Prediabetes Can Develop Into Type 2 Diabetes


Health professionals advise people diagnosed with prediabetesTrusted Source to alter their lifestyle by adopting a healthier diet and getting more exercise.
Experts also say these changes should be made sooner rather than later.

That’s because although prediabetes usually doesn’t initially progress to type 2 diabetes, prediabetes can develop into a more serious condition over time if action isn’t taken.

A recent studyTrusted Source published in JAMA Network Open looked at data from more than 50,000 older adults with prediabetes between January 2010 and December 2018.

Researchers reported that slightly more than 5 percent of these people per year developed type 2 diabetes.
Researchers looked at blood sugar levels over time. Levels of hemoglobin A1C of 5.7 percent to 6.4 percent after fasting for 8 hours indicated prediabetes.

Older adults with obesity were at greater risk of developing diabetes after prediabetes diagnosis as were older Black adults, low-income seniors, and those with a family history of diabetes. Older adults with blood sugar between 6 percent and 6.4 on the A1C range were also at higher risk. Men also had a slightly higher risk when compared to women.

Experts point out that those numbers increase the longer someone waits to address the issue. The initial diagnosis helps health professionals individualize a program.

“That is a very surprising number since 37 million adults in the United States have diabetes and roughly 20 percent of them don’t even know they have it, according to the CDC,” Dana Ellis Hunnes, Ph.D., RD, MPH, a senior clinical dietitian at UCLA Medical Center and assistant professor at the UCLA Fielding School of Public Health, told Healthline.

“Having diabetes is extremely expensive and can be highly debilitating, so, yes, anything someone can do to prevent going from prediabetes to diabetes is absolutely worth it,” Hunnes said. “Anything a person can do to improve their health will help them avoid polypharmacy, or other expensive and debilitating chronic diseases, including heart disease or stroke.”

“I would urge anyone with a diagnosis of prediabetes to make every effort they can to avoid a worsening of that into diabetes, or of their health in general,” she added.

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The need to take action
Dr. David Cutler, a family practitioner at Providence Saint John’s Health Center in Santa Monica, California, told Healthline prediabetes is easy for some to ignore. They shouldn’t.

“It’s important to recognize and address prediabetes while keeping its risk in perspective,” Cutler said. “Prediabetes is not a disease. There are rarely complications from prediabetes and no medication is necessary.”

“But this is a glass seen half full or half empty because 25 to 50 percent of people with prediabetes will [eventually] go on to develop… diabetes,” Cutler said. “You may ignore this problem counting on the fact that 95 percent of prediabetics each year do not progress to diabetes.”
“On the other hand, if you understand the risks of diabetes and want to take reasonable measures to prevent diabetes, then aggressively managing prediabetes is the logical thing to do,” he added.

Cutler said most doctors avoid medication with a prediabetes diagnosis, opting to recommend a better diet and more exercise.

“I do not think we label too many people as prediabetes,” Cutler said. “I think it’s a good warning to people to improve their health. And since overweight and obesity are somewhat predictive of prediabetes and diabetes and more and more people are becoming overweight and obese, I think having that diagnosis or that warning can be a good thing if it awakens people to the need for improving their diet and physical activity and other health behaviors.”

If they don’t, that’s when the problem can start, Dr. Eva Shelton, a resident at Harvard and Brigham and Women’s Hospital in Boston, told Healthline.

“About a thirdTrusted Source of Americans are in the prediabetic range and if they make no changes to their lifestyle/diet/medication, many will develop diabetes within 10 years, according to the National Institute of Diabetes and Digestive and Kidney Disease,” Shelton said.

“However, some very simple changes can make drastic differences, such as switching from white rice to brown rice, from caramel macchiato to black coffee, and exercising a few times a week can decrease the risk of diabetes by 58 percent,” Shelton said.

“Some may also consider starting medications like metformin to help decrease blood glucose levels. These easy changes can prevent or delay diabetes down the road,” Shelton said.

“Prediabetes and diabetes are on one spectrum and share similar risks such as increased risks for cardiovascular diseases like heart attacks or strokes.”