Prediabetes – Symptoms and Causes
Understanding Insulin Resistance
Insulin resistance happens when cells in your body don’t respond well to insulin, a hormone that helps control blood sugar.
When you eat, your body turns food into sugar for energy. Insulin tells your cells to open up and take in this sugar. But with insulin resistance, cells ignore these signals, leading to high blood sugar levels.
Over time, your pancreas works harder to produce more insulin to overcome this resistance. Eventually, the pancreas can wear out, causing blood sugar to rise to diabetic levels.
This condition is often called prediabetes because it can lead to type 2 diabetes if not addressed.
Risk Factors for Insulin Resistance
Several factors increase your risk of developing insulin resistance:
- Excess weight or obesity
- Family history of type 2 diabetes
- Age over 45
- African, Latino, or Native American ancestry
- Smoking
- Certain medications (steroids, antipsychotics, HIV treatments)
Medical conditions that often occur alongside insulin resistance include:
- Obstructive sleep apnea
- Fatty liver disease
- Polycystic ovarian syndrome (PCOS)
- Cushing’s syndrome
- Lipodystrophy syndromes (conditions causing abnormal fat distribution)
Common Signs and Symptoms
Most people with insulin resistance have no obvious symptoms. Doctors often discover it during routine checkups or blood tests.
However, there are physical signs that may indicate insulin resistance:
| Physical Signs | Measurement Thresholds |
|---|---|
| Increased waistline | >40 inches in men, >35 inches in women |
| Skin tags or dark, velvety skin patches (acanthosis nigricans) | Visual observation |
| High blood pressure | 130/80 or higher |
| Elevated fasting glucose | ≥100 mg/dL |
| Post-glucose test blood sugar | ≥140 mg/dL after 2 hours |
| Elevated A1c | Between 5.7% and 6.3% |
| High triglycerides | >150 mg/dL |
| Low HDL cholesterol | <40 mg/dL in men, <50 mg/dL in women |
Diagnosis Process
If your doctor notices these warning signs, they may order tests to confirm insulin resistance:
- Physical examination
- Blood glucose tests (fasting or glucose tolerance)
- Hemoglobin A1c test, which shows average blood sugar over three months
Effective Treatment Approaches
The good news is that insulin resistance can often be reversed through:
-
Lifestyle changes: These form the foundation of treatment and prevention.
- Balanced nutrition with fruits, vegetables, nuts, beans, and lean proteins
- Regular physical activity that you enjoy
- Healthy weight management (without extreme dieting)
Medication: Sometimes prescribed alongside lifestyle changes.
Stress reduction: Managing stress helps improve insulin sensitivity.
Prediabetes doesn’t always progress to type 2 diabetes. With proper care, blood sugar levels can return to normal.
Even though insulin resistance can’t always be permanently eliminated, you can significantly improve your body’s response to insulin through these approaches. The same damage that happens with diabetes—affecting the heart, blood vessels, and kidneys—may already be starting with prediabetes.
Signs You May Notice
Prediabetes typically has no obvious signs. Some people might develop darkened skin patches on their neck, armpits, or groin area.
If you move from prediabetes to type 2 diabetes, you may notice these symptoms:
- Feeling thirsty more often
- Using the bathroom frequently
- Feeling hungrier than usual
- Unusual tiredness
- Vision is becoming blurry
- Tingling or numbness in the feet or hands
- Getting infections often
- Cuts or wounds that heal slowly
- Losing weight without trying
When You Should Talk to Your Doctor
Visit your doctor if you worry about diabetes or notice any of the symptoms listed above. If you have risk factors for diabetes, ask about getting your blood sugar tested.
Early detection can help prevent prediabetes from developing into type 2 diabetes.
Causes
Prediabetes occurs when blood sugar levels are higher than normal but not yet high enough for a diagnosis of diabetes.
While the exact cause remains unknown, genetics and family history play significant roles in its development. The condition develops due to problems with how the body processes glucose.
When you eat, food is broken down and glucose enters your bloodstream. Normally, the pancreas (a gland behind your stomach) releases insulin, which allows cells to use glucose for energy while lowering blood sugar levels.
In prediabetes, this system becomes impaired. Instead of properly fueling your cells, sugar accumulates in the bloodstream due to one of two main issues:
- Insufficient insulin production – Your pancreas may not make enough insulin to effectively process blood sugar.
- Insulin resistance – Your cells become less responsive to insulin, preventing glucose from entering.
When your body can’t regulate blood sugar properly, levels remain elevated after eating. This disruption in the normal glucose-insulin relationship is the hallmark of prediabetes and may eventually progress to diabetes if left unaddressed.
Health Risk Factors
Metabolic syndrome represents a cluster of conditions that often appear together and increase your risk for diabetes, heart disease, and stroke. This syndrome occurs when you have at least three of these five health issues:
- Expanded waist measurement (over 40 inches for men or 35 inches for women)
- Elevated blood pressure readings
- High triglyceride levels in your bloodstream
- Low HDL cholesterol (the “good” type of cholesterol)
- Raised blood sugar levels
These conditions work together to create insulin resistance in your body. Insulin resistance prevents your cells from responding to insulin properly, making it difficult for your body to process sugar.
People with excess weight, especially around their abdomen, face a higher risk of developing metabolic syndrome. This fat tissue between muscles and skin increases insulin resistance, making your body less effective at using glucose for energy.
A diet high in red meat, processed foods, and sugary drinks can contribute to these conditions.
Age increases your risk as well, with people over 35 facing higher chances of developing these health issues. Family history matters too – having parents or siblings with type 2 diabetes raises your risk.
Certain groups face higher risks, including Black, Hispanic, American Indian, and Asian American communities. Women who experienced gestational diabetes during pregnancy or who have polycystic ovary syndrome also face increased risks.
Sleep quality affects your metabolic health as well. People with obstructive sleep apnea often develop insulin resistance. Smoking can worsen insulin resistance and increase the risk of complications.
Health Risks
Prediabetes can harm your body even before it develops into type 2 diabetes. It may damage your heart, blood vessels, and kidneys without obvious symptoms. Some people experience silent heart attacks that they don’t even notice.
If prediabetes progresses to type 2 diabetes, several serious health problems may develop:
- Cardiovascular issues: High blood pressure, elevated cholesterol, heart disease, and stroke.
- Organ damage: Kidney disease and fatty liver disease.
- Nerve problems: Pain, tingling, and loss of sensation.
- Vision problems: Including possible blindness.
- Severe complications: In some cases, amputations may be necessary.
Ways to Prevent Diabetes
Making healthy choices can stop prediabetes from turning into type 2 diabetes, even if it runs in your family. Here are some key steps to take:
- Choose nutritious foods
- Stay physically active
- Reach a healthy weight
- Keep blood pressure and cholesterol levels under control
- Avoid tobacco products
These changes can significantly reduce your risk of developing diabetes and improve your overall health.
