What is prediabetes?

What is the test for prediabetes?

The usual test for prediabetes measures your HbA1c levels. HbA1c is a measure of how much sugar has attached to the haemoglobin within your red blood cells. This is called glycated haemoglobin. A HbA1c test shows your average blood glucose levels over the last couple of months.

An HbA1c test is recommended if you:

• are over 40 (or over 25 years if you’re African-Caribbean, Black African, South Asian or Chinese)
• have a history of gestational diabetes
• have polycystic ovary syndrome (PCOS)
• have a parent with type 2 diabetes

How is prediabetes different to Type 2 diabetes?

The difference between prediabetes and type 2 diabetes is your blood sugar (glucose) levels. With prediabetes your blood glucose levels will be higher than normal, but not yet in the category for type 2 diabetes.

• For prediabetes your HbA1c will be between 42mmol/mol – 47mmol/mol
• In type 2 diabetes your HbA1c levels will be 48 mmol/mol or higher

A healthy HbA1c level is below 42 mmol/mol.

How long does it take prediabetes to turn into type 2 diabetes?

The time it takes for prediabetes to become type 2 diabetes will vary between people. Without treatment it can occur within 5 years, but depends on factors such as:

• age
• genetics
• health issues
• lifestyle choices

The good news is, you can take steps to prevent type 2 diabetes if your blood sugar levels are in the prediabetes range.

What are the warning signs of prediabetes?

Unlike type 2 diabetes, there are usually no symptoms of prediabetes. This is why it often goes undetected - about 1 in 5 people in the UK have prediabetes. Many people have it without realising.

However, there are symptoms of type 2 diabetes, so if you have any of the following, see a doctor for more advice:

• feeling thirstier than usual
• peeing more than normal, especially at night
• feeling tired
• losing weight without trying
• blurry vision

What changes should you make if you’re prediabetic?

There is lots you can do to reduce your blood sugar levels to a healthier range. Raised blood sugar levels are often the result of your lifestyle, which means you have a lot of power to improve your health.

1) Reduce your carbohydrate intake

Many of us eat more carbohydrates than we need – which can lead to both obesity and raised blood sugar levels. Try to keep your carb intake to a quarter of your plate.

2) Change the type of carbohydrates you consume

Remove refined carbohydrates from your diet and replace them with complex carbohydrates. So, choose granary bread, jumbo oats, and brown pasta instead of white flour products. Complex carbohydrates are higher in fibre which means sugar is released more slowly. This can improve your blood sugar levels over time.

3) Reduce your added sugar intake

Added sugar sneaks into many foods and drinks including juices, condiments and yoghurts. So always check the labels for sources of sugar and aim to consume drinks with under 5g sugar per 100ml. Ideally make water your drink of choice.

4) Move more

Exercise can use up excess blood sugar so try to move as often as you can. Just 30 minutes of daily walking can halve your risk of developing type 2 diabetes. Resistance exercise such as weightlifting and squats have also been shown to lower blood glucose.

5) Reduce stress and sleep well

Both high stress levels and poor sleep can raise your blood sugar levels. The following may help:

• sleep and wake at the same time every day
• avoid alcohol and heavy meals before bed
• try to get morning light exposure
• take time out to rest and relax
• try mind-body exercises such as yoga

6) Lose excess weight

If you are overweight, losing excess weight can improve your blood sugar levels. Cutting down your calories by 500 to 600 calories per day may help you to lose weight in a sustainable way.

7) Improve your gut health

There is evidence to suggest that improving your gut microbiome (the number and variety of helpful gut bugs living in your large intestine) can improve your blood sugar levels. To do this:

• eat lots of fibre rich foods such as vegetables, pulses, nuts, seeds and wholegrains
• increase your intake of pre and probiotic foods such as asparagus, garlic, oats, live yoghurts and kimchi
• eat a diverse diet with a wide range of colourful plant-based foods

Can you reverse prediabetes?

Yes – prediabetes can be reversed through lifestyle changes. This means you can avoid developing type 2 diabetes and its health risks. You will need to stick to the changes you make, and to check that your blood sugar levels are in a healthier range.

Even if you have already been diagnosed with type 2 diabetes, you can put the condition into remission if you strictly follow healthy changes. But prevention is always best.