6 Early Signs That You Might Have Prediabetes

While prediabetes may not seem as serious as full-blown diabetes, it still signals that your blood sugar is higher than normal, though not yet in the diabetic range. At this point, medication may not be necessary, but without significant lifestyle changes, you could soon find yourself at risk for type 2 diabetes.

A diagnosis of prediabetes isn't a reason to ignore elevated blood sugar. Think of it as a red flag that calls for action, urging you to take steps to prevent more serious health problems down the road.

The good news is, the habits that help manage prediabetes are the same ones that promote overall health. You can boost your activity level, eat a nutritious diet with lean proteins, fiber, fruits, and vegetables, manage stress, reduce sugar and refined carb intake, and get sufficient rest.

The great part is that these changes don't just help manage blood sugar—they also pave the way for a healthier lifestyle and can prevent the progression to full-blown diabetes.

What Is Prediabetes and How Is It Different from Diabetes?

Prediabetes is a condition where blood sugar levels are elevated but not high enough to be classified as diabetes. In the U.S., one in three adults are living with prediabetes.

Blood sugar, or glucose, is produced by the foods you consume. High-carb foods, such as white bread and sugary treats, cause a rapid spike in blood glucose compared to lower-carb options like meat and fresh vegetables. Persistent high blood sugar can lead to inflammation and long-term damage to your body.

Fasting blood sugar levels can be used by doctors to diagnose prediabetes:

• Normal fasting blood sugar — under 100 mg/dL
• Prediabetes — 100 to 125 mg/dL
• Diabetes — above 126 mg/dL

"Diabetes is a serious endocrine disorder that affects multiple organs due to poor blood sugar control," says Dr. William Li, a globally recognized medical expert, researcher, and founder of the Angiogenesis Foundation, as well as the author of the bestselling book Eat To Beat Disease.

What Leads to Prediabetes?

Insulin is a hormone that enables your cells to absorb glucose from your bloodstream. Glucose is vital as it fuels your cells, providing the energy they need to function properly.

"In a healthy individual, insulin levels fluctuate according to the body's needs," Dr. Li explains.

If your body has insufficient insulin, as seen in type 1 diabetes, your cells are unable to absorb the glucose they need. Without this essential energy source, the cells cannot function properly.

In type 2 diabetes, the issue isn't a lack of insulin; it's the cells' inability to respond to insulin effectively.

"The early stage of this condition is called 'insulin resistance,' which occurs in prediabetes. While the exact cause of insulin resistance is still unclear, it is associated with factors like inactivity, smoking, obesity, aging, and poor dietary choices," he explains.

Many people don't realize they have prediabetes until they're diagnosed with diabetes. However, an annual physical exam and blood tests can help you and your healthcare provider track blood glucose levels and detect potential concerns.

Recognizing the Signs and Symptoms of Prediabetes

The most common signs of prediabetes closely resemble those of diabetes. If you experience two or more symptoms of prediabetes, it’s important to schedule a visit with a healthcare provider. Simple tests can help determine your blood sugar levels and whether you need to take steps to improve them.

1. Elevated A1C blood test results.

The A1C test — also known as the hemoglobin A1C or HbA1c test — is a standard blood test that measures your average blood sugar levels over the past three months. It’s commonly used to assess your risk of prediabetes or diabetes.

A1C test results are given as a percentage. The higher the percentage, the higher your average blood sugar levels have been over the last 90 days.

• Normal: 5.7% or below
• Prediabetes: 5.7% to 6.4%
• Diabetes: above 6.5%

If you're diagnosed with prediabetes or diabetes, your doctor will regularly monitor your A1C throughout the year to track how well the condition is being managed.

2. Constant thirst.

Excessive thirst could be a warning sign of prediabetes.

When blood sugar levels are high, the excess glucose remains in the bloodstream. The kidneys then work to flush it out. Your body can use water to help dilute the sugar, triggering your brain to send a signal for you to drink more water.

"High blood sugar in prediabetes triggers your body to seek more fluids in an effort to dilute the sugar concentration," explains Dr. Li. This increased thirst leads to drinking more water — and the result is more frequent urination.

"People with prediabetes also experience frequent urination, known as polyuria. As a result, the body wants to replenish the lost fluids, which activates the brain's thirst centers," he adds. Those with polydipsia may drink as much as six liters of water a day, which is excessive.

3. Occasional blurry vision.

When blood glucose levels are high, as they are in prediabetes, the excess glucose can build up in the lens of your eye, affecting your vision.

"This buildup in the lens can cause blurred vision, as it interferes with light traveling from the front to the back of the eye, where the brain interprets visual signals," explains Dr. Li.

High blood sugar can also cause the lens of your eye to swell, making it harder to focus light on the retina — the part of the eye that processes light into images. It's similar to when your phone camera struggles to focus before taking a photo.

"This type of blurry vision is different from the kind caused by dirty contact lenses, which can simply be cleaned and put back in," he adds.

4. Frequent urination.

In addition to drinking more fluids because of increased thirst, you may also notice changes in your kidney function and the amount of urine you produce.

"High blood sugar from prediabetes can affect how your kidneys filter water from your blood into your bladder," says Dr. Li. When your kidneys aren't functioning properly, you may feel the need to urinate more often than usual.

"Excess glucose in the urine can make the kidneys extract more fluid from the blood, leading to increased urine production and more frequent trips to the bathroom," he explains. This is often an early sign of prediabetes: "If left untreated, diabetes can damage the kidney's filtration system, causing even more water loss through urination."

5. Constant hunger.

When you have prediabetes, your body struggles to absorb blood sugar effectively, meaning you don’t get as much energy from your meals or snacks as you used to.

"As a result, you feel hungrier than usual and tend to eat more," says Dr. Li. "The lack of energy from nutrients causes your brain to signal that you need to eat more to fuel your body. But if your cells can't process the energy properly, the hunger persists even after eating large amounts of food," he explains.

The key to breaking this cycle in prediabetes is reversing it. Regular exercise, a balanced diet, reducing stress, improving sleep, and focusing on your overall well-being will help restore your cells' ability to absorb blood sugar, stopping the cycle of frequent hunger (polyphagia).

6. Unusual fatigue.

There are many factors that can leave you feeling drained. With the pressures of daily life, it's common to feel exhausted from time to time.

The inefficient use of blood sugar in prediabetes also leads to decreased energy levels and increased fatigue. Your cells rely on glucose from the blood to function, and without enough of it, your body struggles to fuel your daily activities.

"Healthy, energized cells support proper muscle and organ function. But when energy levels are low due to prediabetes, cells don't perform as well, which can leave you feeling drained," he explains.

How to Reverse Prediabetes

The most effective way to reverse prediabetes is by adopting healthy lifestyle habits. Start by getting active and creating a daily exercise routine. Exercise helps your body process blood glucose more efficiently and can help reverse prediabetes. Pair that with nutritious food choices at every meal and snack. Before long, your A1C levels could begin to drop.

1. Get moving.

"For prediabetes, it’s recommended to aim for at least 150 minutes of moderate-intensity aerobic exercise per week, which breaks down to about 30 minutes a day, along with some resistance training a few times a week," says Dr. Li.

Effective exercises for those with prediabetes include brisk walking, swimming, biking, tennis, aerobics, and strength training exercises like squats, push-ups, and weightlifting.

2. Eat more plant-based foods.

Revitalize your diet by incorporating more whole, plant-based foods like vegetables, legumes, and nuts.

"High-fiber foods nourish the gut microbiome, which produces metabolites that support the metabolism of blood sugar," explains Dr. Li.

3. Personalize your diet.

Consider working with a nutritionist to customize your eating plan. In general, avoid processed foods, sugary sodas, sweetened coffee, fried snacks, candies, and cakes — all of which can stress your metabolism and make it harder for your body to manage blood sugar.

4. Reduce stress.

It’s important to find ways to manage stress, as this can help lower the levels of catecholamines your body produces. Catecholamines are substances that can disrupt glucose metabolism.

"Catecholamines are stress hormones released by the brain, nerves, and adrenal glands, which are located on top of your kidneys. These hormones trigger the body's 'fight or flight' response during stress," says Dr. Li.

"One effect of this response is the increased production of glucose, which raises your blood sugar levels, preparing your body to handle stress. However, this rise in blood sugar is not beneficial when you have prediabetes," Dr. Li explains.

To ease stress, try activities like deep breathing, meditation, going for a walk, exercising, reading a book, spending time with a pet, or chatting with friends or family when you feel tense.