What is pre-diabetes?

Pre-diabetes, also commonly referred to as borderline diabetes, is a metabolic condition and growing global problem that is closely tied to obesity.  

If undiagnosed or untreated, pre-diabetes can develop into type 2 diabetes; which whilst treatable is currently not fully reversible.

Pre-diabetes is characterised by the presence of blood glucose levels that are higher than normal but not yet high enough to be classed as diabetes.

For this reason, pre-diabetes is often described as the “gray area” between normal blood sugar and diabetic levels. In the UK, around 7 million people are estimated to have pre-diabetes and thus have a high risk for developing type 2 diabetes. 

The increasing number of new cases of pre-diabetes presents a global concern as it carries large scale implications towards the future burden on healthcare. Between 2003 and 2011, the prevalence of pre-diabetes in England alone more than tripled, with 35.3% of the adult population, or 1 in every 3 people having pre-diabetes.

Learn more about pre-diabetes

Pre-diabetes is a critical stage in the development of diabetes, for it is at this point that lifestyle choices can be made to turn it around. Early, decisive action can slow down or even halt the development of type 2 diabetes. 

What are the symptoms of pre-diabetes?

Many people have pre-diabetes but are completely unaware of it. This is because the condition often develops gradually without any warning signs or symptoms. In many cases, the sufferer only learns of their borderline diabetic state once the symptoms of type 2 diabetes start to appear. 

Testing for pre-diabetes

The amount of sugars in the blood is detected by either a fasting plasma glucose test or an HbA1c and may be used to diagnose type 2 diabetes or pre-diabetes.

The following results indicate the presence of pre-diabetes:

• Fasting plasma glucose:5 mmol/L to 6.9 mmol/L

• HbA1c: 42 to 47 mmol/mol (6.0 to 6.4%) 

If your results are above the upper limits for pre-diabetes, your GP may either diagnose you with type 2 diabetes or take another test in the near future to confirm whether you have diabetes. If you have symptoms of diabetes but have an HbA1c of below 42 mmol/mol (6.0%), you may be given a glucose tolerance test (GTT).

If you are diagnosed with pre-diabetes, you can attend a pre-diabetes education program which clearly set out the steps you need to take to lower your risk of developing type 2 diabetes.

Can I stop pre-diabetes developing into type 2 diabetes?

The good news is that cases of pre-diabetes that are identified early on can be reversed, preventing them from progressing into full-blown type 2 diabetes. Each year in the UK, 5% to 10% of people diagnosed with pre-diabetes go on to develop type 2 diabetes.

The two principle factors for consideration are making changes to your diet and increasing physical exercise which is appropriate for your lifestyle.  By making these changes, blood sugar levels can be returned to normal.