What is prediabetes?

Millions of older Americans have “prediabetes.” This means their glucose levels are higher than normal but not high enough to be called diabetes. People with prediabetes have a greater chance of developing type 2 diabetes and having a heart attack or stroke.

If you have prediabetes, there are things you can do to prevent or delay getting type 2 diabetes. Losing weight may help. Healthy eating and being physically active can make a big difference. Work with your doctor to set up a plan to help you make healthier food choices and get regular exercise. Get help with quitting smoking (if you smoke), because smokers are more likely than nonsmokers to develop type 2 diabetes. Make sure to ask how often you should have your glucose levels checked. Your doctor may also talk with you about taking medication to delay or prevent type 2 diabetes.

Symptoms of type 2 diabetes

Symptoms of type 2 diabetes may include feeling tired, increased hunger or thirst, losing weight without trying, urinating often, or having trouble with blurred vision. You may also get skin infections or heal slowly from cuts and bruises. Some people with type 2 diabetes may not realize they have it because symptoms often develop slowly and go unnoticed. Sometimes older adults dismiss these symptoms as “getting old,” but they can be signs of a serious problem. Talk with your doctor if you have any of these symptoms.

Tests for diabetes

Doctors use several blood tests to help diagnose diabetes:

• Random plasma glucose test — given at any time during the day
• A1C test — given at any time during the day; shows your average glucose level for the past three months
• Fasting plasma glucose test — taken after you have gone without food for at least eight hours
• Oral glucose tolerance test — taken after fasting overnight and then again two hours after having a sugary drink (This is not regularly given for type 2 diabetes).

Your doctor may want you to be tested for diabetes twice before making a diagnosis.

Managing type 2 diabetes

Many people with type 2 diabetes can manage their blood glucose levels with diet and exercise alone. Others may need diabetes pills or insulin injections, along with medicines to manage other conditions like high blood pressure and high cholesterol. Over time, a person with diabetes may need both lifestyle changes and medication.

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Once you’ve been told you have diabetes, a health care team will work with you to create a diabetes management plan. Your plan will be based on your lifestyle, preferences, health goals, and other health conditions you have.

As part of your plan, your doctor may prescribe one or more medications. Other health care professionals may also be involved. For example, a diabetes educator may help you understand diabetes and provide support as you make lifestyle changes to manage your diabetes. A dietitian may help with meal planning. An exercise coach may help you become more physically active.