6 Things Older Adults Should Know About Prediabetes

3. Symptoms are often silent

You may have prediabetes and not even know it, since it often doesn’t come with any signs or symptoms, according to Mayo Clinic. Some people have darkened skin on certain body parts, such as the groin, armpits or neck.

There are, however, signs that prediabetes has progressed into type 2 diabetes, including:

• Frequent urination
• Feeling thirstier than normal
• Fatigue
• Blurry vision
• Numbness or tingling in hands or feet
• Unintentional weight loss
• Frequent infections
• Increased hunger
• Sores that heal more slowly than usual

4. Many prediabetes risks can be reduced 

Genetics can play a part in prediabetes, but these things can also raise your risk for the condition:

• Being overweight
• Having a large waist circumference
• Lack of exercise
• Diet
• Being Black, Hispanic, American Indian or Asian American
• Having had gestational diabetes during pregnancy
• Smoking

Additionally, other health conditions are associated with a higher risk for prediabetes, including:

• Polycystic ovary syndrome
• Obstructive sleep apnea
• High blood pressure
• Low levels of high-density lipoprotein (HDL) cholesterol, the “good” cholesterol
• High triglyceride levels
• Metabolic syndrome

5. A blood test can diagnose prediabetes

Since most people don’t experience symptoms, screening is key, Kalyani says. And most adults should be screened for prediabetes every three years, Rooney adds.

People with certain risk factors, such as obesity, high blood pressure or high cholesterol, may benefit from more frequent screening.

A few different blood tests can detect blood sugar levels to see if you have prediabetes:

• Fasting plasma glucose (FPG): This test measures your blood sugar in the moment, after you haven’t eaten for at least eight hours. Healthy blood sugar levels are between 70 to 99 milligrams per deciliter (mg/dL). If you have prediabetes, your levels will be between 100 to 125 mg/dL. Diabetes is considered to be 126 mg/dL or higher, according to the ADA.
• Hemoglobin A1C: This test measures your average blood glucose for the past two to three months. If your results are less than 5.7 percent, that’s normal. Prediabetes is diagnosed when A1C is between 5.7 and 6.4 percent, and diabetes is confirmed when A1C is 6.5 percent or higher.
• Oral Glucose Tolerance Test (OGTT): This test measures how your body processes sugar before and after you consume a sugary drink. Normal levels are less than 140 mg/dL. A reading of 140 to 199 mg/dL is considered prediabetes, and diabetes is diagnosed when results are 200 mg/dL or higher.

Usually, doctors will repeat the test to confirm a diagnosis, the ADA reports.

6. The condition is reversible

“Prediabetes can often be reversed with healthy lifestyle habits and weight loss,” Rooney says — and it can be reversed at any age.

The CDC says this weight loss doesn’t need to be drastic to make a difference — losing between 5 to 7 percent of your body weight can help. Still, it’s important to note that age-related changes in metabolism can make weight loss more difficult.

Adopting a Mediterranean-style diet, getting enough sleep and aiming for 150 minutes of moderate to vigorous activity per week can also help prevent prediabetes from progressing.

A few other tips:

• Watch your blood work. Ask your doctor how often you should have blood work done and which markers to watch. While some doctors may focus solely on blood glucose and A1C, ask yours if you should keep an eye on inflammation as well, as it’s implicated in cardiometabolic health, notes Dr. Louis Aronne, a professor of metabolic research at Weill Cornell Medicine.
• Use medication. Your doctor may prescribe medication like metformin to manage blood sugar and prevent prediabetes from becoming diabetes. But the drug isn’t used for that in those over 60 who already have prediabetes, Rooney points out. Your doctor also may suggest drugs to manage cholesterol and high blood pressure, which are linked with diabetes.
• Quit smoking. When you stop smoking, it can improve how your body handles insulin.
• Strength train. Building muscle is key because it burns calories without needing insulin and affects our resting metabolic rate, explains Dr. Heather Ferris, an associate professor at the University of Virginia School of Medicine. As our resting metabolic rate declines, we need fewer calories to maintain the same weight, so if we consume the same number of calories over time, we will gain weight, forcing the pancreas to make more insulin, Ferris says. Weight loss, along with building and maintaining muscle through exercise, can make it easier on the pancreas because it decreases the body’s need for insulin, she explains.
• Try a CGM — maybe. You may be wondering if a continuous glucose monitor, which can be purchased over the counter, can help if you have prediabetes. These devices let you see, in real time, how your body responds to food and exercise so you can adapt your behaviors based on that data. Rooney says there’s no long-term data showing that they can improve outcomes for those with prediabetes, though.

A study published last year in The Lancet Diabetes & Endocrinology found that people who lowered their blood sugar levels to normal ranges — what’s known as prediabetes remission — had improved heart health.