What Comes Before Type 2 Diabetes?

I remember when I was in medical school, learning all about diabetes, how and why it happens, and the treatment for it. One day, the term “prediabetes” came up. Right then, it dawned on me that my dear old dad is categorized as one.

Prediabetes means that you are not a diabetic, but you are not normal either. What it signifies is that your blood sugar is higher than normal but not high enough to be classified as a diabetic. Without lifestyle changes, prediabetics are very likely to progress to type 2 diabetes.

Many may say that they have nothing to worry about since they technically do not have diabetes yet. However, studies have shown that prediabetics may already suffered from long-term damage to their heart, blood vessels, and kidneys.

The good news is that the progression from prediabetes to type 2 diabetes can be avoided by eating healthy, exercising, and maintaining a healthy weight. Generally, prediabetes has no signs and symptoms.

The exact cause is unknown. With that said, researchers believe that it could be a combination of various risk factors that can lead to prediabetes. Some of them include:

  • Being overweight
  • Large waist size (>40 inches for men, >35 inches for women)
  • Dietary patterns – Eating red meat and processed meat, sweetened beverages
  • Inactivity
  • Age – Risk increases after the age of 45
  • Family history
  • Race – African-Americans, Hispanics, Native Americans, Asian-Americans, and Pacific Islanders have higher risk of diabetes
  • Gestational Diabetes – If you had this during pregnancy, your risk of diabetes is higher
  • Polycystic Ovarian Syndrome – A condition characterized by irregular periods, excess body hair, and obesity
  • Sleep – Individuals with sleep apnea have an increased risk of diabetes



Screening is recommended for adults at the age of 45 or earlier if you are overweight or have additional risk factors. Here are the tests and results:

Normal Prediabetic Diabetic
HbA1c <5.7 5.7-6.4 6.5 or above
Fasting Blood Glucose <5.6mmol/L 5.6-7.0mmol/L 7.0mmol/L or above
Oral Glucose Tolerance <7.8mmol/L 7.8-11.0mmol/L 11.1mmol/L or above

Children and adults that are found to be prediabetes should be screened at least annually to make sure there is no progression to type 2 diabetes. For prediabetics, steps should be taken to prevent the progression of prediabetes to type 2 diabetes.

[expand title=”References“]

Patient Care & Health Infirmation. Prediabetes. Mayo Clinic. Accessed February 8, 2017.

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