In 2018, 10.5% of the American adult population had diabetes. Of all these individuals, approximately one-third were undiagnosed. Additionally, it is estimated that one in three adults have prediabetes. That’s approximately 88 million American adults. Of that 88 million, over half don’t even know they have it.


What is prediabetes?


Prediabetes is type 2 diabetes in the early stages. To understand prediabetes you need to understand that type 2 diabetes does not happen over a few days. It takes time . . . years to develop. As type 2 diabetes develops, blood glucose (sugar) levels begin to rise. Blood glucose after meals is the first to go higher than normal. During times of physical stress, pregnancy, illness, or some medication use, blood glucose levels tend to be higher than normal. Eventually, fasting glucose levels begin to rise to higher than normal levels.


Prediabetes is diagnosed when one of three conditions exist:

  • A1c of 5.7% to 6.4%. The A1c test represents an average of blood glucose over the most recent two – three months.
  • Fasting blood glucose of 100 to 125 mg/dL. A fasting blood glucose means the individual has had nothing to eat or drink (except water) for at least 8 hours. Blood is drawn from a vein for analysis.
  • Oral Glucose Tolerance Test with a 2-hour result of 140 to 100 mg/dL. This test begins with a fasting blood glucose. After drinking a high glucose drink, blood is drawn for analysis at set times.


Sometimes a healthcare provider may perform a random plasma glucose test. This is a blood test when the individual is not is a fasting state. This test may be a finger stick or a blood draw. The results determine if additional glucose testing is necessary.


The importance of knowing if you have prediabetes:

  • Prediabetes comes before type 2 diabetes. An early diagnosis improves the opportunity to reverse prediabetes and prevent type 2 diabetes.
  • Prediabetes could exist for years before progressing to type 2 diabetes. Unfortunately, having prediabetes increases risk for heart disease and stroke.
  • Prediabetes can be reversed. Adopting long-term lifestyle behaviors can reduce type 2 diabetes risk up to 58%. These same behaviors are more impressive for persons 60 years of age or older where risk of developing type 2 diabetes is reduced up to 71%.


Are you at risk of developing type 2 diabetes?


How do you know if you’re at risk of developing type 2 diabetes? If you have these risk factors, you may have an elevated risk than others for developing prediabetes and/or type 2 diabetes.

  • Overweight or a BMI of 25 or greater.
  • 45 years of age or older.
  • Parents or siblings with a type 2 diabetes diagnosis.
  • Physically inactive (active fewer than 3 times per week).
  • History of giving birth to a baby that weighed more than 9 pounds.
  • History of diabetes while pregnant (gestational diabetes).
  • High risk ethnicity: African Americans, Hispanic/Latino Americans, American Indians, Pacific Islanders, and some Asian Americans.


You can also participate in an online Prediabetes Risk Test:



Knowing your prediabetes risk is the beginning to taking action to reduce your chances of developing type 2 diabetes. Things you should know:

  • Act sooner rather than later. It takes years to develop type 2 diabetes. The sooner you initiate changes to lower your risk the more likely you will be successful. Once you’re diagnosed with type 2 diabetes, although not impossible, your chances of reversing your diabetes is low.
  • The little things can make big changes. Learning the little things that make big changes and performing these little changes every day can have a big impact on reducing your prediabetes risk.
  • There’s a lot of focus on losing weight in preventing type 2 diabetes risk. More than 90% of patients with type 2 diabetes have a BMI of 25 or more. Research has shown that for every 2.2 pounds of excess weight loss, risk for type 2 diabetes is reduced 13%.
  • Physical activity is critical in creating the foundation for success. Not only does regular physical activity improve general wellness, it reverses the insulin resistance that is type 2 diabetes. Success is not about being “busy”. Success is just moving more: walking farther, taking stairs vs the elevator, and more.


If you ask, most people will tell you they’ve lost weight plenty of times . . . it always seems to find it’s way home. This is a well known situation. Built on the principles learned from the Diabetes Prevention Program Research Program, the CDC’s National Diabetes Prevention Program (National DPP) works to break the weight loss – weight gain cycle.


In partnership with organizations across the country, the National DPP’s 12-month curriculum with evidence-based, lifestyle change programs are available to those at risk of type 2 diabetes. A list of National DPP lifestyle change program providers can be found at this website:  Just enter your zip code and the distance you want to search; clicking submit will give you a listing and map of National DPP sites according to your search parameters. Many programs have added remote options with the changing COVID-19 recommendations.


If you’ve been diagnosed with prediabetes make a commitment to the National DPP. Don’t just lose the weight to gain it back, learn how to maintain weight loss. The National DPP’s trained lifestyle coaches will help you stop type 2 diabetes.