What to look out for and what to do if you notice symptoms

The thought of diabetes or prediabetes can be scary. But as they say, knowledge is power; knowing what the warning signs are for prediabetes and diabetes can help you fight the condition.

Diabetes is a chronic disease that impacts how the blood processes sugar. The specific type of sugar in question is glucose, which provides fuel for the brain as well as the muscles and tissues.

Insulin, a hormone produced in our body, converts glucose into energy. That hormone also communicates with the liver, directing it to store extra sugar for later use if you haven’t eaten in a while. As sugar enters the cells, leading the amount of available glucose in the bloodstream to decrease, insulin decreases too. The decrease in insulin levels serves as a sign for the liver to release the blood sugar you have stored up.

When diabetes is left unchecked, it leads to an excess of glucose, which can cause major health issues. Prediabetes is the lead-up to diabetes, meaning the body is struggling with glucose and insulin levels, but not to the point where damage is irreversible.


Prediabetes occurs when blood sugar levels are higher than normal and can eventually cause diabetes to develop. It affects one in three adults in the United States, which amounts to about 96 million people. The good news is, prediabetes is reversible. Pre-diabetic people can cure themselves of the oncoming disease, however careful monitoring is still important even if a person gets their blood sugar levels back down.

Prediabetes is also sometimes referred to as “Hyperglycemia” which is the medical term for “high blood sugar.” However, a person can be hyperglycemic without being prediabetic; it’s how high that blood sugar rises that will serve as the determining factor. Prediabetes is also occasionally called “borderline diabetes” or an “impaired glucose tolerance.”

Type 1 vs. Type 2 Diabetes

There are two different types of diabetes. Type 1 is a genetic condition that typically appears early in life. It’s technically an autoimmune disorder that keeps one’s body from making insulin because the body starts attacking itself out of confusion. Since patients with type 1 diabetes aren’t able to produce enough insulin to survive, they need lifelong treatment.

Type 2 diabetes, in contrast, develops over time. It used to be called adult-onset diabetes. In the past, it was also sometimes referred to as non-insulin-dependent diabetes, since the body does technically still produce insulin. A family history of type 2 diabetes can raise the risk that one may develop diabetes. Obesity – and particularly an extra store of fat around the waist – significantly raises the risk of diabetes development. It’s more common in people over the age of 40, though it’s becoming much more widespread in teenagers and young adults than ever before. Certain racial groups also tend to be at higher risk, though that may have more to do with socioeconomic issues than ethnicity.

Symptoms & Warning Signs

There are some tell-tale signs of diabetes and pre-diabetes that should signal a trip to the doctor is needed. Increased thirst and more frequent urination are both warning signs. Doctors may also look for ketones, which are byproducts of muscle and fat being broken down. When there isn’t enough insulin available, ketones are released into the urine. If a test detects ketones in a patient’s urine, a doctor may order further testing for prediabetes or diabetes in response.

Feeling tired, weak, irritable, or noticing drastic mood swings can also be a cause for concern if a person is worried he or she may be prediabetic. Blurry vision and dry eyes also call for a check-up at the doctor’s office. Diabetics may also notice that sores and other wounds are slow to heal and that infections seem more common. Those infections are most often noticeable in the gums, skin, and vagina.

The warning signs of pre-diabetes are extremely similar to diabetes, as are the risk factors.

Risk FactorsPrediabetesDiabetes
Physical ActivityYesYes
Family HistoryYesYes

Complications of Diabetes and Prediabetes

The main complication associated with prediabetes is the possible result of diabetes, which is a lifelong and incurable condition.

Having too much glucose in the bloodstream can damage the eyes, kidneys, and nerves over time. It often leads to heart disease, the risk of which is worsened by obesity – something which often goes hand-in-hand with diabetes. Diabetes can also lead to stroke.

Further, diabetes can result in peripheral artery disease, narrowing the arteries that push blood to the legs and feet. Without that blood flow, the feet and legs can develop open sores and ulcers that often become infected. Blood flow issues also mean wounds heal more slowly, causing them to fester and worsen. If left unchecked, those injuries can reach the point where the feet or portions of the legs must be amputated.

Diabetic neuropathy can also lead to amputations. Since diabetes can damage the nerves, diabetics may not feel pain in certain areas. For instance, a cut or burn that leads to an open wound may go unnoticed by a patient with diabetes. Since the patient isn’t aware of the injury, there’s no effort made to clean it. That means the wound is more likely to get infected, and that infection is more likely to spread. Gangrene is a major risk, in this case, causing the patient’s tissue to die and decay. In severe cases, gangrene can only be stopped through amputation, otherwise, the infection can continue to spread through the blood.

Why and How Diabetes Sets in

There are several ways blood sugar levels can get to an unhealthy state. One is simply when an excess of glucose gets into the bloodstream all at once, which causes the pancreas to pump extra insulin so the blood sugar can get into the cells. However, cells can eventually become resistant to insulin and stop responding. The pancreas then produces more insulin in an attempt to keep up with the glucose, however, blood sugar levels continue rising if the pancreas can’t keep up. Glucose has to be transferred into the cells; having it sit at high levels within the bloodstream is unhealthy. Furthermore, since insulin levels are heightened, this signals the liver to store extra sugar, which leads to weight gain and excess body fat. This vicious and ongoing cycle can lead to pre-diabetes and then diabetes over time.

Diagnostic Tests for Diabetes and Prediabetes

There are three main diagnostic tests that are used to check for both prediabetes and diabetes. For a Fasting Plasma Glucose test, the patient does not consume any food or liquids for eight hours, and then a doctor measures their blood sugar levels. A Two-Hour Postprandial Glucose Test is a measurement taken two hours after a meal. Lastly, a Glycosylated Hemoglobin Test, more commonly known as an A1C test, is a diagnostic assessment done over the course of 2-3 months that measures the patient’s average blood sugar.

Fasting Plasma Glucose100-125 mg/dL126+ mg/dL
Two-Hour Postprandial Glucose140-199 mg/dL200+ mg/DL
A1C5.7% – 6.4%6.5%+

Reversing the Disease

Type 1 diabetes can never be cured and requires life-long treatment. However, the way diabetics take care of their bodies will determine how intense that treatment will need to be.

Type 2 diabetes cannot technically be cured, though people can go into remission. That means glucose levels return to a level that is no longer considered diabetic. Partial remission is when glucose levels are in the pre-diabetes range but are still unhealthy.

The problem is, those glucose levels aren’t permanent. By the time a person develops diabetes, the cells have already been damaged, making relapse more likely. Weight gain can lead diabetes to return as well. Plus, the underlying genetic conditions that led the body to be susceptible to diabetes initially never dissipate, meaning the disease could strike again and cause further insulin intolerance. However, it’s still important that patients do everything in their power to reach remission, then keep an eye on things thereafter.

Thankfully, it is possible to reverse prediabetes. Pre-diabetics can train their bodies to become more sensitive to insulin over time. There are simple lifestyle changes patients can institute to remove the term “pre-diabetic” from their medical charts.

One of the most important adjustments is the level of physical activity. Exercise increases insulin sensitivity. The sooner patient starts healthier habits such as incorporating a workout routine into their weekly schedule, the more quickly they’ll see results in their attempt to remedy their insulin resistance.

Weight loss is also an important mission for pre-diabetics. Of course, exercise can assist with that. Doing things like avoiding sugary foods that could not only spike blood glucose levels but also lead to weight gain can make a big difference. Pre-diabetics should also keep an eye out for refined carbohydrates like pasta, white bread, and bagels. Fried foods can be an issue since they’re high in fats. It’s also important to pay attention to things that are marketed as healthy, but in actuality have high sugar levels and little nutritional value. Examples of unhealthy foods of that nature include things like flavored yogurts, breakfast cereals, and jams or jellies.

Reducing stress levels can also help patients lose weight. When the body is stressed, it releases the hormone cortisol, which makes people hungry and causes them to crave unhealthy foods. Managing stress levels can cut down on cravings thus making it easier to lose weight.

Finally, it’s important to get a good night’s sleep. Researchers from the University of Chicago found that sleep deprivation makes people feel hungrier and crave foods that are higher in fats and sugars. Those cravings can be extremely hard to resist since the body insists it needs the extra fats and sugars. Making sure to get a good night’s sleep will be crucial to a patient’s ability to dedicate themselves to healthy eating and an overall healthier lifestyle.