Prediabetes is an in-between phase: your blood sugar is higher than normal, but not yet high enough to be called type 2 diabetes. It often causes few or no complaints, so it can go unnoticed for years. That is exactly why a blood test of your fasting glucose and your HbA1c can give an early signal.
I notice that many women are alarmed by the word prediabetes, while it is mainly a warning you may take seriously. In this article you will read what prediabetes is, which symptoms can occur and which blood values point to it. You will also read who has a raised risk and what you can do about it together with your GP.
What is prediabetes?
Prediabetes means your blood sugar values are raised, but stay below the threshold for type 2 diabetes. Your body then responds less well to insulin, the hormone that regulates your blood sugar. According to Thuisarts.nl this is a risk phase, not a disease, and often still reversible.
Doctors usually speak of impaired fasting glucose or a slightly raised HbA1c. Both show that your sugar metabolism is under pressure. It is a step between a healthy blood sugar and diabetes.
Important to know: prediabetes is not a diagnosis you can make yourself. It is about a pattern in your blood values that a doctor assesses and usually confirms with a second measurement. If you want to know more about the underlying cause, read our article on insulin resistance in women and which blood values to test.
What are the symptoms of prediabetes?
Prediabetes often gives few or no clear symptoms. That is the tricky part: you can feel perfectly fine while your blood sugar slowly rises. If there are complaints, they are usually vague and easily attributed to something else.
Possible signals are tiredness, more thirst, urinating more often or feeling hungry shortly after eating. Some women notice that small wounds heal more slowly or that they feel listless after a carbohydrate-rich meal.
These complaints are not specific to prediabetes and can have many other causes.
Because symptoms say so little, a blood test is the most reliable way to map your blood sugar. If you recognise complaints that fit a high blood sugar, also read high blood sugar: symptoms and when to test.
Which blood values point to prediabetes?
Prediabetes is read from two blood values: your fasting glucose and your HbA1c. Fasting glucose measures your blood sugar at a moment when you have not eaten for a number of hours. HbA1c shows your average blood sugar over the past two to three months.
With prediabetes your fasting glucose usually falls between roughly 6.1 and 6.9 mmol/l and your HbA1c between roughly 42 and 47 mmol/mol. The table below sets the rough cut-off values side by side.
| Blood value | Normal | Prediabetes | Diabetes |
|---|---|---|---|
| Fasting glucose | Below 6.1 mmol/l | 6.1 to 6.9 mmol/l | 7.0 mmol/l or higher |
| HbA1c | Below 42 mmol/mol | 42 to 47 mmol/mol | 48 mmol/mol or higher |
These values are indicative and can differ slightly per guideline and per laboratory. The NHG, for example, uses its own cut-off values, and not every lab reports HbA1c in the same way. A single measurement is also never enough for a diagnosis.
If you want to understand what your HbA1c says exactly, read our article on the HbA1c value and what it means for your long-term blood sugar. You always discuss an abnormal result with your GP, who looks at your whole situation.
Who has a raised risk of prediabetes?
Some women have a greater chance of prediabetes than others. According to the Diabetes Fonds, overweight, little exercise, age and hereditary predisposition play a role. A previous gestational diabetes also raises your risk.
In addition, your waist counts: a lot of belly fat is linked to insulin resistance. Certain ethnic backgrounds and conditions such as PCOS can raise the risk too.
If you recognise yourself in several of these points, it can be useful to have your blood sugar checked. That does not mean you have prediabetes, but that a test gives you more clarity. Discuss with your GP whether testing is sensible for you.
Can you reverse prediabetes?
With prediabetes there is often still room to improve your blood sugar. Lifestyle plays the main role: eating more healthily, moving more and losing weight if you are overweight can favourably influence your values. Research shows that lifestyle change can considerably lower the risk of type 2 diabetes.
The Voedingscentrum advises a fibre-rich diet with fewer added sugars and more vegetables, wholegrains and legumes. Regular exercise helps your muscles absorb sugar better. Small, lasting steps usually work better than a strict diet you cannot keep up.
Whether prediabetes is truly reversible for you depends on many factors and is never guaranteed.
Your GP can think along with you about a plan that suits you, and keep an eye on your blood sugar with repeated measurements. That way you see whether your approach is having effect.
Testing your own blood values
If you want to map your blood sugar, you can have your glucose and HbA1c drawn at Lunara without a referral. The Diabetes blood test looks at these values, so you have an objective starting point for a conversation with your GP.
You order the test online and visit one of the more than 750 draw locations in the Netherlands. The blood draw is preferably in the morning and fasting, because that is needed for a reliable fasting glucose. Every result is assessed by a BIG-registered doctor.
Important: testing yourself does not replace the care of your GP. It is meant as an addition and as a starting point for a conversation. You always discuss an abnormal result, or doubt about your values, with a professional.
Frequently asked questions
Is prediabetes the same as diabetes?
No. With prediabetes your blood sugar is higher than normal, but not yet high enough for a diagnosis of type 2 diabetes. It is a risk phase that is often still reversible. Your GP assesses your values and decides whether follow-up is needed.
Which test is best for prediabetes?
Usually your fasting glucose and your HbA1c are looked at. Fasting glucose measures your blood sugar at that moment, HbA1c gives your average over two to three months. Together they give a more complete picture than a single value.
Do I have to be fasting for a blood sugar test?
For a fasting glucose you do: you have then usually not eaten for eight to twelve hours. For HbA1c you do not need to be fasting. If you have both drawn, plan the draw in the morning and fasting.
Can you feel prediabetes?
Often not. Prediabetes usually gives few or no complaints, so it can go unnoticed. If there are signals, such as tiredness or more thirst, they are vague and not specific. A blood test is therefore more reliable than going by complaints.
Does prediabetes raise my risk of diabetes?
Yes, prediabetes increases the chance of type 2 diabetes. Still, it is not a certainty: with lifestyle change you can often lower that risk. Your GP can follow your values and think along with you about suitable steps.
References
- NHG and Thuisarts.nl. Type 2 diabetes and raised blood sugar. Dutch College of General Practitioners.
- Diabetes Fonds. Prediabetes and risk factors for type 2 diabetes.
- Voedingscentrum. Healthy eating with a raised blood sugar and diabetes.
- RIVM. Diabetes in the Netherlands. National Institute for Public Health and the Environment.
Every blood test result through Lunara includes a professional assessment by a BIG-registered doctor. Blood testing through Lunara does not replace the care of your GP and does not make a diagnosis. For treatment decisions, discuss your results with your GP.
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