Most people with prediabetes don't know they have it 

You may know your blood pressure. You may know your cholesterol. You may even step on the scale every morning. But do you know your blood sugar, and whether you're on the road to diabetes?

According to the CDC, about 115 million American adults, more than 2 in 5, have prediabetes. About 8 in 10 of them don't know it. Here at home, about 14 percent of Shelby County adults already have diabetes.

Prediabetes isn't "a little high sugar." It's a warning sign that your body is starting to struggle with how it handles blood sugar. The good news is that it's also an opportunity. In the landmark Diabetes Prevention Program study, people who made lasting lifestyle changes lowered their risk of type 2 diabetes by 58 percent.

Start here: know your risk 

The first step is awareness. The CDC's free one-minute Prediabetes Risk Test looks at your age, family history, blood pressure, activity level, and weight.

Take the CDC Prediabetes Risk Test

The test doesn't diagnose prediabetes or diabetes. If your score shows higher risk, the next step is a conversation with your doctor and a simple blood test.

Prediabetes is usually silent 

Most people with prediabetes feel fine. The problem can build quietly for years before anything feels wrong. As blood sugar climbs into the diabetes range, some people start to notice:

• Unusual tiredness
• Needing to urinate more often
• More thirst or hunger
• Blurry vision
• Weight loss without trying
• Infections that keep coming back
• Cuts that heal slowly
• Tingling or numbness in the hands or feet

Many people notice none of these. Feeling well doesn't mean your blood sugar is normal.

What is prediabetes?

When you eat, your body breaks carbohydrates down into sugar (glucose), which travels through your blood to fuel your cells. Insulin, a hormone made by the pancreas, works like a key that unlocks your cells so the sugar can get in.

With insulin resistance, the lock gets sticky. Your muscles, liver, and fat cells stop responding well to insulin. At first, your pancreas makes extra insulin to force the door open, so blood sugar can look normal for a while. Over time, it can't keep up, and blood sugar starts to rise.

Think of two people who each earn $5,000 a month. One manages it well. The other watches it leak away. Same income, different outcome. Blood sugar works the same way: what matters is how well your body uses it.

The path usually looks like this: normal blood sugar, then insulin resistance, then prediabetes, then type 2 diabetes. Prediabetes is the window to step in, not a guarantee of what comes next.

How prediabetes is diagnosed

One common test is the A1C, which shows your average blood sugar over the past three months. According to the CDC:

• Normal: below 5.7 percent
• Prediabetes: 5.7 to 6.4 percent
• Diabetes: 6.5 percent or higher

Your doctor may also use a fasting blood sugar test or a glucose tolerance test. A full evaluation looks beyond one number to answer a bigger question: what is changing in your body, what is driving it, and what can we change now?

Why prediabetes matters

Blood sugar that stays high slowly damages blood vessels, nerves, and organs. Over time, diabetes raises the risk of:

• Heart disease and stroke. People with diabetes have twice the risk of heart disease.
• Kidney disease. About 1 in 3 adults with diabetes may have chronic kidney disease.
• Nerve damage, which can cause numbness, tingling, and pain in the feet and legs.
• Vision loss from damage to the small blood vessels in the eyes.
• Foot problems, including wounds and infections that can lead to amputation.

Insulin resistance is also closely tied to fatty liver disease. The goal isn't to wait until blood sugar is high enough to need treatment. It's to catch the risk early and act.

Five ways to prevent and manage type 2 diabetes

No single food, workout, or medication fixes metabolic health. Lasting change comes from five areas working together. 

1. Nutrition: lighten the load

This isn't just about avoiding sugar. It's about building meals that help your body handle blood sugar well. Fill your plate with:

• Vegetables and other high-fiber foods
• Beans and lentils
• Whole, minimally processed foods
• Enough protein
• Healthy fats like olive oil, nuts, and avocado
• Sensible portions of whole-grain carbohydrates

Cut back on sugary drinks and highly processed foods. Fiber and protein also help you feel full longer, which makes healthy eating easier to stick with.

2. Movement: your muscles use the sugar 

Muscle is one of the biggest users of blood sugar in your body. When your muscles work, they pull more sugar out of your blood. A strong plan includes:

• Cardio, like brisk walking or cycling, for your heart and blood sugar
• Strength training to build and keep muscle
• Everyday movement, like taking the stairs and sitting less

Even a short walk after meals makes a difference.

3. Sleep: metabolic health happens at night too

Poor sleep affects hunger, stress hormones, food choices, and blood sugar. You can be eating well and exercising and still struggle if you're not sleeping well. Ask yourself:

• How many hours am I sleeping?
• Do I wake up feeling rested?
• Do I snore heavily or feel very sleepy during the day?

4. Stress: your mind and metabolism are connected

Ongoing stress affects sleep, eating habits, and blood sugar. Managing stress doesn't mean removing it from your life. It means building your ability to handle it. Regular exercise, breathing exercises, time outdoors, time with people you care about, counseling, and short breaks during the day can all help.

5. Medication: a tool when it's needed

Lifestyle change is the foundation, but medication isn't a failure. Depending on your blood sugar, weight, heart and kidney health, and other conditions, your doctor may recommend it. The best plan isn't lifestyle or medication. It's the right mix of nutrition, movement, sleep, stress management, and medical care for you.

Don't wait for symptoms

Prediabetes gives you something valuable: time. Time to improve how you eat, build strength and fitness, sleep better, manage stress, and, when needed, start treatment before problems develop.

The first step is knowing where you stand. Take the one-minute CDC risk test today. If your results show higher risk, or if you have risk factors like extra weight, a family history of diabetes, high blood pressure, low activity, past gestational diabetes, or fatty liver, talk with your doctor about screening.

At Health 360 Wellness, our physician-led team, including a registered dietitian, exercise specialist, and behavioral health specialist, helps patients find what is driving their blood sugar and build a plan to turn it around. Book a $99 Discovery Visit or call (901) 494-6066.

Prediabetes is a warning sign. It's also your chance to act.

This article is intended for general health education and does not replace individualized medical evaluation, diagnosis or treatment