Signs, Symptoms and How to Reverse It

One-third of United States adults have prediabetes, but does that really matter? After all, these adults aren’t diabetic yet, so the health risk isn’t actually there, right? Wrong. UnityPoint Diabetologist, David Trachtenbarg, MD, talks about how to prevent prediabetes from becoming diabetes.

What is Prediabetes?

Prediabetes is a condition where blood sugar levels aren’t high enough to diagnose Type 2 diabetes, but without change, will usually develop into diabetes within 10 years.

“The large number of adults who already have prediabetes indicates millions of people will develop diabetes, which is a disease with many serious complications,” Dr. Trachtenbarg says.

This is the concern of healthcare providers across the country, so much so that some have labeled prediabetes as “an epidemic that’s out of control.” There’s good reason to take prediabetes seriously. Even before an adult is diagnosed with diabetes, prediabetes can start to have negative effects on the body.

“Prediabetes is more common than overt diabetes, if you have prediabetes, you are at increased risk for heart disease and strokes in addition to the risk of developing overt diabetes,” Dr. Trachtenbarg says.

Signs and Symptoms of Prediabetes

The Centers for Disease Control and Prevention says about 90% of people with prediabetes don’t know they have it. That’s because it usually doesn’t have symptoms. 

Common Prediabetes Risk Factors:

• You’re overweight or obese
• You have a family history of Type 2 diabetes
• You’re physically active less than 3 times per week
• You’re age 45 or older
• You’ve had gestational diabetes during pregnancy
• You are African American, Hispanic, American Indian or Asian American

“Since prediabetes doesn’t have clear signs and symptoms, it’s important to talk to your doctor about getting your blood glucose, or blood sugar, tested regularly,” Dr. Trachtenbarg says.

How to Read Blood Sugar Results

For someone who is diabetic, a fasting blood glucose result would be 126 mg/dL (milligrams per deciliter) or higher. Blood glucose results would fall in the 100-125 mg/dL for the prediabetes range. 

A provider might also do another blood test, an A1C, which looks at the amount of glucose (sugar) stuck to blood. A1C results of 6.5% or higher would point to diabetes; 5.8-6.4% is categorized as prediabetes.

Prediabetes Can be Reversed

Luckily, prediabetes can be reversed. If identified, the progression toward diabetes can be prevented through lifestyle changes, such as diet and regular exercise.  

“Controlling weight is a key factor. For people with prediabetes, even a 5% weight loss can be a powerful preventive measure,” Dr. Trachtenbarg says.

5 Ways to Reverse or Prevent Prediabetes 

• Get regular exercise. Try walking, jogging or resistance training for 30 minutes, five times per week. Adding resistance training (weights) three times a week helps even more.
• Manage stress. Stress can cause you to lose sight of your goals. Try these 11 stress relief activities.
• Learn about healthy eating. Talk to a UnityPoint Health dietitian or investigate local diabetes education programs.
• Consider medication. In some cases, healthcare providers may prescribe medication. Talk to your doctor to determine if this is an option for you.
• Find a support group. People with similar goals and challenges can help you through struggles.

“Participating in a Certified National Diabetes Prevention Program has been shown to reduce your chance of developing diabetes by up to 50%. However, like many other lifestyle changes, these programs require a significant time commitment,” Dr. Trachtenbarg says.

Are you included in the number of adults who have prediabetes? Take this quick diabetes assessment to determine how at-risk you are for the disease. For questions about reversing prediabetes or prediabetes treatment options, talk to your UnityPoint Health provider.

Fasting blood sugar levels and testing

Blood sugar tends to peak about an hour after eating and declines after that. Fasting blood sugar levels are measured several hours after eating, as this gives a more accurate view of a person’s glucose levels. In most cases, fasting blood sugar levels should be below 5.7%.

According to the American Diabetes Association, a measure of 5.7–6.4% indicates prediabetes. At 6.5%, a doctor will diagnose diabetes.

High fasting blood sugar levels point to insulin resistance or diabetes, while abnormally low fasting blood sugar can be due to diabetes medications.

Knowing when to test and what to look for can help people stay healthy, especially if they have diabetes or are at risk of developing the condition.

Keep reading to learn more about fasting blood sugar levels, including information on testing and tips for maintaining normal levels.

The body needs glucose for energy, and glucose comes from the food a person eats. However, the body does not use all of this energy at once. Insulin makes it possible to store and release glucose as necessary.

Following a meal, blood sugar levels rise and usually peak about an hour after eating.

How high blood sugar rises and the precise timing of the peak depends on a person’s diet.

Food-related factors that can trigger significant rises include:

• eating large meals
• consuming sugary foods and drinks
• eating foods with simple carbohydrates, or carbs, such as bread and sweet snacks

As blood sugar rises, the pancreas releases insulin. Insulin lowers blood sugar, breaking it down so the body can use it for energy or store it for later.

However, people who have diabetes have difficulties with insulin in one of two ways.

Those with type 1 diabetes do not produce enough insulin because their body attacks its insulin-producing cells. Those with type 2 diabetes do not respond well to insulin in their body and, later, may not make enough insulin.

In both cases, people experience high blood sugar levels and have difficulty using glucose, or blood sugar.

Fasting blood sugar depends on three factors:

• the contents of a person’s last meal
• the size of their previous meal
• their body’s ability to produce and respond to insulin

Blood sugar levels between meals offer insight into how the body manages sugar. High levels of fasting blood sugar suggest the body was not able to lower blood sugar levels.

This points to insulin resistance, inadequate insulin production, or in some cases, both.

Very low blood sugar levels may indicate that diabetes medications are lowering the blood sugar too much.

To assess fasting blood sugar levels, people or healthcare professionals can use a glycosylated hemoglobin (HbA1c) test, a conventional blood sugar test, or continuous glucose monitoring.

The HbA1c test

HbA1c is a test doctors use to assess overall blood sugar control. The HbA1c test measures how the body manages blood sugar over time, usually during the past 3 months.

A person will undergo this test at a doctor’s office or in a lab. If levels are very high, the individual may need a second test. The results appear as a percentage.

Blood sugar testing at home

A person can test their blood sugar levels at home.

In most cases, doctors ask people to measure fasting blood sugar immediately upon waking and before they have anything to eat or drink. It may also be appropriate to test blood sugar before eating or 2 hours after a meal, which is when blood sugar returns to normal levels.

The right time to test depends on treatment goals and other factors. For example, most people with diabetes do not need to test between meals unless they are using a diabetes drug that can lower blood sugar. Other people may test between meals if they feel their sugar levels may be low.

Because people with type 1 diabetes do not make enough insulin, they need to test their blood sugar levels several times a day so they can adjust their insulin doses.

A person will test blood sugar levels by:

• preparing the testing strip and glucose monitor to be ready for the blood sample
• using an alcohol swab to clean the testing area, which is usually the side of a fingertip
• lancing the testing area and bracing against a firm surface to help resist the impulse to pull away
• squeezing the testing area around the wound to maximize blood flow
• squeezing a drop of blood onto the test strip
• putting the strip into the monitor
• recording the time, blood sugar reading, and recent food intake in a log

Find out more about home blood sugar testing here.

Continuous glucose monitoring

Another option for daily use is continuous glucose monitoring (CGM).

For CGM, a person wears a monitor 24 hours a day. The monitor records their blood glucose levels on an ongoing basis.

CGM can give a more accurate picture of a person’s levels and fluctuations throughout the day. However, this type of kit can be more expensive in some cases, depending on a person’s insurance coverage.

There are also nonfasting blood tests.

These include the random plasma glucose (RPG) test and oral glucose tolerance test (OGTT).

For an RPG, a doctor does a conventional blood sugar test when a person is not fasting.

For an OGTT, a healthcare professional tests a person’s blood sugar levels over 2 hours, starting with a fasting blood test. Next, the person drinks a sugary beverage, and the doctor takes a blood sample every 30–60 minutes over a 2-hour period.

Blood sugar target levels are the ideal range that people should try to maintain as often as possible.

Because blood sugar levels vary throughout the day due to factors such as medications, food intake, and physical activity, no single blood sugar reading can reveal how well someone processes sugar.

HbA1c results

According to the American Diabetes Association, the results of an HbA1c test will be one of the following:

• normal: less than 5.7%
• prediabetes: between 5.7% and 6.4%
• diabetes: 6.5% and over

Prediabetes is when blood sugar levels are higher than normal levels but not high enough to indicate diabetes. People can take measures to reverse prediabetes and stop diabetes from developing. Find out more here.

Home testing

Doctors express target blood sugar numbers for people with diabetes in milligrams per deciliter (mg/dL) as follows:

• fasting (testing in the morning before food or water): 80–130 mg/dL
• 2 hours after eating a meal: under 180 mg/dL

Meanwhile, for people without diabetes, target blood sugar levels are:

• fasting (testing in the morning before food or water): 72–99 mg/dL
• 2 hours after eating a meal: under 140 mg/dL

For people with prediabetes, the goal is to reach the same target blood sugar levels as people without diabetes.

However, the target numbers will vary between people. A healthcare professional will help a person identify their target levels.

Fasting blood sugar test

Doctors consider a fasting blood sugar level of less than 99 mg/dL as normal.

On the other hand, fasting blood sugar levels ranging from 100–125 mg/dL indicate prediabetes, and levels of 126 mg/dL or above indicate diabetes.

It is vital to follow a healthy diet to keep fasting blood sugar from rising too high. Strategies include:

• eating plenty of fiber-rich foods
• choosing whole grain bread and pasta instead of white bread and pasta
• eating high-protein foods to increase feelings of fullness
• limiting sugar and salt intake
• choosing nonstarchy vegetables

People who take diabetes medications and are at risk of dangerous blood sugar dips should follow a similar diet. They also must take proactive steps to prevent blood sugar from dropping. This includes:

• eating regular meals throughout the day
• increasing food intake and snack frequency during intense physical activity
• avoiding or limiting alcoholic beverages
• consulting a doctor if vomiting or diarrhea make it difficult to manage blood sugar

Louise Morales-BrownADULTHOOD T1D

Finding balance

I need to try and stay within a healthy range to avoid hypoglycemic and hyperglycemic episodes. This can be challenging, as so many things, such as emotions, misjudging a dose, exercise, and illness, can all impact my glucose levels….There are days when it can be challenging, but generally, I feel in control of the condition. Read full article

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People are likely to experience symptoms if their blood sugar levels are too low or too high.

Low blood sugar levels

Blood sugar that is too low can cause symptoms such as:

• shaking and sweating
• feeling jittery
• difficulty concentrating
• lack of energy
• skin that looks paler than usual
• fatigue or tiredness
• headaches or muscle aches
• fast or irregular heartbeat
• weakness
• lack of coordination

In extreme cases, low blood sugar can trigger seizures, loss of consciousness, confusion, and an inability to drink or eat.

Find out more about hypoglycemia or low blood sugar here.

High blood sugar levels

High blood sugar levels, or hyperglycemia, can cause the following symptoms:

• increased hunger or thirst
• excessive urination
• blurred vision
• headache
• tiredness

As with low blood sugar, high blood sugar may cause loss of consciousness or seizures if people do not get treatment. Persistent high blood sugar can increase the risk of serious complications that doctors relate to diabetes, such as cardiovascular disease.

Any significant change in blood sugar patterns warrants a visit to a doctor. People with diabetes and those at risk of diabetes should also speak with a doctor if:

• blood sugar levels become unusually high or low
• well-managed blood sugar levels suddenly start fluctuating
• they have new or worsening symptoms of diabetes
• they change their medication or stop using it
• they experience abnormally high blood pressure
• they develop an infection or sore that will not heal

Diabetes needs ongoing monitoring, and the treatment can change over time. Information about diet and exercise is vital for a doctor to outline a proper treatment plan for each individual.

People with diabetes can assist their doctor by keeping detailed logs of their blood sugar levels and any relevant information, such as changes in activity, medications, or sleep. They should talk with a doctor about dietary and lifestyle habits that affect their blood sugar levels.

To manage diabetes, it is important to monitor and maintain healthy fasting blood sugar levels. For people with prediabetes, managing blood sugar levels can help reverse the condition and prevent the development of diabetes.

People who have diabetes or prediabetes need to test their blood sugar levels regularly and record their results. They should talk with a doctor if they notice any changes or unusual symptoms.

How to properly prepare for a blood test for sugar (glucose). Preparing for sugar analysis.

What does a blood sugar test show?

The analysis shows the level of sugar (glucose) in the blood, which can indicate the presence of diabetes and other diseases.

Low sugar levels (hypoglycemia) can signal diseases of the pancreas, liver, kidneys and adrenal glands, as well as the hypothalamus.

The most common cause of high blood sugar (hyperglycemia) is diabetes mellitus. Hyperglycemia can also speak of other endocrine diseases, problems of the liver and hypothalamus, and a constant inflammatory process in the body.

There is also a glucose tolerance test (also known as a glucose tolerance test or GTT), which is carried out to detect prediabetes, and is also prescribed for pregnant women.

Test indications

Symptoms that may be caused by low blood sugar include:

• constant lethargy, fatigue;
• increased sweating;
• anxiety;
• bouts of hunger.

Symptoms that high blood sugar can cause include:

• rapid breathing;
• dry mouth, thirst;
• dry skin;
• decreased clarity of vision;
• frequent urge to urinate;
• poor wound healing;
• itching of the skin and mucous membranes;
• weight loss.

If you notice some of the listed symptoms behind you, make an appointment with a general practitioner, he will diagnose and write out a referral for the necessary analysis.

With both deviations from the norm, an unstable mental state, mood swings can be observed.

How sugar is tested

A blood sugar test is done by taking blood either from a finger (capillary blood) or from a vein under the elbow (venous blood).

Blood sugar norms

l The norm of blood sugar in an adult is:

• 3.3–5.5 mmol/l (for capillary blood sampling)
• 3.7–6.1 mmol/l (at collection)

If the mark exceeds 6.1 mmol/l, it is necessary to be examined.

In order for your results to be reliable, you need to properly prepare for the test for sugar.

How to take a blood sugar test

So that the test results do not turn out to be false, it is necessary to follow some rules for preparing the patient for a blood test for sugar. Otherwise, a retake of the analysis may be required (and this is a waste of your time and money), or an incorrect diagnosis and treatment may be prescribed.

Can I drink water before testing for sugar?

You can drink water. But no more – it is necessary to exclude alcoholic and containing sugar and sweeteners drinks.

Preparing for a glucose test

• On an empty stomach. 8-hour or better 12-hour fasting. Drink only water. Alcohol (for 102 days it is better to exclude) and sweet drinks are strictly prohibited.
• Better sleep well
• Avoid intense mental work, stress and outbursts of emotions. The body can increase blood glucose levels during a stressful situation. Excessive emotions can suppress insulin production.
• It is best not to brush your teeth with sugary toothpaste.
• No smoking. (with diabetes it is better to exclude smoking altogether)
• Be careful with medication. If necessary, treatment of acute or chronic episodes of the disease should warn the doctor about the existing problems and reschedule the study or interpret its results in accordance with the ability of some drugs to raise or lower the studied parameters
• During the period of colds or other acute infections, the result may be false positive
• On the eve of the analysis, you should not participate in feasts, eat tightly before bedtime, drink alcohol, get involved in fatty foods, fast food, etc.
• Immediately after therapeutic procedures and serious studies (massage, ultrasound, X-ray, physiotherapy), you cannot take a sugar test.
• On the eve and before donating blood for sugar, it is better not to engage in active sports. It is better to spend the day and morning before the analysis in the usual calm mode.

What not to eat before a sugar test

What can you eat before a sugar test?

If you need to prepare for a blood glucose test, but you are overcome by hunger, then eat something light and healthy. For example:

• boiled/baked chicken
• green vegetables
• cereals

Can I brush my teeth before donating blood for sugar

It is not recommended to brush your teeth before the examination, because. toothpastes contain sugar, which is well absorbed through the oral mucosa and can affect the accuracy of the analysis. Avoid chewing gum as well.

Preparation for blood sugar test during pregnancy

Preparing for a glucose tolerance test for pregnant women does not differ from the above measures. It is recommended to do a glucose tolerance test for a period of 24-28 weeks.

Typically, pregnant women are prescribed such a test to prevent excessive weight gain in the fetus, which can be caused by an increase in maternal blood sugar. And this can happen even if you have never had diabetes. After all, the heavy loads that the body experiences when carrying a fetus can reveal some pathologies that appear only at the time of expectation of the baby. Such diseases include diabetes mellitus.

Gestational Diabetes – IVF Clinic Bahçeci

How is Gestational Diabetes Diagnosed?

Diabetes mellitus is an extremely important medical problem when the pancreas produces very little or no insulin. Diabetes, the number of diseases of which is increasing along with obesity, has become a global health problem.

Diabetes is a metabolic disease that is associated with the metabolism of proteins, fats and especially carbohydrates. Without insulin, sugar and other nutrients cannot get to the cells that need them. Thus, when cells lack sugar, blood glucose levels rise to above normal levels. There are two different forms of diabetes: type 1 and type 2. In type 1 diabetes, the pancreas cannot supply enough insulin to the body. Usually the diagnosis is made at an early age. Type 1 diabetes is always treated with insulin. Type 2 diabetes is known as non-insulin dependent diabetes. In women, it is observed especially in combination with polycystic ovary syndrome. However, a woman who has never been diagnosed with diabetes may be diagnosed with diabetes during pregnancy. This condition, known as gestational diabetes, may go away on its own after pregnancy. Women at risk for gestational diabetes include women with a family history of diabetes, high blood pressure, high cholesterol, and overweight. Gestational diabetes occurs in about 3 percent of all pregnant women, but in about 10 percent of these cases, the condition becomes permanent.

How does Gestational Diabetes develop?

Women with gestational diabetes do not have diabetes before pregnancy. Although these women have adequate insulin levels, the hormones produced by the placenta prevent the action of insulin, and therefore blood sugar levels rise. This effect usually increases at the 20th and 24th weeks of pregnancy. However, in overweight women, blood glucose levels may be high from the first months of pregnancy. As the placenta leaves the mother’s body at birth, these hormones stop being produced and the disease goes away.

Who is at Risk for Gestational Diabetes?

• Women with a family history of diabetes,
• Women who are overweight,
• Women whose previously born children weighed more than 4 kg,
• Women who have had a miscarriage,
• Pregnant women over 25,
• Women with high blood glucose levels in previous pregnancies,
• Women who have sugar in their urine.

What Should People with Gestational Diabetes Do?

Women at risk for gestational diabetes should have an oral glucose tolerance test during the first months of pregnancy. Even if diabetes is not diagnosed at this stage, the test should be repeated at 20-24 weeks of gestation.

Because this condition is asymptomatic, all pregnant women should be tested for gestational diabetes. During an oral glucose tolerance test, a solution containing 50 g of glucose is given at any time of the day. An hour later, the level of glucose in the blood is assessed. If the blood glucose level exceeds 140 mg/dl, another test with 100 g of glucose is performed, as the situation is considered risky. If the results show glucose levels below 140 mg/dl, there is no risk of developing diabetes.

If a pregnant woman has a fasting glucose level of more than 126 g/dL, or if the glucose level measured at any time is more than 200 g/dL, she had diabetes before pregnancy.

How does Gestational Diabetes affect the baby?

In women with gestational diabetes, blood sugar levels usually rise around the 24th week. This does not lead to any deviations in the development of the baby. However, if the disease is diagnosed during the first trimester, the expectant mother should be careful. Women diagnosed with diabetes before pregnancy can also have healthy babies. However, these women should have their blood glucose checked regularly.

Gestational diabetes is an important risk factor as it leads to high birth weight. Because the mother’s blood sugar is high, the baby’s pancreas produces more insulin, which leads to weight gain. Therefore, a caesarean section may be required. The baby may have low blood sugar at birth, so the baby’s blood sugar must be monitored. In addition, these children may suffer from low levels of calcium and magnesium, which should also be monitored.

What should I look out for in Gestational Diabetes?

There are two ways to monitor gestational diabetes. The first way is to control the mother’s blood sugar levels. The second way is to monitor the development of the child. The most important thing in gestational diabetes is to keep blood sugar under control. Blood sugar levels are maintained between 60 and 120 mg/dL with regular blood tests. It is necessary to measure blood sugar levels on an empty stomach and after meals. In addition, blood sugar levels should be measured before dinner and at 22:30 (sometimes at 3-4 am). Fasting blood sugar should be at or below 95 mg/dl; and postprandial blood sugar levels should be equal to or below 140 mg/dL (one hour after a meal) and 120 mg/dL (two hours after a meal). In addition, it is important to measure the level of ketone bodies in the urine from time to time. High urinary ketone levels are an important marker of diabetes.

Nutrition and Exercise

Acceptable weight gain during pregnancy is 9 to 12 kg. If a woman was overweight before pregnancy, then the corresponding weight gain is 7-8 kg; and if she was underweight, the corresponding weight gain should be 17-20 kg. Exercise and a healthy lifestyle are essential for diabetes. This is because exercise helps lower blood sugar levels as well as keep them under control. Pregnant women are advised to go for walks 4-5 times a week. In addition to walking, they can do 45 minutes of daily aerobic exercise. While nutrition is very important for all pregnant women, it is even more important for women with gestational diabetes. Preference should be given to vegetables, whole grains, dried legumes, and meaty foods. Olive oil, whole grain bread, low-fat yogurt, and low-fat milk should be consumed. Margarine should not be consumed, and carbohydrate intake should be limited. Carbohydrates should not exceed 40% of the total daily calorie intake. Another important point is the values ​​​​of blood pressure. Blood pressure should be monitored regularly; in case systolic blood pressure is over 140 and diastolic blood pressure is over 90, you should contact your doctor immediately.

When and How is Gestational Diabetes Treated with Insulin?

If fasting blood sugar is greater than 105 mg/dl despite diet, and blood sugar is greater than 120 mg/dl within 2 hours of a meal, insulin treatment is required. Pregnant women who start insulin treatment should monitor their blood sugar levels at home. Insulin can be taken several times a day, as directed by your doctor. Oral antidiabetic agents are not used during pregnancy as they pass through the placenta.

Childbirth and the Postpartum Period

Women diagnosed with gestational diabetes may have a vaginal delivery. However, the condition of the child is a major factor in the decision. Delivery usually occurs at 38 weeks of gestation. If blood sugar levels remain high during labor, insulin is administered through a drip. With regular monitoring, you can give birth to a healthy baby.

During the postpartum period, the mother’s diet should be the same as during pregnancy. When blood sugar returns to normal, insulin treatment ends. For this reason, blood sugar levels should be measured regularly on the day of delivery and the following days. If blood sugar levels after childbirth are within the normal range, it should still be measured 1-2 months after childbirth.