Part 4 – Diabetes and Prediabetes: The Warning Signs We Should Not Ignore

Recognizing the Risks, Understanding Your Numbers and Taking Control Early

By: Dr. Avi Verma

What if a routine blood test could reveal a health problem years before you develop serious symptoms? Millions of adults live with prediabetes without knowing it. Blood sugar levels are elevated, yet many feel perfectly healthy. By the time symptoms appear, the condition may have progressed to Type 2 diabetes. In our previous installments, we explored brain health, strong bones and fall prevention. This week, we examine another crucial aspect of healthy aging: understanding blood sugar, recognizing risk factors and taking action early. Prediabetes is a serious warning, but timely lifestyle changes can substantially reduce the risk of developing diabetes.

What Is Prediabetes—and Why Does It Matter?

Prediabetes occurs when blood glucose levels are higher than normal but not high enough to meet the criteria for Type 2 diabetes. A major contributor is insulin resistance. Insulin helps glucose move from the bloodstream into cells for energy. When cells respond poorly to insulin, the pancreas produces more to compensate. Over time, blood sugar can rise further.

Without intervention, some people with prediabetes develop Type 2 diabetes. Elevated blood sugar and associated metabolic risk factors can also increase the risk of heart disease, stroke and kidney complications. Early detection creates an opportunity to reduce these risks before more serious damage develops.

Prediabetes does not inevitably lead to diabetes, and blood sugar levels can return to the normal range for some people. However, continued monitoring remains important.

Warning Signs You Should Not Ignore

Prediabetes often causes no noticeable symptoms, making screening especially important. As blood sugar rises, some people experience increased thirst, frequent urination, fatigue, blurred vision or slow-healing wounds. These symptoms can also indicate diabetes or other conditions and warrant medical evaluation.

Dark, velvety patches of skin around the neck, armpits or groin may indicate insulin resistance. Small skin tags can also occur, although neither finding alone confirms prediabetes.

Do not wait for symptoms to appear before getting tested if you have risk factors.

Who Is at Greater Risk?

Risk factors include:

• Excess weight, particularly abdominal fat.
• Physical inactivity and prolonged sitting.
• A diet high in sugary drinks, refined carbohydrates and heavily processed foods.
• A parent or sibling with Type 2 diabetes.
• Increasing age, especially from 35 onward.
• High blood pressure, abnormal cholesterol or triglyceride levels, and sleep apnea.
• A history of gestational diabetes or polycystic ovary syndrome (PCOS).

People from several ethnic backgrounds, including South Asian, Black, Hispanic and Native American communities, may develop Type 2 diabetes at higher rates. South Asian adults can face increased metabolic risk even at lower body weights.

These factors do not guarantee diabetes, but they make appropriate screening and prevention more important.

Know Your Numbers: Blood Sugar Testing

Three tests are commonly used to identify prediabetes and diabetes in nonpregnant adults.

Unless blood sugar is unequivocally elevated with classic symptoms, an abnormal result generally requires confirmation by repeat testing or another diagnostic test. Your healthcare professional can determine which test is appropriate and how often you should be screened.

Four Steps That Can Make a Difference

1. Improve food choices. Build meals around vegetables, beans, lentils, whole grains, nuts and suitable sources of lean protein. Choose high-fiber carbohydrates more often and reduce sugary drinks, sweets and highly refined foods. Portion sizes matter, too; no single food or diet reverses prediabetes for everyone.

2. Aim for modest, sustainable weight loss. For adults who are overweight, losing approximately 5%–7% of body weight can improve insulin sensitivity and reduce diabetes risk. A gradual, realistic approach is more sustainable than crash diets.

3. Move regularly. Aim for at least 150 minutes of moderate activity each week, such as brisk walking, cycling or swimming. Strength training twice weekly can help preserve muscle, which plays an important role in glucose use. Start at a safe level and increase activity gradually.

4. Protect sleep and manage stress. Aim for seven to nine hours of sleep when possible. Address persistent sleep problems, including possible sleep apnea, and develop healthy ways to manage stress. Avoid tobacco and limit alcohol.

For some people at particularly high risk, clinicians may recommend medication such as metformin alongside lifestyle changes. Treatment decisions should be individualized.

Take Action Before Diabetes Takes Hold

Research from the landmark Diabetes Prevention Program found that a structured lifestyle intervention reduced the development of Type 2 diabetes by 58% among high-risk participants during the trial; the reduction was 71% among participants aged 60 and older. These findings demonstrate the potential of lifestyle changes, although individual results vary.

Prediabetes is not a reason to panic, but it is a reason to act. Know your numbers, discuss your risk with your healthcare professional and make manageable changes that you can maintain. Small steps taken consistently can protect your heart, blood vessels, kidneys and long-term independence.

Next Week: Part 5 – Kidney Health: The Silent Organ We Often Forget

In the next installment of Healthy Aging, Healthy Living, we will explore kidney health—how the kidneys work, why high blood pressure and diabetes can damage them, the importance of hydration and medication safety, warning signs of kidney disease, and when screening may be needed.

Medical Disclaimer

This article is for general educational and informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Blood sugar testing, screening schedules, dietary changes, exercise and medication decisions should be tailored to individual health needs. Consult a qualified healthcare professional regarding your personal risk factors or test results. Do not start, stop or change medication without medical guidance. Seek prompt medical attention concerning symptoms and emergency care for a medical emergency.