Could you have prediabetes?

Posted on 2 November 2020

Spoiler alert: It’s possible to have prediabetes and have no idea until it’s too late. Here’s how to find out, and if you do have it, what you can do to avoid developing diabetes later on.

‘Like type 2 diabetes, prediabetes is a silent condition,’ says Dr Alisha Wade, an endocrinologist at Wits Donald Gordon Medical Centre in Johannesburg. You may have no idea that you have it until revealed by a test. But left unchecked, prediabetes can develop into life-threatening diabetes. That’s why it’s so important to see your doctor for regular screenings.

What is prediabetes?

“People’s bodies handle sugar on a continuum,” says Dr Wade. “So, there are going to be people who handle sugar normally and those who have diabetes. People with prediabetes are in the middle of that continuum. They don’t have blood sugars that are abnormal enough to be called diabetes, but their bodies don’t handle sugar in a healthy way either.”

How is prediabetes diagnosed?

The tests for prediabetes are the same as those for diabetes. ‘What’s different is how we interpret the results,’ says Dr Wade. For example, in a fasting glucose test (early morning, pre-breakfast finger prick), a blood sugar reading over 7mmol/l would indicate diabetes. ‘But if that number is 6.1 to 6.9, then you can be said to have prediabetes,’ explains Dr Wade. Other tests can be similarly interpreted on a continuum.

Does having prediabetes mean you’ll definitely develop diabetes?

The short answer is no. ‘Some people will go on to develop diabetes, some will continue to have prediabetes, and some will revert to normal blood sugar,’ says Dr Wade. ‘But your risk is certainly higher for developing diabetes if you have prediabetes.’

How can you reverse prediabetes?

‘One of the major risk factors for prediabetes is obesity,’ says Dr Wade. For this reason, losing weight (7% of body weight is considered good practice) is one of your best defences against developing diabetes and your best hope of reverting to normal blood sugar – even more so than medication. 

What is the best prediabetes diet?

‘According to the latest Society for Endocrinology, Metabolism and Diabetes of South Africa guidelines (SEMDSA 2017), no specific diet is considered superior or ideal in terms of the percentage of calories that should come from carbohydrates, fat or protein,’ says Vanessa McEwan, a dietitian at Mediclinic Durbanville in Cape Town. Instead, the ratio of macronutrients should be individualised. McEwan does, however, recommend replacing highly refined foods with whole foods. ‘Whole foods are the best source of micronutrients and, unless there are specific clinical indications, vitamins and supplements are not recommended,’ she says.

How can a dietitian help?

A dietitian will evaluate your current eating habits and will show you how to adapt them in a way that you can stick to long term, explains Mareli Conradie, a dietitian at Mediclinic Worcester. They’ll also answer your questions and help you monitor your weight. ‘I see myself as an accountability partner,’ she says. ‘The biggest danger, in my opinion, is that you can tell yourself that you’re not diabetic yet, and that you’re okay, when in fact, you were lucky enough to get a warning sign. I believe knowing that you’re booked in for a follow-up session acts as encouragement to stick to healthy eating principles and prevent you from developing diabetes.’


Published in Diabetes

In the interest of our patients, in accordance with SA law and our commitment to expertise, Mediclinic cannot subscribe to the practice of online diagnosis. Please consult a medical professional for specific medical advice. If you have any major concerns, please see your doctor for an assessment. If you have any cause for concern, your GP will be able to direct you to the appropriate specialists.

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