showed that the onset of diabetes can be delayed and possibly prevented in high-risk people with an intensive 16-week lifestyle (healthy eating and physical activity) intervention.  This study was called the “Diabetes Prevention Program

In this study about 3200 American adults with pre-diabetes were randomly assigned to one of three study intervention groups as follows: lifestyle, diabetes medication, and placebo.

Lifestyle (16 week program)

  • Reduced calories, low-fat diet
  • 150 minutes of exercise per week (30 minutes of walking 5 days per week)
  • Weight loss goal = 7% of body weight

Metformin (Diabetes Drug)

  • 850 milligrams 2 times per day


  • No intervention

Diabetes Prevention Program Study Results


  • Compared to placebo, risk for developing diabetes decreased by 58%

Metformin (Diabetes Drug)

  • Compared to placebo, risk for developing diabetes decreased by 31%

What You Can Do Now!

If you are at increased risk or already have pre-diabetes:

  • Eat well-balanced, reduced calorie, low-fat meals
  • Accumulate at least 30 minutes of physical activity on at least 5 days of the week
  • If you are overweight, try to reduce your weight by about 7%


Interested in Taking a Class on Pre-diabetes?

Learn more


American Diabetes Association.  Standards of medical care in diabetes- 2011.
Diabetes Care 34 (Supplement 1): S11-S61, 2011.

CDC. National Diabetes Fact Sheet: National estimates and general information on diabetes and pre-diabetes in the United States, 2011.

Cheng, Y. J., et al.  Association of A1C and fasting plasma glucose Levels with diabetic retinopathy: Prevalence in the U.S. population.  Diabetes Care 32:2027–2032, 2009.

Diabetes Prevention Program Research Group.  Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin.  New England Journal of Medicine 346: 393-403, 2002.

Meigs, J. B.  Epidemiology of type 2 diabetes and cardiovascular disease: translation from population to prevention.  Diabetes Care 33:1865–1871, 2010.

Papanas, N., et al. Neuropathy in prediabetes: does the clock start ticking early? Nat. Rev. Endocrinol. 7, 682–690, 2011.

Plantiga, L. C., et al.  Prevalence of chronic kidney disease in US adults with undiagnosed diabetes or prediabetes.  Clin J Am Soc Nephrol 5: 673–682, 2010.

Zhang, X., et al.  A1C level and future risk of diabetes: A systematic review.  Diabetes Care 33:1665–1673, 2010.