Prediabetes vs. Diabetes: What Are the Differences?

Prediabetes and type 2 diabetes have a lot in common. Both conditions involve problems with keeping blood sugar at healthy levels. Type 2 diabetes occurs when your body can’t make enough insulin or has difficulty using it. The result is a buildup of sugar in the blood that can damage your heart, kidneys, and eyes.

Prediabetes occurs when glucose (blood sugar) levels are above a healthy range but not high enough to be considered diabetes. This happens when the cells in your body are not responding well to insulin. Unlike type 2 diabetes, prediabetes can be reversed.

In this article, you will learn more about the differences between the two conditions and how to lower your risk of developing type 2 diabetes.

Symptoms

Prediabetes and type 2 diabetes have some similarities. Both can cause higher than normal blood sugar. But when it comes to other symptoms, there are notable differences.

Risk factors for prediabetes and type 2 diabetes also overlap. Because prediabetes often shows no symptoms, you may consider getting your blood sugar checked before symptoms appear if you have more than one or two risk factors. Risk factors include:

• Having a parent or sibling with type 2 diabetes
• Being over 45 years old
• A history of gestational diabetes (diabetes during pregnancy)
• Being physical inactive
• Having polycystic ovary syndrome (PCOS)

Causes

Type 2 diabetes and prediabetes are caused by problems making or using insulin, a hormone produced by your pancreas. This is called insulin resistance and occurs when your cells don’t properly respond to insulin. Your body makes more insulin to compensate, but it won’t be able to make what it needs to take the sugar out of your blood.

The underlying issues that cause the body to have problems using or making insulin are very similar in both type 2 diabetes and prediabetes.

Prediabetes

Medical researchers are not exactly sure what causes prediabetes, but they have enough information to know what health conditions and lifestyle choices increase your chances of developing prediabetes, including:

• Excess weight: Too much visceral fat, located around the organs and intestines, is a cause of insulin resistance. Stomach fat can make hormones that cause chronic inflammation, which may contribute to insulin resistance.
• Lack of physical activity: Any physical activity lowers blood sugar levels. Not getting enough exercise has been linked to insulin resistance.
  

Type 2 Diabetes

Excess weight and lack of physical activity can also cause type 2 diabetes. Genetics can also play a role. Incidence is higher among the following U.S. populations than others:

• African American
• Native American
• Asian American
• Hispanic/Latinx
• Pacific Islander

Diagnosis

The tests for diagnosing prediabetes and type 2 diabetes are the same. Your healthcare provider will do a series of blood tests to measure how well sugar is removed from your blood, including:

• Fasting plasma glucose (FPG): This test measures your blood sugar without food. You can't eat or drink (except for water) for eight hours or more before the test.
• Random plasma glucose (RPG): This test measures your blood sugar levels without fasting. Your healthcare provider may recommend this test to make sure your blood sugar is not at dangerously high levels.
• A1C Test: This test's results will show your average blood sugar levels over the previous three months.
  

Treatment Options

Because prediabetes can be reversed, treatment options can differ from type 2 diabetes. Options may include changes in diet, an exercise regimen, or medication.

Prediabetes

If you are diagnosed with prediabetes, the goal is to prevent or delay the onset of type 2 diabetes. Your healthcare provider will include a treatment plan that will consist of:

• Losing weight (if needed)
• Increased physical activity
• A healthy, low-calorie diet   
• Diabetes medication

Type 2 Diabetes

Diabetes treatment also includes weight management, increased exercise, a healthier diet, and medication. Additional treatment options are:

• Use of insulin: Over time, your pancreas may make less insulin, so you may need to use injectable insulin. Pregnancy or illness may require more insulin as well.
• Regular blood sugar checks: Consistently check your blood sugar to make sure they remain in your target range. If blood sugar stays too high for too long, it can cause health complications.
• Blood pressure and cholesterol checks: High blood sugar lowers high-density lipoprotein (HDL) cholesterol (considered "good" cholesterol), increases low-density lipoprotein (LDL) cholesterol (considered "bad" cholesterol), and damages your arteries. These conditions can cause high blood pressure.
  

Prevention

Regular physical activity, eating well, and maintaining a healthy weight will help lower your risk of developing both prediabetes and type 2 diabetes. Make sure to manage any health conditions that increase your diabetes risk.

Summary

Prediabetes and type 2 diabetes are similar conditions that cause blood sugar to increase above healthy levels. Both conditions are diagnosed with blood sugar tests.

Treatments for prediabetes center around lifestyle changes, including a low-calorie and low-fat diet, increased physical activity, and oral diabetes medications. Prediabetes is reversible, but If left untreated, it can turn into type 2 diabetes.

Once diagnosed with type 2 diabetes, exercise, and healthy eating are still important. In addition, you'll likely require oral diabetes medications or insulin injections and will need to monitor your blood sugar regularly.