Diabetes Pre Diabetes

Overview

Prediabetes means your blood sugar is higher than normal, but not high enough to be called diabetes. Diabetes is a long-term condition where your body cannot use sugar from food properly, so sugar builds up in your blood. This article focuses mainly on type 2 diabetes, which is the most common type. Prediabetes is a warning sign, and it can often be turned around.

Very common. Prediabetes and type 2 diabetes are among the most common long-term health conditions worldwide. Many people have prediabetes without knowing it.

Anyone can get prediabetes or type 2 diabetes. It is more common in adults over 40, or over 25 in some higher-risk groups. Risk is also higher if you are overweight, have a parent or sibling with diabetes, had diabetes in pregnancy, have polycystic ovary syndrome, have high blood pressure, or are from some South Asian, African, Caribbean, or Middle Eastern backgrounds.

Symptoms

Common symptoms

• Often no symptoms at all
• Feeling very thirsty
• Peeing more often, especially at night
• Feeling tired or lacking energy
• Blurred vision
• Cuts or sores healing slowly
• Getting infections more often
• Unexplained weight loss, which is more common as diabetes develops

Symptoms in children

• May have no symptoms
• Being very thirsty
• Peeing a lot, including bedwetting in a child who was dry before
• Tiredness
• Weight loss
• Dark, velvety skin folds around the neck or armpits, which can happen with type 2 diabetes risk
• Stomach pain, vomiting, or fruity-smelling breath need emergency care

Symptoms in older adults

• Symptoms can be vague or put down to ageing
• Tiredness or confusion
• Thirst and peeing more, but this may be missed
• More infections than usual
• Slow healing
• Sometimes no symptoms at all

Causes

Main causes

• Insulin resistance: the body does not respond well to insulin, a hormone that moves sugar from the blood into cells.
• The pancreas cannot make enough insulin to keep blood sugar in a healthy range.
• A mix of genes, lifestyle, body weight, and ageing.
• Extra fat around the belly and liver can make insulin work less well.
• Long-term stress on the body and changes in sleep can also play a part.

Risk factors

• Being overweight or having a lot of fat around the belly
• Low physical activity
• A parent, brother, or sister with type 2 diabetes
• Having had diabetes in pregnancy
• Polycystic ovary syndrome
• High blood pressure or unhealthy cholesterol levels
• Smoking
• Poor sleep or long-term stress
• Some medicines, such as steroid tablets
• Being older, or being from a higher-risk ethnic background

When to see a doctor

See a doctor urgently if:

• You have symptoms of very high blood sugar, such as severe thirst, confusion, vomiting, or fast breathing
• You have a foot wound, ulcer, or a foot that is red, hot, or swollen
• You have sudden vision changes
• You cannot keep fluids down
• You feel very unwell and are not sure why

Book a routine appointment if:

• You have risk factors for prediabetes or type 2 diabetes
• You have had diabetes in pregnancy
• You have symptoms such as thirst, peeing more, or tiredness
• You want help with weight, food, or activity changes
• You have a family history of diabetes and want to know your risk

Diagnosis

Blood tests measure the sugar in your blood. Prediabetes is when the result is above normal but below the diabetes range. Your clinician may repeat a test to confirm the result and to rule out other causes.

Tests that may be done

• HbA1c blood test: shows your average blood sugar over the past 2 to 3 months.
• Fasting blood glucose test: a blood test after not eating for about 8 hours.
• Oral glucose tolerance test: a sugary drink is given, and blood sugar is checked before and after.
• Random blood glucose test: used if you have clear symptoms.
• Ketone test: may be used if you are very unwell or your blood sugar is very high.

What to expect at your appointment

You will usually have a simple blood sample. Some tests need you to fast, so ask before you go. Results may take a few days. Your clinician will explain your numbers and whether you need monitoring, lifestyle support, or treatment.

Treatment

The goal is to lower blood sugar and protect your heart, kidneys, eyes, feet, and nerves. With prediabetes, healthy changes can bring blood sugar back to normal. With type 2 diabetes, healthy habits plus regular checks and sometimes medicines keep you well.

Self-care at home

• Eat regular, balanced meals with vegetables, fibre, and protein.
• Choose water instead of sugary drinks.
• Move more: aim for activity you enjoy and can keep doing.
• If you are overweight, losing a small amount of weight can make a big difference.
• Get enough sleep and manage stress where you can.
• Stop smoking and keep alcohol within low-risk limits.
• Check your feet every day for cuts, blisters, or redness.
• Attend your check-ups for eyes, feet, kidneys, and blood pressure.
• Take any prescribed medicine as directed and ask if you are unsure.

Medical treatments

Your healthcare team may suggest glucose-lowering medicines if lifestyle changes are not enough. They may also offer medicines to protect your heart and kidneys, and treatment for blood pressure or cholesterol. Vaccinations and regular checks are part of care. Treatment is personal, and you should not start or stop any medicine without advice.

When is surgery considered?

Surgery is not a usual treatment for prediabetes or type 2 diabetes. Weight-loss surgery may be considered for some people with severe obesity and type 2 diabetes when other approaches have not worked. Ask your healthcare team whether it is an option for you.

Living with this condition

Living with prediabetes or diabetes means building routines that you can keep. Check your feet, take medicines as prescribed, keep appointments, and have a plan for sick days. If you take glucose-lowering medicine, carry something that says so and ask your team what to do if your blood sugar drops.

Lifestyle tips

• Plan meals around vegetables, fibre, and lean protein.
• Build activity into your day, such as walking after meals.
• Keep a regular sleep routine.
• Limit alcohol and avoid smoking.
• Ask for help with stress, low mood, or burnout.
• Keep a simple record of your readings if your team asks you to monitor.

Diet and exercise

Try the plate method: half vegetables or salad, one quarter protein, and one quarter starchy foods such as wholegrains. Choose water instead of sugary drinks. Aim for about 150 minutes of moderate activity a week, such as brisk walking, plus strength exercises twice a week. Break up long sitting time with short walks.

Mental health and emotional wellbeing

Prediabetes and diabetes can feel worrying or tiring. Many people feel diabetes distress, low mood, or anxiety at times. These feelings are common and treatable. If you ever have thoughts of harming yourself, call your local emergency number or a local crisis support line immediately.

Prevention

Type 2 diabetes can often be prevented or delayed, and prediabetes can often be reversed. Small, steady changes to food, activity, sleep, and weight are more helpful than perfect short-term plans.

Vaccines

Ask your healthcare team which vaccines are recommended for you. People with diabetes are often advised to get flu and other routine vaccines because infections can raise blood sugar and make you more unwell.

Screening programmes

Many health systems offer blood sugar checks for people with risk factors. Ask your clinician whether you should be tested, especially if you are over 40, have a family history, had diabetes in pregnancy, or have other risk factors.

Complications

If left untreated

• Prediabetes can develop into type 2 diabetes.
• Heart disease and stroke
• Kidney damage
• Nerve damage, especially in the feet
• Eye problems that can affect vision
• Foot sores and infections
• Sexual problems
• More infections and slower healing

Long-term outlook

The outlook is hopeful. Prediabetes often can be reversed, and type 2 diabetes can be managed well. Regular checks, healthy habits, and support lower the risk of problems. Many people live full, active lives with diabetes.

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