Study: Prediabetes Can Progress in Just One Year

People who are diagnosed with prediabetes are often warned that their condition can progress to diabetes. But a new study has quantified just how likely that is to happen within a year.

About one in 20 adults aged 65 and up with prediabetes will end up developing diabetes within 12 months, according to an analysis of data from the Longitudinal Epidemiologic Assessment of Diabetes Risk (LEADR) study. Researchers analyzed data from more than 2 million adults between January 2010 and December 2018.

Of those, 14.3% of the 50,152 adults diagnosed with prediabetes progressed to diabetes within 2.3 years. That led to an estimated annual progression rate of 5.3%.

However, certain factors influenced the likelihood of progression. Body mass index (BMI) and initial A1C level—a measure of average blood glucose levels for the last two to three months—were the biggest predictors. Patients with high BMIs and those with high A1C levels were the most likely to develop diabetes, with the risk increasing as those levels increased themselves.

People with a family history of diabetes and those with hypertension were also more likely to develop diabetes. The study was published in JAMA Network Open.

Experts aren’t shocked by the findings. 

“Insulin resistance is common among overweight or obese people,” Claudia Ramirez Bustamante, MD, fellow physician of medicine-endocrinology at Baylor College of Medicine, told Verywell. “This is not a surprising result.”

Having a family history of diabetes “is a strong predictor of diabetes,” Christoph Buettner, MD, PhD, chief of the division of endocrinology at Rutgers Robert Wood Johnson Medical School, told Verywell, adding that there is also a clear link between obesity and the development of diabetes. “Obesity is what drives the diabetes epidemic.”

How to Control Prediabetes

If you’re diagnosed with prediabetes, it’s important to take quick action.

“Prediabetes is a significant warning sign. It is the time to act,” Phallon LoveLady, DNP, RN, manager of Community Health Programs with Spectrum Health, told Verywell. “It is when your body is saying, ‘If we do not turn around now, it will be too late.’”

The best thing to do if you’re given a prediabetes diagnosis is to “adopt a healthy lifestyle that includes a well-balanced diet and a daily step count of 8,000 to 10,000 steps a day if younger than 60, or 6,000 to 8,000 for individuals aged 60 and older,” Bustamante said.

She recommends increasing the number of vegetables you eat and increasing your physical activity to include activities you and your family can do like Zumba, water sports, and biking.

“In addition, you can also improve your daily step count by switching a few things around such as taking the stairs instead of the elevators, or walking around your workplace while on a break,” she added. Weight loss, doing your best to avoid stress, and getting regular sleep can help, too, Buettner said.

“The earlier we diagnose diabetes, the better our chances that we can intervene and prevent progression to diabetes,” Buettner said.

If you’re concerned about your prediabetes and diabetes risk, talk to a healthcare provider.

“Unfortunately, prediabetes and early diabetes tends to be silent and most people get diagnosed incidentally when they have labs for other reasons or when they already have complications,” Bustamante said.

Still, she added, “there is plenty you can do to halt or revert its progression with the help of a physician or endocrinologist—the sooner, the better.”