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Understanding and Managing Prediabetes


You heard that right

Prediabetes is a health condition where your blood sugar is higher than normal, though not so high to label it as diabetes. It is also known as Impaired Fasting Glucose (IFG) or Impaired Glucose Tolerance (IGT).

So, prediabetes is not an actual disease but a warning sign. The good news is if you are motivated to make lifestyle changes you can reverse Prediabetes and have a healthy life. About 15-35% of people can reverse prediabetes by making suitable changes to their lifestyle

Common tests to diagnose prediabetes are:

  1. Fasting blood sugar level, where a blood sample is taken after an overnight fast or after you haven’t eaten for at least 8 hours
  2. Glycated Hemoglobin (HbA1c) which measures your blood sugar level for the past 3 months. When you have sugar (glucose) in the blood, it glycates or sticks to hemoglobin. More the amount of sugar is in the blood, the more it sticks. So, this test measures the average amount of sugar that’s been attached to hemoglobin over a period of time.
  3. Oral glucose tolerance test – you need to fast overnight and then drink 75g of sugary liquid at the laboratory. Your blood sugar levels will be measured periodically for the next two hours.

Here’s a sneak peek into what is prediabetes range:


Fasting blood sugar

Oral Glucose tolerance

Glycated Hemoglobin


70-100 mg/dl

< 140 mg/dl


Pre-diabetic or IGT

100-125 mg/dl

140-199 mg/dl

5.7 – 6.4%


126 mg/dl or higher

200 mg/dl or higher

6.5% or higher

As per the International Diabetes Federation, 1 in 11 adults has diabetes. Almost 1 in 2 adults with diabetes are unaware that they have diabetes.

Causes and risk factors for Prediabetes

The exact cause of prediabetes is unknown, but there are certain factors that put you at an increased risk.

  1. Family history of diabetes, if any of your parents or siblings are diabetic
  2. Being overweight
  3. Waist size over 40 inches in males and over 35 inches in females
  4. Lack of exercise
  5. Regular consumption of junk food, sugar-sweetened beverages, high-calorie snacks, and processed foods
  6. Tobacco/alcohol/drug abuse
  7. Disturbed sleep or lack of sleep


Women with a history of gestational diabetes, and polycystic ovarian syndrome (PCOS) are also at increased risk of prediabetes.

You are more likely to develop prediabetes if you are overweight and or eat a diet that contains too many calories from refined carbohydrates and processed foods.

What are the Symptoms of Prediabetes?

The bitter part of Prediabetes is the absence of any clear signs and symptoms. Over 80% of people don’t know they are prediabetic unless they get their blood sugar tested.

Result? They advance to more serious symptoms of insulin resistance which include:

  • Increased appetite and thirst – A person feels hungry even after a meal or thirsty even after drinking water.
  • Frequent urination
  • Fatigue
  • Blurred vision
  • Numbness or tingling in hands and feet – high blood sugar damages the nerves that send signals from your hands and feet, leading to numbness and tingling. It is labeled as diabetic neuropathy.
  • Frequent infections due to weakened immunity caused by high blood sugar levels
  • Slow-healing sores
  • Unintended weight loss
  • Few prediabetic people may notice thick velvety darkened skin in certain parts of the body, like the neck, groin, and armpits.

What is the treatment of prediabetes?

The goal of treating prediabetes is to return to normal blood sugar levels and prevent the development of actual diabetes. This can be accomplished with a healthy lifestyle. The two healthy habits that can make the biggest difference are making healthy food choices and regular exercise

  • Eat healthy food – Choose a diet rich in fruits, vegetables, nuts, whole grains, and cold pressed oils, which is associated with a lower risk of prediabetes. Consume foods low in fat and calories, and high in fiber. Replace sugary drinks like Packed fruit juices, soda, and sweetened beverages, with water. Make your water more interesting by adding kiwi, cucumber, mint leaves, ginger etc. You can consult a dietician to avoid comprising on taste while choosing nutritious food. Research suggests that a low carbohydrate diet could help improve blood glucose levels, insulin levels, and weight
  • Be more active – Regular physical activity helps control weight, thus lowering your blood sugar levels. Aim for at least 150 minutes of moderate exercise per week, like brisk walking or 75 minutes of vigorous exercises a week, or a combination of moderate and vigorous exercises, as per your capability. Not only exercise helps in weight loss but also causes your muscles to use up blood glucose
    • The best ways to incorporate physical activity into your daily routine.
    • Ride a bicycle
    • Brisk walking/ jogging
    • Going to the gym
    • Swimming
    • Recreational sports
  • Losing weight – losing just 5 – 10% of your body weight can significantly reduce your risk of developing Type II Diabetes and eliminate your prediabetes.
  • Reduce Mental stress – get active, meditate, laugh more, connect with others, and try yoga.
  • Stop smoking and drinking – as this can improve the way insulin works in your body and improve your blood sugar level.
  • Take medications – and other necessary treatments for other health conditions like PCOD, high blood pressure, and high cholesterol.

Take away

If left untreated prediabetes can cause health issues including type II diabetes, heart diseases, and kidney ailments.

Fortunately, it is reversible and can be treated by simple lifestyle changes and changes to your diet.

Connect with the experienced doctors at CareFirst if you are worried about prediabetes, observe any signs or symptoms, or need assistance with prediabetes.



Dr. Uma Nagpal


Dr. Uma Nagpal retired as a Deputy Director General of NHI South Africa. She has worked across specialties over an illustrious 40+ years of clinical experience. She has worked as a Senior resident in the Department of Obstetrics and Gynecology and anesthesia. She Independently practices as GP for thirteen years. Then worked as Medical Officer, Principal Medical officer, and Chief Medical Officer in various hospitals in South Africa.



Col. (Retd.) Dr. VK Popli


Col. (Retd.) Dr. V K Popli is a Family Physician with more than 45 years of work experience. He is a veteran & has managed various army healthcare facilities across India.  

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