With 88 million Americans or approximately 1 in every 3 adults, suffering from prediabetes in this country (and 34 million Americans, or 1 in 10, with full-blown type 2 diabetes), many people are walking around with a ticking time bomb in their bodies, and don't even know they have the condition.

Prediabetes is when your blood sugar level is higher than it should be for optimal health, but not high enough for your doctor to diagnose the disease. It's also known as impaired fasting glucose or glucose intolerance. The scary part is, 90 percent of those with prediabetes don’t know that they have it.

We have all heard that excessive thirst or urinating more often than normal is a sign that you could have diabetes, but what are the telltale signals that you may have prediabetes? Why does it matter? The sooner you find out the better, for your health and to know that changing your lifestyle can alter the course of the disease and head it off at the pass.

Could You Have Prediabetes and Not Know It? The Simple Answer Is Yes!

Prediabetes, unlike diabetes, is an asymptomatic condition. The sooner someone finds out that they have prediabetes the better, experts say, since it's possible to make lifestyle changes that can reverse your health and get you back onto a healthy path, with simple switches like eating more plant-based foods, losing a small amount of body weight, and being more active, such as walking 30 minutes a day, five days a week.

"Prevention is the best medicine! If you are given a prediabetes or diabetes diagnosis—do not despair," since you can make simple lifestyle changes (exercise, diet, and losing a small amount of weight) to reverse course on the disease, says Kellie Antinori-Lent, MSN, RN, and President of the Association of Diabetes Care and Education Specialists (ADCES) and diabetes clinical nurse specialist at the University of Pittsburgh Medical Center, Shadyside Hospital in Pittsburgh.

What can you do if you think you are experiencing the symptoms of prediabetes?

"If someone is at risk for developing prediabetes or diabetes, they should schedule an appointment with their doctor to discuss their concerns and questions. The best first place to begin is with a visit to your provider—whether in person or virtual—and don’t delay," says Antinori-Lent. Prevention is the best medicine! If you are given a prediabetes or diabetes diagnosis—do not despair!" There are simple things you can do to dial back the condition such as exercise 30 minutes a day, lose 7 to 10 percent of your body weight, and eat a mostly whole-food, plant-based diet, high in fiber and low in added sugars and chemicals.

How do you know if you have diabetes or prediabetes? We asked Antinori-Lent, who makes it her life's work to educate people about the changes they can make to ensure their future health, and here is what she had to tell us:

The Beet: What are the symptoms of and who is at risk for prediabetes?

Kellie: That is a really good question, however, prediabetes does not have symptoms. There is a physical sign of insulin resistance, which is associated with prediabetes. This sign is darkened skin in areas such as the neck, under the arms, and elbows. Some people mistake it as an area of skin they didn't wash well—but you cannot wash acanthosis nigricans (the name of the dark skin areas). Instead, there are risk factors. These include:


  • Age: as we age, our risk increases, something we cannot change 
  • Weight: if we are over our ideal weight for our height, also known as BMI, our chances of developing prediabetes and diabetes increase (a BMI of over >25 or >23 for Asian Americans is considered overweight)
  • Some medications can tip the scale, or increase glucose levels; a few examples include glucocorticoids, thiazide diuretics, and atypical antipsychotics
  • A family history of prediabetes or diabetes increases your risk
  • Activity level—exercise does the body good–and, in this case, can prevent the development of both prediabetes and diabetes; 150 minutes of moderate activity per week is the current recommendation from the CDC or 30 minutes a day
  • Men are more likely to develop prediabetes or diabetes than women (this could be because they are more likely to see their doctor regularly, so women may have prediabetes and undiagnosed)
  • High blood pressure can contribute to your overall risk for prediabetes and diabetes
  • Race or ethnicity are risk factors—certain races and ethnicities are at greater risk, including Native Americans, Pacific Islanders, and African Americans
  • History of PCOS or experiencing gestational diabetes


The Beet: What should you do if you have risk factors or suspect you have prediabetes?

Kellie: Take the CDC online quiz, and see a doctor. If someone is interested in learning their risk, the CDC and ADA collaborated to develop a risk assessment which can be found and completed/results given by clicking on this link. It's simple and asks you about your family history, activity levels and your weight. You can take it as many times as you like.

Keep in mind that prediabetes can develop into type 2 diabetes if left untreated. People can prevent this from happening by evaluating their lifestyle habits, including changing their diet, increasing their exercise and activity levels and seeing their doctor regularly, and working with him or her to prevent the progression.

The Beet: Even if you don’t think you have prediabetes or diabetes...

But you have the symptoms, like excessive thirst or urinating more often than usual, what are the reasons to see your doctor?

Kellie: Anytime, ANYTIME, someone experiences excessive thirst and urination—all day and all night—they must immediately seek medical attention. Those are the classic symptoms of diabetes….not prediabetes. Prediabetes isn’t associated with a set of classic symptoms like diabetes is. These symptoms are also often accompanied by other symptoms as well, including weight loss and lethargy. One symptom often overlooked with women is a chronic yeast infection that will not resolve with treatment.”

The Beet: Why is it so important to catch it early? Can pre-diabetes be reversed?

Kelli: A diagnosis of pre-diabetes is an opportunity. Yes, an opportunity. An opportunity to prevent Type 2 diabetes. It does not have to be the inevitable next step. We know that for some it can be prevented if someone is up for the challenge. I believe the latest research shows that about 25 percent of people with pre-diabetes will develop diabetes within 3 to 5 years. There are two main areas of focus within prevention: Healthy eating and being active. Many people are advised to eat better and start exercising, but very few are referred to a prevention program that can help them make these changes and do so successfully—like fewer than 5 percent. Think of how many people we can help if we would simply refer to these programs!”

“Some information on these lifestyle behaviors is helpful since it's not as hard as you may think," says Antinori-Lent. Diabetes prevention includes behavioral lifestyle modifications to achieve and maintain 7% weight loss which includes an increase in moderate-intensity exercise/activities to at least 150 minutes/week (Diabetes Care) and healthy eating.”

“But keep in mind an individual will always have the predisposition or at risk, of developing it again. Sustainability is also important.” The best way to lose weight and keep it off is to eat a diet of mostly whole plant-based foods, such as vegetables, legumes, whole grains, nuts, and seeds. For how to start, try the 7 Day Beginner's Guide to Going Plant-Based.

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