Pre-diabetes symptoms, causes and risk factors

Whether you have elevated blood sugar numbers and have been told you’re borderline diabetic, or you have a family history of type 2 diabetes, chances are you’ve heard the phrase: pre-diabetes. While receiving a diagnosis of pre-diabetes isn’t necessarily a sign that you will eventually develop type 2 diabetes, it’s a good indicator that something is going on internally. And for some people, recognising pre-diabetes symptoms can lead to making major changes (like dietary and overall lifestyle) to help them avoid moving from the pre-diabetic stage to type 2 diabetes.

While high blood sugar (hyperglycemia) definitely has some telltale signs, not everyone will be able to recognise the signs of pre-diabetes. We spoke with two endocrinologists to find out pre-diabetes symptoms and preventative measures you could be taking to help mitigate your chances of developing type 2 diabetes.

What is pre-diabetes?

Pre-diabetes refers to blood sugar (plasma glucose) levels that are higher than normal but do not meet the criteria for types of diabetes, explains endocrinologist Dr Aleem Kanji. Diabetes Australia considers people who meet one of these specific criteria to be pre-diabetic:

Impaired glucose tolerance (IGT) - higher blood glucose levels than normal but not high enough to be classed as diabetes.
Impaired fasting glucose (IFG) - escalated blood glucose levels in the fasting state but not high enough to be classified as diabetes.
Both Impaired Fasting Glucose (IFG) and Impaired Glucose Tolerance (IGT).

Those diagnosed with pre-diabetes may have an increased risk of developing type 2 diabetes and cardiovascular disease, such as heart disease, explains Dr Kanji. “Pre-diabetes can remain unrecognised for years,” he says. “Prompt diagnosis and treatment [are] necessary to prevent the progression to diabetes and reduce the risk of cardiovascular disease.” If you think you’re suffering from pre-diabetes, you should reach out to your primary care physician to talk about your symptoms and testing options immediately.

Pre-diabetes symptoms

Unfortunately, there is no checklist when it comes to determining if you’re experiencing some of the early signs of diabetes because pre-diabetes does not have any overt (or clinically obvious) symptoms, according to endocrinologist Dr Benjamin U. Nwosu.

That can make it hard for the average person to know if their blood sugar has reached those concerning markers without the aid of a blood test. Considering how significantly a diabetes diagnosis can change a person’s day-to-day lifestyle, that can be worrisome.

That being said, Dr Kanji says that if your blood sugar is rising enough (and/or frequently enough), you may notice some common hyperglycemia-related symptoms that could raise a red flag in patients.

Symptoms of hyperglycemia (high blood sugar):

Increased urination
Increased thirst
Increased hunger
Blurry vision
Numbness/tingling of the hands or feet
Sudden unplanned weight loss
Frequent infections and sores that are slow to heal

While not a sign of pre-diabetes, another type of insulin resistance called acanthosis nigricans, which Dr Kanji says presents as a “darkening of the skin in certain body areas,” can be related to pre-diabetes and is worth mentioning to your healthcare provider.

Pre-diabetes causes and risk factors

Pre-diabetes can serve as a precursor to type 2 diabetes, according to Dr Nwosu. “In patients with pre-diabetes leading up to type 2 diabetes,” he says. “The risk factors are obesity, which increases insulin resistance, and a family history of type 2 diabetes.”

Dr Kanji says that in addition to the risk factors mentioned by Dr Nwosu, environmental causes, age (more specifically those over the age of 45), history of gestational diabetes, and polycystic ovary syndrome, can all play a role in a person’s risk of developing pre-diabetes.

Pre-diabetes prevention

Knowing that pre-diabetes can lead to type 2 diabetes makes prevention important. “We have proof that pre-diabetes can be reversed in a population of people through intensive lifestyle changes or Metformin [a drug often used to help treat type 2 diabetes],” says Dr Kanji. “Of those who didn’t reverse pre-diabetes, a significant number lowered their chance of developing type 2 diabetes.” Adjusting your diet, increasing your level of exercise, and losing weight if applicable can all help.