What is Prediabetes?

by Michael_Koger

Prediabetes can be a forerunner of diabetes mellitus, but this depends on how the physician and patient manage the situation.

Prediabetes is the occurrence of blood sugar elevation in which that rise is insufficient to make a diagnosis of diabetes mellitus. When this occurs, it is essential that a physician screen the patient and detect that the serum glucose is abnormal. The earlier the diagnosis, the more effective will be lifestyle changes such as exercise and weight loss to prevent the development of diabetes and its complications [1, 2, 3].

Approximately 90 percent of prediabetic adults in the United States do not know that they have it. In 2012, there were 86 million Americans who were at least 20 years old with prediabetes. During that year, the cost of diabetes mellitus in that country was 245 billion dollars, and the epidemic has continued to grow [1, 2].

Screening Methods

There are three approaches to diagnose someone with prediabetes.  One method is to draw blood for glucose when the client has not consumed anything but water after midnight, and a result of at least 126 milligrams percent indicates the presence of diabetes mellitus.  Should the fasting serum glucose return with a reading range from 100 to 125 milligrams percent, the patient has prediabetes [2]. 

The fasting serum glucose which ranges from 100 to 125 milligrams percent indicates that the client has impaired fasting glucose [2].

Moreover, fasting plasma glucose levels less than or equal to 99 milligrams percent--and not in the hypoglycemic range--are normal [2].

The most sensitive method to resolve the matter is to draw blood from the patient two hours after a 75 gram challenge with oral glucose.  This two-hour sample will indicate diabetes mellitus when the result is at least 200 milligrams percent.  For those whose two-hour post-challenge glucose ranges from 140 to 199 milligrams percent, the diagnosis is prediabetes as the client has impaired glucose tolerance [2].

In fact, the two-hour challenge approach is the gold standard to screen for diabetes or prediabetes.  However, it is also the least convenient method because the patient must be present at the health care center two hours after he or she has received the 75 gram challenge with oral glucose [2].

A two-hour glucose challenge which yields a result less than 140 milligrams percent is normal [2].

The physician must also consider the hemoglobin A1C results.  In normal individuals, this value will be less than or equal to 5.6 percent.  Those who have prediabetes will show a hemoglobin A1C which ranges from 5.7 percent to 6.4 percent.  Diabetic individuals will have a measurement of at least 6.5 percent.

Impact of other Medical Conditions

Sometimes the blood sugar will rise to abnormal levels because the individual has another medical condition.  For example, this can take place in the presence of an infectious ailment such as pneumonia or sepsis. 

In any event, a serum glucose of at least 200 milligrams percent is never normal regardless of concurrent medical problems, and the physician must indicate on the medical record that this has taken place so the primary care physician in the community can appropriately manage it.


The early detection of prediabetes requires careful physician diagnostic skill as well as cooperation from the client.


  1. Centers for Disease Control.  (2015).  Diabetes.  Retrieved June 28, 2015.
  2. University at Albany.  State University of New York.  School of Public Health.  (2015).  Prediabetes:  How healthcare providers can take action.  Retrieved June 28, 2015.
  3. World Health Organization.  (2015).  Diabetes programme.  Retrieved June 29, 2015. 
  4. The photo is of a library at the United States Centers for Disease Control.


The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact their physician for advice.

Updated: 07/03/2015, Michael_Koger
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frankbeswick on 07/07/2015

Thank you for this informative article. I had never heard of this condition, so your article serves a valuable educational function.

Mira on 07/07/2015

This was helpful. Thank you.

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