The Diabetes Center of Excellence at Shands at UF

Formerly called Impaired Glucose Tolerance or Impaired Fasting Glucose, pre-diabetes is the state that occurs when a person's blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. It is estimated that "pre-diabetes" is a condition that may affect 16 million Americans and that sharply raises the risk for developing type 2 diabetes.

Research shows that people with pre-diabetes will likely develop type 2 diabetes within ten years. However, moderate changes in diet and level of physical activity can reduce the risk of developing this disease. People with pre-diabetes also have a 50% greater chance of developing cardiovascular disease compared to people with normal blood glucose.

To diagnose pre-diabetes, doctors use either the fasting plasma glucose test (FPG) or the oral glucose tolerance test (OGTT). Both require a person to fast overnight. In the FPG test, a person's blood glucose is measured in the morning before eating. In the OGTT, a person's blood glucose is tested after fasting and again two hours after drinking a glucose-rich drink.

A normal person's fasting plasma glucose test would be below 110 mg/dl. A person with pre-diabetes would have a fasting blood glucose level between 110 and 125 mg/dl. If the blood glucose level rises to 126 mg/dl or above, the person has diabetes.

Using the oral glucose tolerance test, pre-diabetes is diagnosed when the two-hour blood glucose is 140-199 mg/dl. If the two-hour blood glucose rises to 200 mg/dl or above, a person has diabetes. Normal value blood glucose two hours after the drink is below 140 mg/dl.

People with diabetes and pre-diabetes may not have symptoms, and may not know they have the disease. New treatment guidelines recommend that if you are age 45 or older and overweight, you should be tested for pre-diabetes during your next routine medical office visit. If you are younger than 45 and overweight and have any of the following risk factors, your physician may want to test you. These risk factors include:

high blood pressure
low HDL cholesterol and high triglycerides
a family history of diabetes
a history of gestational diabetes or giving birth to a baby weighing more than nine pounds
belonging to an ethnic or minority group at high risk for diabetes.

Studies have shown that losing just 10-15 pounds can made a substantial difference in a person's propensity to develop diabetes. Recommendations also include participating in modest physical activity - like walking - for 30 minutes each day. These interventions, coupled with dietary changes, have been shown to delay or prevent the development of type 2 diabetes by up to 58%.