What is prediabetes (borderline diabetes)?

Prediabetes is a condition where your blood sugar levels are higher than normal but not high enough to be classified as diabetes. However, if prediabetes is left untreated, it can lead to type 2 diabetes. If you are diagnosed with borderline diabetes, it should be considered a warning sign that you are at risk of getting diabetes. The good news is that borderline diabetes can be reversed through lifestyle changes like diet and exercise. Staying physically active, maintaining a healthy weight, and eating the right food can prevent the risk of prediabetes developing into a more serious condition like type 2 diabetes. Usually, your body produces a natural hormone known as insulin that helps to regulate blood glucose levels.

When you eat, glucose is absorbed into the bloodstream. Glucose refers to a form of sugar which is one of the major sources of fuel. Insulin helps the body tissue to absorb glucose from the bloodstream for energy. If you have prediabetes, this process does not function normally. This is because your body is not capable of producing enough insulin after eating a meal, or cannot properly utilize the insulin it produces. As a result, you may experience high levels of blood sugar. Borderline diabetes can affect both children and adults. To prevent the risk of heart disease or stroke, adults and children with prediabetes can adopt lifestyle changes to bring their blood glucose levels back to the normal range.

Signs and symptoms of prediabetes

The signs and symptoms of prediabetes are not always clear. If you have prediabetes, you may experience signs associated with conditions like acanthosis nigricans and polycystic ovarian syndrome. This may include discoloration around the neck, armpits, elbows, or knuckles and dark, patchy skin. If your prediabetes has moved to type 2 diabetes, you may experience symptoms like:

  • Blurry vision
  • Fatigue
  • Increased urination
  • Increased thirst

If you notice any of these signs and symptoms, you should visit your doctor for testing.


It is not yet known what really causes prediabetes. However, it is believed that genetic factors and family history could play a vital role. Lack of physical activity and excess abdominal fat are other factors that can contribute to borderline diabetes.

The following are the risk factors that can cause borderline diabetes:

  • Age

The risk of developing prediabetes increases when you are over the age of 45. This is because people above this age don’t always exercise regularly and are likely to gain more weight.

  • Sedentary lifestyle

If you have a sedentary lifestyle, you have an increased risk of developing prediabetes. Staying physically active can help you maintain a healthy weight and make your body more sensitive to insulin.

  • Family history

If you come from a family with a history in diabetes, you have a higher chance of developing prediabetes.

  • Race

People from certain races like Hispanics, African Americans, Asian Americans, and Native Americans have a higher risk of getting borderline diabetes.

  • Weight

If you are overweight, you have a higher risk of developing prediabetes. This is because the more fat you have, especially around the waist, the higher the risk of becoming insulin resistant. If you are a man, having a waist larger than 40 inches increases your risk of becoming insulin resistant, while for women it is 35 inches.


Before treatment can begin, your doctor will carry out a blood test to ensure prediabetes is accurately diagnosed. That means a blood sample will have to be drawn. There are different blood tests that will be performed, and the results will vary depending on the test.

The following are the tests that will be performed

  • Hemoglobin A1c test

Also known as glycated hemoglobin test or simply A1c test, this blood test is used to measure your average blood glucose level. If your A1c value is between 5.7 to 6.4 percent, then it is prediabetes. Usually, a second hemoglobin A1c test is required to confirm the values of the first test. The higher the A1c values, the higher the chance that your borderline diabetes will become type 2 diabetes.

  • Oral glucose tolerance test

This blood test requires you to fast. Your health-care provider will then check your blood glucose levels at the start of your medical appointment and 2 hours after you have a sugary drink. If your blood glucose level shows the reading to be between 140 to 199mg/dL, then your test indicates you have prediabetes.

  • Fasting blood sugar test

This blood test requires you fast for 8 hours before a blood sample is withdrawn for testing. If the reading shows your blood glucose levels to be between 100 to 125mg/dL, then it indicates you have prediabetes.

Once you are diagnosed with prediabetes, your health-care provider will ask you to adopt specific lifestyle changes. This may include weight control, exercising regularly, and proper nutrition.

  • Nutrition

As part of your nutrition, your nutritionist may ask you to watch out for foods that have high glycemic index, check your food portions, reduce sugary drinks, and eat foods that are rich in fiber. It is advisable you avoid refined carbohydrates that have high glycemic index. This includes white rice, white bread, and drinks like juice and soda. Instead, eat more foods with low glycemic index such as beans, corn, sweet potatoes, pasta, carrots, and leafy greens. It is also important you include foods that are rich in fiber into your diet. This includes whole grains, fruits, and vegetables with edible skin. If you are alcoholic, it is advisable you only drink alcohol in moderation. Drink plenty of water to avoid dehydration.

  • Exercise

Just like nutrition, exercise is an important part of lifestyle changes for patients with prediabetes. If you don’t exercise, you increase your risk of becoming insulin resistant. It is recommended you do 30 minutes of regular exercise for at least 5 days every week. Exercising regularly can help your body cells respond better to insulin. Consider activities such as dancing, walking, or cycling to stay physically active.

  • Weight control

Being overweight increases your risk of developing prediabetes. This is because body fat, especially abdominal fat, can cause your body to become insulin resistant. If you are overweight, there is a higher risk that your borderline diabetes may develop into diabetes. To avoid this risk, it is recommended you maintain a normal weight. Exercising regularly and eating healthy food can help you maintain a normal weight.



Disclaimer: Please note that the contents of this community article are strictly for informational purposes and should not be considered as medical advice. This article, and other community articles, are not written or reviewed for medical validity by Canadian Insulin or its staff. All views and opinions expressed by the contributing authors are not endorsed by Canadian Insulin. Always consult a medical professional for medical advice, diagnosis, and treatment.