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Pre-diabetes an early warning sign for diabetes

Gail Carlson, MPH Ph.D., former State Health Education Specialist, University of Missouri Extension


Pre-diabetes is a condition people may have before developing type 2 diabetes. Pre-diabetes is caused by higher than normal blood glucose (or blood sugar) levels, but the levels are not high enough for the person to be diagnosed with type 2 diabetes. Other names for pre-diabetes are “impaired glucose tolerance” and “impaired fasting glucose.” These are the names of two tests commonly used to decide if someone has pre-diabetes or diabetes.


Pre-diabetes is not just an early warning sign for diabetes. Individuals with pre-diabetes have a 50 percent greater risk of cardiovascular disease (heart disease and stroke) compared to people with normal glucose levels. People who are at risk of diabetes are also at risk of pre-diabetes. You should get tested for pre-diabetes if:


  1. You are age 45 or older and overweight
  2. You are overweight and younger than age 45 and have any of these risk factors:
    • High blood pressure
    • High cholesterol
    • Family history of diabetes
    • History of gestational diabetes (diabetes that occurs during pregnancy)
    • Gave birth to a baby weighing more than 9 pounds
    • Are a minority ethnic group


If you are aged 45 and older, with a normal weight, ask your health care provider if he or she recommends testing.


People with pre-diabetes may have the same symptoms of people with diabetes, like unusual thirst, a frequent need to go to the bathroom, blurred vision or a feeling of being tired most of the time for no apparent reason. However, people often do not know they have pre-diabetes or type 2 diabetes because they do not feel symptoms or the symptoms develop so gradually that people don’t recognize them. That is why it is important to ask your provider about being tested, particularly if you have a number of the risk factors mentioned earlier.


Many people with pre-diabetes develop type 2 diabetes within 10 years. However, the onset of diabetes can be prevented or delayed. The Diabetes Prevention Program study, completed in 2002, showed that diabetes can be delayed by slight weight loss (5 to 10 percent of current body weight), through a healthy diet and 30 minutes of moderate physical activity at least five days a week. These lifestyle changes were found to work better than medication alone in delaying diabetes. If you have other risk factors, your doctor will likely recommend the use of medication and lifestyle changes to delay getting diabetes.


For more information on pre-diabetes and diabetes, call 1-800-DIABETES, or go to the National Diabetes Education Program website at or the American Diabetes Association website at


Updated May 2010. Updates to this article were made by Julie Birsinger, Nursing Student Intern, and Molly Vetter-Smith MPH, MEd, RD, State Health Education Specialist, University of Missouri Extension.


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Last Updated 11/10/2014