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Prediabetes vs. Diabetes: Know the Difference

a woman applying a cgm
a woman applying a cgm

Diabetes and prediabetes are two conditions that affect the way the body processes glucose. With the prevalence of these conditions projected to continue to increase over time, it’s important to understand what they are, and the difference between them.

Let's explore the differences between prediabetes and diabetes, and how to manage and prevent these conditions. 

What is Prediabetes?

Prediabetes is a condition in which someone has higher than normal blood sugar levels that are not yet high enough to be diagnosed as diabetes. According to the American Diabetes Association, prediabetes occurs when fasting blood glucose levels are between 100-125 mg/dL.

Prediabetes is becoming more prevalent, and it’s projected that more than 470 million people around the world will have prediabetes by 2030. At the same time, 415 million people worldwide currently have a form of diabetes, and it’s estimated that number will reach 500 million by 2040. 

People with prediabetes are at risk for developing type 2 diabetes, and around five to 10 percent of people with prediabetes become diabetic every year. 

Symptoms and Causes of Prediabetes

a list of symptoms of prediabetes

The exact cause of prediabetes is not fully understood, but genetics and family history may play a role. There are often no obvious symptoms of prediabetes, which is why this condition is only able to be diagnosed through blood sugar level testing.

If left untreated, it can progress to type 2 diabetes, which can lead to a range of serious health complications. Here are some of the warning signs that prediabetes has progressed to type 2 diabetes:

  • Increased hunger or thirst
  • Frequent urination
  • Fatigue
  • Blurred vision
  • Numbness or tingling in the hands and feet
  • Frequent infections or slow-healing sores
  • Unintended weight loss

The absence of these signs does not mean that you don’t have prediabetes or high blood sugar, and only a doctor can rule out or diagnose prediabetes or diabetes. If you are concerned about your blood sugar levels, visit your doctor for further guidance. 

What is Diabetes? Type 1 vs. Type 2

Diabetes is a chronic condition in which the body is unable to produce or use insulin properly, leading to elevated blood sugar levels. There are three main types of diabetes: type 1, type 2, and gestational diabetes. 

Type 1 diabetes is an autoimmune disorder in which the body attacks and destroys insulin-producing cells in the pancreas, causing complications like high blood sugar and ketoacidosis. People with type 1 diabetes make up about five to 10 percent of all people with diabetes. It often occurs in childhood or adolescence, but it can develop at any time. 

Type 2 diabetes, which accounts for the majority of diabetes cases, occurs when the body becomes resistant to insulin and/or doesn't produce enough insulin to meet its needs, causing glucose to build up in the blood. Type 2 diabetes is most common in older adults, but can develop in childhood as well. 

Gestational diabetes (GDM) is considered a complication of pregnancy and may occur due to changes in glucose tolerance associated with pregnancy. GDM affects approximately 16.5% of pregnancies throughout the world. 

Symptoms of Type 1 Diabetes

a blood glucose monitor

The symptoms of type 1 diabetes can develop quickly, over a period of a few weeks or months. Some of the most common symptoms of type 1 diabetes include:

  • Polydipsia, or increased thirst
  • Polyphagia, or increased appetite
  • Frequent urination
  • Unintended weight loss
  • Fatigue

If you notice any of the above symptoms, or have risk factors for type 1 diabetes such as a family history of type 1 diabetes, it's important to get regular check-ups and blood sugar level testing.

Symptoms of Type 2 Diabetes

The symptoms of type 2 diabetes may develop slowly over time, and some people with the condition may not experience any symptoms at all. However, some of the most common symptoms of type 2 diabetes include:

  • Polydipsia, or increased thirst
  • Polyphagia, or increased appetite
  • Frequent urination
  • Unintended weight loss
  • Fatigue
  • Blurred vision
  • Slow-healing sores
  • Frequent infections
  • Numbness or tingling in the hands and feet
  • Areas of darkness skin, usually in the armpits or neck

It's important to note that some people with type 2 diabetes may not experience any symptoms, or may have mild symptoms that are easily overlooked. As with type 1 diabetes, it's important to get regular check-ups and blood sugar level testing if you have risk factors for type 2 diabetes or if you notice any of the above symptoms.

Who Is at Risk of Prediabetes and Diabetes

a list of risk factors for prediabetes

Certain people may be more at risk for developing diabetes or prediabetes. Risk factors for prediabetes include:

  • Being 45 years or older
  • Being obese or overweight
  • Having a parent or sibling with type 2 diabetes
  • Living a sedentary lifestyle 
  • A history of gestational diabetes (diabetes during pregnancy), or giving birth to a baby who weighs over nine pounds

Risk factors for type 1 diabetes include:

  • Having a parent or sibling with type 1 diabetes
  • Age (younger than 14 years old)

Risk factors for developing type 2 diabetes include:

  • Being overweight or having a higher waist circumference
  • Leading a less-active or sedentary lifestyle
  • Having a parent or sibling with type 2 diabetes
  • Having prediabetes
  • Having polycystic ovary syndrome

Having one or more of these risk factors does not necessarily mean you will develop prediabetes or type 2 diabetes. However, understanding which factors may lead to a higher risk and taking steps to manage them can help reduce the chances of developing these conditions.

The Difference Between Prediabetes and Diabetes

someone checking their blood sugar levels

The main difference between prediabetes and diabetes is your blood sugar levels. Prediabetes occurs when blood sugar levels are higher than normal—but not yet high enough to be diagnosed as diabetes. Diabetes is diagnosed when blood sugar levels are consistently elevated above the normal range.

How Are Prediabetes and Diabetes Diagnosed?

Prediabetes and diabetes can be diagnosed through blood sugar tests, which should be carried out in a health care setting, like a doctor’s office or lab. Here are some of the most common diagnostic blood tests used for prediabetes and diabetes:

Hemoglobin A1C Test 

The A1C test measures the average blood sugar level over the past two to three months. A result of 5.7 to 6.4 percent indicates prediabetes, while 6.5 percent or higher indicates diabetes.

Fasting Plasma Glucose Test (FPG)

This test measures the blood sugar level after an overnight fast. A result of 100-125 mg/dL indicates prediabetes and 126 mg/dL or higher on two separate occasions indicates diabetes.

Oral Glucose Tolerance Test (OGTT)

This test measures the blood sugar level after fasting and then again two hours after drinking a glucose solution. A result of 140-199 mg/dL indicates prediabetes and 200 mg/dL or higher indicates diabetes.

In addition to these tests, a healthcare provider may conduct a physical exam to check for certain symptoms. They may also review the patient's medical history and consider any risk factors for diabetes, such as family history, obesity, and physical inactivity.

Can You Be Prediabetic and Not Get Diabetes?

diabetes informational sheets a the table

People with prediabetes have an increased risk of developing type 2 diabetes, but not everyone with prediabetes will go on to develop the disease. Research indicates that there are ways for those with prediabetes to reduce their risk of developing type 2 diabetes, including adopting a healthy diet, aiming for modest weight loss if needed and regular physical activity.

One 2019 Swedish study followed 2,575 people without diabetes, all aged over 60 years, for up to 12 years. The study found that only 13 percent of those with prediabetes went on to develop diabetes, whereas 22 percent of the participants with prediabetes actually reversed their prediabetes. 

In addition to lifestyle changes, some medications can also be used to prevent or delay the progression of prediabetes to type 2 diabetes. For example, metformin, a commonly prescribed medication for type 2 diabetes, has been shown to be effective in reducing the risk of developing diabetes for those at high risk.

It's important to remember that even if you have prediabetes and never develop diabetes, you may still have an increased risk of heart disease, kidney disease, and nerve damage. Therefore, it's important to take steps to manage your blood sugar levels and maintain a healthy lifestyle to reduce your overall risk of developing chronic health conditions.

How Are Prediabetes and Diabetes Treated?

a plate of rice, green beans, and salmon

If you have been diagnosed with prediabetes, it is important to take steps to reduce your risk of developing diabetes. This may include:

  • Lifestyle changes such as eating a healthy diet and engaging in regular physical activity
  • Losing weight if you are overweight or obese
  • Monitoring blood sugar levels regularly
  • Taking medication if prescribed by your doctor

Treatment and management of both types of diabetes involves ongoing monitoring of blood sugar levels and lifestyle changes such as a healthy diet and regular physical activity to manage blood sugar levels, prevent complications, and improve overall health.

A healthy diet may include nutritious foods like non-starchy vegetables, lean proteins, healthy fats, and attention to carbohydrate tolerance. Many health professionals also suggest cutting down on saturated fats, added sugars, and refined carbs to help manage blood sugar. 

Regular physical activity is also important for managing blood sugar, so an exercise routine should be discussed and approved by a doctor. Weight loss for those who are overweight can also be an important part of type 2 diabetes treatment, as it can result in better control of blood sugar levels.

In addition, medication and/or insulin therapy is often prescribed to help manage blood sugar levels. People with type 1 diabetes will need regular insulin therapy throughout their life, usually delivered through regular injections or an insulin pump.Some people with type 2 diabetes also require insulin therapy, depending on their level of blood sugar control. 

Foods to Limit If You Are Prediabetic

list of foods to limit with prediabetes

Here are some foods that you may want to limit or avoid to help manage your blood sugar levels:

  • Sugary foods and drinks: These can cause a rapid increase in blood sugar levels. This includes candy, soda, juice, sweetened tea, some alcoholic beverages, and other sweet treats.
  • Refined grains: Think white bread, white rice, and pasta, which can negatively affect blood sugar levels. Choose whole grains instead, such as brown rice, quinoa, and steel cut oats.
  • Fried foods and foods high in saturated and trans fats: These foods can contribute to insulin resistance and should be limited. Choose healthy fats, such as those found in nuts, seeds, olive oil, fatty fish, and avocado.
  • Processed and packaged foods: These foods can be high in sugar, sodium, and unhealthy fats. Instead, focus on whole, unprocessed foods.
  • Processed meats: These meats have been linked to an increased risk of type 2 diabetes and should be limited. Instead, choose lean unprocessed proteins.

If you're unsure about what to eat or how to manage your diet, consider working with a registered dietitian or a healthcare provider who specializes in diabetes management.

Can Glucose Monitoring Help?

For people concerned with their blood sugar levels, glucose monitoring can be a helpful tool. Continuous glucose monitors, or CGMs, use a small sensor inserted under the skin to measure blood sugar levels continuously throughout the day. 

Glucose monitoring through a program like the Nutrisense CGM program involves regularly checking your blood sugar levels to understand how your diet and lifestyle impact your blood glucose. With Nutrisense, you’ll have all the tools you need to monitor trends and patterns in your glucose and make lifestyle changes that support metabolic health. 

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Discover the key differences between prediabetes and diabetes in this comprehensive article. Understand the warning signs, risks, and other important information.

Engage with Your Blood Glucose Levels with Nutrisense

Your blood sugar levels can significantly impact how your body feels and functions. That’s why stable blood glucose levels can be an important factor in supporting overall wellbeing.

With Nutrisense, you’ll be able to track your blood glucose levels over time using a CGM, so you can make lifestyle choices that support healthy living.

When you join the Nutrisense CGM program, our team of credentialed dietitians and nutritionists are available for additional support and guidance to help you reach your goals.

Ready to take the first step? Start with our quiz to see how Nutrisense can support your health.

Find the right Nutrisense program    to help you discover and reach your health potential.
Heather Davis, MS, RDN, LDN

Reviewed by: Heather Davis, MS, RDN, LDN

Heather is a Registered and Licensed Dietitian Nutritionist (RDN, LDN), subject matter expert, and technical writer, with a master's degree in nutrition science from Bastyr University. She has a specialty in neuroendocrinology and has been working in the field of nutrition—including nutrition research, education, medical writing, and clinical integrative and functional nutrition—for over 15 years.

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