Prediabetes, also known as impaired glucose tolerance, is a condition where the blood glucose (sugar) level of a person is higher than normal– but not yet high enough to be considered diabetes. Prediabetes is often described as the “borderline” between normal blood sugar and type 2 diabetes. In sub-Saharan Africa, around 26.9 million people are estimated to have prediabetes and thus have a high risk of developing type 2 diabetes and this number is expected to rise to 47·3 million people in 2030. If left untreated, prediabetes can progress into type 2 diabetes. The good news? You can reverse prediabetes by making some lifestyle changes.

Causes and Risk factors

When we eat, the food is broken down into glucose (sugar) and other molecules. Insulin is required to transport glucose into our cells. People with prediabetes are unable to produce enough insulin or their body doesn’t respond to insulin properly (that’s called insulin resistance). This leads to a high amount of glucose in the bloodstream and this does a lot of harm to the body.

Scientists are not sure of the exact cause of prediabetes. Family history and genetics, inactivity and excess fat — especially abdominal fat — appear to play an important role in the development of prediabetes. Factors that increase the risk of developing prediabetes include:

  • Weight: Being overweight (having a BMI —  Body Mass Index — higher than 25) puts you at risk of developing prediabetes. When a person is overweight, the cells in the body become less sensitive to insulin. It is not just how much a person weighs, but also where they carry the weight that puts them at greater risk of prediabetes. People that carrying more weight around their abdomen are more likely to develop prediabetes than someone who carries more weight in their hips and thighs. This is because fat around the abdomen (visceral fat) secretes a protein called retinol-binding protein 4 (RBP4) which has been shown to increase resistance to insulin.
  • Sedentary lifestyle: A sedentary lifestyle often goes hand-in-hand with being overweight.
  • Family history: Research has shown that people who have family members with type 2 diabetes have a high risk of developing prediabetes.
  • Age: The older you are, the more at risk you are for developing prediabetes. Your risk starts to rise at age 45 and increases progressively.
  • Unhealthy eating habits: Foods that are high in carbohydrates and fats often overload the body with excess glucose than it needs.
  • Race: Certain races are more likely to develop prediabetes, including Africans, African-Americans, Hispanic Americans, Native Americans, and Asian Americans. Asian Americans are at increased prediabetes risk at lower body weights than other races.
  • Gestational diabetes: If you developed gestational diabetes while pregnant or gave birth to a baby who weighed more than 4.1 kilograms, you are at higher risk of developing prediabetes.

High blood pressure (hypertension), high cholesterol (the “bad” LDL cholesterol) and high levels of triglycerides (a type of fat in your blood) increase your risk of getting type 2 diabetes.


Prediabetes is usually asymptomatic. You may, however, notice:

  • Increased thirst
  • Increased hunger
  • Weight loss, despite eating more
  • Frequent urination
  • Fatigue
  • Blurred vision


According to the Centers for Disease Control and Prevention (CDC), your doctor will have you take one or more of the following blood tests to confirm the diagnosis:

  • A1C Test: This measures your average blood sugar level over the past 2 or 3 months. An A1C below 5.7% is normal, between 5.7 and 6.4% indicates you have prediabetes, and 6.5% or higher indicates you have diabetes.
  • Fasting Blood Sugar Test: This measures your blood sugar after an overnight fast (not eating). A fasting blood sugar level of 99 mg/dL or lower is normal, 100 to 125 mg/dL indicates you have prediabetes, and 126 mg/dL or higher indicates you have diabetes.
  • Glucose Tolerance Test: This measures your blood sugar before and after you drink a liquid that contains glucose. You’ll fast (not eat) overnight before the test and have your blood drawn to determine your fasting blood sugar level. Then you’ll drink the liquid and have your blood sugar level checked 1 hour, 2 hours, and possibly 3 hours afterward. At 2 hours, a blood sugar level of 140 mg/dL or lower is considered normal, 140 to 199 mg/dL indicates you have prediabetes, and 200 mg/dL or higher indicates you have diabetes.


The number 1 complication you’d want to avoid is its progression to type 2 diabetes. Other complications include:

  • Cardiovascular disease (heart disease and stroke)
  • High blood pressure (hypertension)
  • Neuropathy (nerve damage)
  • Retinopathy (leading to blindness)
  • Nephropathy (kidney disease)
  • Foot disease (leading to amputations)

Really scary 😱😱😱


As we said in the beginning, lifestyle changes can help many people with prediabetes prevent it from progressing to type 2 diabetes.

  • Weight control: Your prediabetes is more likely to progress to diabetes if you’re overweight. Losing even as little as 5% to 7% of your body weight can make the difference in reducing your risk of type 2 diabetes and reversing prediabetes.
  • Eat healthy foods: Go for low-fat proteins like beans, vegetables, and whole grains like brown rice and millet. Limit the size of the food you eat, sugar, and starchy carbs. Eat more fiber-rich foods, which help you feel satisfied and not eat too much.
  • Exercise: Getting at least 2.5 hours of exercise every week would help prevent type 2 diabetes and reverse your prediabetes. Having a 30 mins walk 5 days a week is a good deal.

If you have been diagnosed with prediabetes, it is advisable to join a diabetes prevention program you’ll learn how to make small changes, like altering your diet, exercising more and managing stress, which can help reverse prediabetes and prevent type 2 diabetes.


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