The Truth About Prediabetes

This serious health condition hikes the risk of not only diabetes but also heart disease and stroke

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Jim Edholm, 78, was briefly stumped when his doctor told him he was borderline diabetic. But the North Andover, Mass., resident then realized he’d been less active in the prior three months and had been eating lots of sweets—“mostly cookies.”

Just over a third of American adults have prediabetes, according to the Centers for Disease Control and Prevention. That means their body does not respond normally to the hormone insulin.

Prediabetes hikes the risk of not only diabetes but also heart disease and stroke. Yet many people with pre­diabetes don’t know they have it, in part because it often has no obvious symptoms.

“I tell my patients to think of prediabetes as a warning sign,” says Michael Hochman, MD, director of the Gehr Family Center for Health Systems Science and Innovation at the Keck School of Medicine of University of Southern California in Los Angeles. “Unless you make changes to your lifestyle, such as a healthier diet, weight loss, and more physical activity, you are likely to progress to diabetes over time. The good news is that if you make these changes, you have a very good chance of preventing yourself from moving into the diabetic range.”

Even when people learn they have prediabetes, many— especially Blacks and Hispanics, who are already more likely to develop the condition—may receive little treatment.

More on Diabetes

“Lots of people came to our clinic and were told they had prediabetes but not given education around what that means,” says Leonor Corsino, MD, an endocrinologist at the Duke University School of Medicine in Durham, N.C., who also focuses on diabetes prevention in her local Hispanic community.

And the pandemic has made it harder to rein in the problem: Thirty-four percent of people in a new Consumer Reports survey of 2,911 people who have diabetes or live with someone who does say it’s now harder to get the exercise that can help keep blood sugar in check.

Here’s what you can do:

  • Have an annual diabetes screening if you’re older than 40 and overweight.
  • If you’re told you have pre­diabetes, the American Diabetes Association recommends losing weight and doing moderate exercise—such as 150 minutes a week of brisk walking.
  • When lifestyle changes alone don’t work, medication might. The ADA recommends the generic drug metformin, especially for very overweight people younger than 60.

As for Edholm, 30-minute daily walks and avoiding added sugars did the trick. “I’ve found I don’t feel right if I don’t walk nearly every day,” he says, “and I no longer crave sugar.”

Editor’s Note: This article also appeared in the January 2021 issue of Consumer Reports magazine.

Head shot of CRO author Lisa Gill

Lisa L. Gill

As a dorky kid, I spent many a Saturday at the Bloomington, Ind., public library, scouring Consumer Reports back issues for great deals. Now, as a (much) bigger kid, that's still my job! Identifying products and services, especially in healthcare, that are safe, effective, and affordable—and highlighting those that aren't—is my top concern. Got a tip? Follow me on Twitter ( @Lisa_L_Gill)