Pre-diabetes: what is it and how can you prevent it from developing into diabetes? - Drauzio Varella Portal

Behavioral measures can help reverse prediabetes and prevent the onset of type 2 diabetes. Learn more.

Normal fasting blood glucose (blood sugar concentration) should be below 100 mg/dL. To diagnose diabetes , blood glucose must be 126 mg/dL or above. So what happens to those in the middle? This range is called prediabetes .

"Prediabetes is an intermediate condition between a patient with normal blood sugar levels and a patient with type 2 diabetes. Not every patient with prediabetes will develop diabetes. However, prediabetics have at least a 50% risk of developing diabetes within the next ten years," explains Ruy Lyra da Silva Filho, coordinator of the Diabetes Mellitus Department at the Brazilian Society of Endocrinology and Metabolism (SBEM).

How to diagnose prediabetes

Prediabetes doesn't cause symptoms and can only be detected through blood tests. According to the endocrinologist, people at increased risk for diabetes should be evaluated periodically, especially from the age of 30 to 35.

“We can diagnose [pre-diabetes] through fasting blood glucose, which is blood glucose between 100 and 125 mg/dL, or eventually with the glycated hemoglobin test, when the result is between 5.7% and 6.4%,” he explains.

Those at higher risk for developing diabetes include people with a family history of the disease, those who are overweight or obese , those with hypertension , and those with dyslipidemia (high cholesterol) , among others. For these individuals, Dr. Ruy says it's important to have a checkup two to three times a year.

See also: DrauzioCast #168 | FAQs about diabetes

Possible complications

Even without symptoms, prediabetes already poses a health risk. "Some studies have shown that even in prediabetes, these people are already at risk of developing chronic complications, such as diabetic retinopathy, diabetic nephropathy, and cardiovascular disease," warns the specialist.

What to do to reverse prediabetes

The good news is that prediabetes can be reversed. That is, with the right measures, it's possible to prevent the condition from progressing to type 2 diabetes. These measures include:

• Weight loss, in the case of people who are overweight or obese;
• Maintaining a healthy diet (ideally, reducing the consumption of high-calorie foods — not just sugar, as many people think, but fats, processed meats and ultra-processed foods , for example);
• Regular physical exercise (at least three times a week);
• Use of the drug metformin for specific groups (which can help prevent diabetes).

In an interview with DrauzioCast about pre-diabetes , João Eduardo Salles, endocrinologist and professor at the Faculty of Medical Sciences of Santa Casa de São Paulo, highlighted the importance of eating home-cooked food: a dish with rice, beans, salad and a lean protein (such as chicken thigh, fish fillet, pork or lean beef, for example) is a complete and balanced meal.

And when the condition progresses to diabetes?

Even when diabetes is present, there may be no symptoms initially. However, when symptoms do occur, the main signs include frequent urination, excessive hunger and thirst. Blurred vision, slow-healing wounds, and frequent infections may also occur.

Once diagnosed, it's crucial to follow appropriate treatment to avoid complications, which can be serious. Although it's a chronic condition, diabetes can be controlled with medication and lifestyle changes.

See also: Diabetes and quality of life: what it's like to live with the disease