If you are middle age, inactive, and overweight you may have prediabetes, meaning your blood glucose (sugar) levels are higher than normal. Since they haven’t yet reached the levels required for an official diabetes diagnosis and a need for insulin (the hormone required for the metabolism of foods and the regulation of blood sugar levels)—there’s still time to reverse your course down a dangerous and potentially deadly road to poor health.

All About Prediabetes

Prediabetes is a common condition: According to the Centers for Disease Control (CDC), in 2010, an estimated one out of three adults (and one out of two of those 65 and older) had prediabetes. Worse, most people with prediabetes are not even aware they have it. Without intervention, many of these people will go on to develop type 2 diabetes.

Functional physician Mark Hyman, MD, has his own name for this condition: diabesity, which he says describes the continuum from optimal blood sugar balance to full-blown diabetes. In his book, The Blood Sugar Solution, Hyman writes: "Nearly all people who are overweight (over 70 percent of adult Americans) already have prediabetes and have significant risks of disease and death." Even if an individual has normal blood sugar, he or she may still have diabesity. Hyman calls diabesity the single biggest global health epidemic of our time.

Signs and Symptoms

One of the most common symptoms of prediabetes is darkened areas of the skin (acanthosis nigricans). These usually appear on the neck, armpits, elbows, knees, or knuckles. Other potential symptoms include increased thirst, frequent urination, fatigue, and blurred vision. Unfortunately, says diabetes expert Amber Taylor, MD, most individuals with prediabetes don’t have symptoms and don’t know they should be tested.

Testing for the Condition

There are a few tests for prediabetes and diabetes:

  • The A1C Test measures the average glucose (sugar) in your blood stream over the previous two to three months. A score of 5.7 to 6.4 percent can be categorized as prediabetes.
  • The Fasting Blood (or Plasma) Glucose Test measures blood sugar after at least eight hours of fasting; 100 to 125 mg/dl (milligrams per deciliter of blood) indicates prediabetes.
  • The Oral Glucose Tolerance Test (OGTT) checks your blood sugar levels before and after you drink a specially formulated (and very sweet) drink. It measures how well your body processes sugar. Results of 140 to 199 ml/dl indicate your blood sugar is elevated.

Good News for People With Prediabetes

On the bright side, prediabetes responds very well to lifestyle changes, even if you have other diabetes risk factors, such as family history. Taylor says simple adjustments such as improving your diet and adding exercise to your day can make an enormous difference. Look at it as an opportunity to improve your health and help prevent a future diagnosis of type 2 diabetes.

Taylor suggests eating foods low in saturated and trans fats (aka partially hydrogenated oils) and calories, and high in fiber, such as fruits, vegetables, whole grains. Lean protein sources and foods rich in mono and polyunsaturated fats should be emphasized. Minimize alcohol consumption and exercise regularly; just a few pounds less on the scale can make a positive difference.

Amber Taylor, MD, reviewed this article.


  1. "Diagnosing Diabetes and Learning About Prediabetes." American Diabetes Association. 4 January 2014.
  2. "Prediabetes." Mayo Clinic. 26 January 2013.
  3. "Prediabetes: Am I at Risk?" Centers for Disease Control and Prevention. 20 September 2013.
  4. Lowry, Fran. "Awareness of Prediabetes in the US is Low." Medscape Medical News. 27 March 2013.
  5. Hyman, Mark, MD. The Blood Sugar Solution. New York: Little, Brown and Company, 2012.