My Doctor Says I’m Pre-Diabetic. What Does That Mean?

People generally understand what type 2 diabetes is. But a diagnosis of pre-diabetes tends to elicit one of two reactions: confusion or indifference.

The confusion comes from thinking that pre-diabetes is the same as diabetes. The indifference comes from not understanding how close to the edge of diabetes a patient might be.

Medically, pre-diabetes is characterized by an A1C glucose level between 5.7 and 6.4. Practically, it’s when you are at increased risk of progressing to diabetes if changes aren’t made. These changes can be a matter of diet, exercise or smoking cessation – but usually reducing your risk of developing diabetes requires a combination of all three.

What won’t reduce your risk is remaining blasé about it.

As an endocrinologist, by the time patients see me, their pre-diabetes has progressed to diabetes. What I have found is that some patients didn’t realize that they were at risk of developing the disease. No matter how many times they have heard that they are pre-diabetic, when they are referred to my office, they say, “No one told me.”

It is important for patients to understand – and for primary care physicians to thoroughly explain – that a diagnosis of pre-diabetes is a warning sign, an ultimatum to get it together, lose weight, increase exercise and quit smoking.

The diagnosis of pre-diabetes is almost a gift in that it gives patients the opportunity to turn their health around while they still can. Yes, diabetes can be managed with lifestyle modification and medication, but it is far better to avoid developing the disease altogether.

The challenge in motivating people to change their eating, exercise and smoking habits is that people don’t “feel” diabetic. Because you don’t feel or see the damage occurring to your body, it can be hard to take the diagnosis seriously.

It takes an extra dose of care and intention to edge away from pre-diabetes. Modest weight loss – about 5 to 10 percent of your body weight – along with 30 minutes of exercise five days a week and smoking cessation can go a long way toward getting you out of the danger zone. Also, if you are pre-diabetic, your primary care physician might recommend checking your A1c level (a measure of glucose control) yearly or even more frequently.

If you’re able to lower your blood sugar levels, you might be able to prevent diabetes or at least delay your progression to diabetes. For people at particularly high risk, lowering your odds of developing diabetes might require medication as well.

I don’t personally advocate for any one type of exercise regime or diet over another. What is important is eating healthily and reducing your calories. An online basal metabolic rate calculator can help you determine how many calories you actually need per day, which can help you cut out the extra calories contributing to your pre-diabetes diagnosis.

Pre-diabetes is a serious diagnosis that can have long-term implications for a person’s health. But it is also a beacon that lets people know that it is time to turn your health around. By taking the diagnosis seriously and making meaningful lifestyle modifications, patients can reduce their risk and avoid developing diabetes altogether.