Pre-diabetes is a condition in which blood glucose levels are higher than normal, although not high enough to be diabetes. Pre-diabetes has no signs or symptoms. People with pre-diabetes have a higher risk of developing type 2 diabetes and cardiovascular (heart and circulation) disease.
Without lifestyle changes, including healthy eating, exercise and losing weight, approximately one in three people with pre-diabetes will develop type 2 diabetes.
Type 2 diabetes is a condition where blood glucose levels are higher than normal. This occurs when the body cannot make enough insulin, or the insulin it makes does not work as well as it should (also known as insulin resistance).
Insulin is a hormone that moves glucose from the blood into the cells for energy. A lack of insulin leads to raised glucose levels in the blood. Type 2 diabetes is a serious long-term medical condition that, over time, can lead to damage of nerves, blood vessels, kidneys, heart, eyes and feet, if not managed well.
Pre-diabetes has no signs or symptoms, so it is important to be aware of the risk factors.
Risk factors for pre-diabetes
The risk factors for developing pre-diabetes are the same as for type 2 diabetes. They include:
- a family history of type 2 diabetes
- being overweight
- waist measurement (in men) – Caucasians – greater than 94 cm, Asians – greater than 90 cm
- waist measurement (in women) – greater than 80 cm
- low level of physical activity
- high blood pressure or high cholesterol (blood fats), or both
- history of heart disease or stroke
- gestational diabetes (diabetes during pregnancy)
- polycystic ovary syndrome
- some antipsychotic medications
Also, the risk of developing pre-diabetes is greater for:
- Aboriginal and Torres Strait Islander people
- Middle Eastern people
- South Asian people
- Pacific Islander people
- North African people.
Diagnosis of pre-diabetes
Pre-diabetes is diagnosed by a blood test that checks your blood glucose level.
Any blood glucose test that shows higher than normal blood glucose levels needs to be checked further. This is likely to involve an oral glucose tolerance test (OGTT). The results of the OGTT will show whether your blood glucose levels are in the normal, pre-diabetes or diabetes range.
If you are diagnosed with pre-diabetes, you will have one or both of:
- Impaired fasting glucose (IFG) – is when your fasting blood glucose level is higher than normal, but still below the level for a diagnosis of diabetes.
- Impaired glucose tolerance (IGT) – is when your blood glucose level two hours after an OGTT is higher than normal, but is still below the level for a diagnosis of diabetes. The fasting blood glucose level may be in the normal range.
Management of pre-diabetes
Pre diabetes, type 2 diabetes and heart disease can be prevented by making lifestyle changes, including:
- Weight loss – helps the insulin your body makes to work better and lower your blood glucose levels.
- Physical activity – it is important to do regular moderate physical activity to help manage your weight, and reduce your blood glucose, blood pressure and cholesterol levels. Exercise also makes your insulin work better.
- A healthy diet – this involves less fat, especially saturated fats, and more fruit, vegetables and high-fibre wholegrain foods.
- Stopping smoking – smoking causes insulin resistance and increases the risk of blood vessel disease.
- Blood pressure and cholesterol control – these should be kept under control and checked regularly.
In most cases, if enough lifestyle changes are made, type 2 diabetes can be prevented.
Follow-up for pre-diabetes
You don’t need to test your own blood glucose levels when you have pre-diabetes. Once you are diagnosed with pre-diabetes, lifestyle changes are most important. Your doctor should organise a repeat oral glucose tolerance test in 12 months, unless you develop symptoms of diabetes earlier.
Where to get help
- Your doctor
- Community health centre
- Diabetes Australia Victoria Tel. 1300 136 588
- Dietitians Association of Australia Tel. (02) 6163 5200
Things to remember
- Pre-diabetes has no signs or symptoms and can progress to type 2 diabetes.
- If you have pre-diabetes, lifestyle changes can reduce your risk of developing type 2 diabetes.
- Risk factors for pre-diabetes include a family history of type 2 diabetes, obesity, smoking and some ethnic backgrounds.
This page has been produced in consultation with and approved by:
Diabetes Australia Victoria
Page content currently being reviewed.
Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your doctor or other registered health professional. Content has been prepared for Victorian residents and wider Australian audiences, and was accurate at the time of publication. Readers should note that, over time, currency and completeness of the information may change. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions.