Pre-diabetes: Are you at risk?

Diabetes Australia estimates 2 million Australians have pre-diabetes. Left untreated, pre-diabetes can develop into Type 2 diabetes, which can have serious health consequences. Most people with pre-diabetes aren’t even aware they have it.

Are you one of them?

What is pre-diabetes?

Pre-diabetes means your blood glucose levels are higher than normal, but not high enough for you to be classified as diabetic. A diagnosis of pre-diabetes is a warning sign that should be heeded, as it means you’re likely to develop Type 2 diabetes in the future unless you take preventative action now.

The condition occurs when your insulin (the hormone that helps convert sugars from food into energy) isn’t working properly, and can’t transport the glucose from your blood into your body’s cells where it needs to be to be converted into energy. This is known as insulin resistance.

Do you have pre-diabetes?

How do you know if you have pre-diabetes? You can take a blood test, but the first thing to do is to check if you have any of the following risk factors:

  • Do you have a family history of diabetes?
  • Are you overweight?
  • Do you have a low level of physical activity?
  • Do you have a high triglyceride level and low HDL cholesterol level and/or high total cholesterol?
  • Do you have high blood pressure?
  • Do you have Polycystic Ovarian Syndrome and are you overweight?
  • Have you had gestational diabetes (diabetes during pregnancy) previously, or given birth to a baby weighing more than 4.5 kg?
  • What is your ethnic background? Aboriginal and Torres Strait Islanders, Pacific Islanders, Asians and Indians are at higher risk of developing diabetes.

If you answered “yes” to two or more of these questions, you’re at risk of pre-diabetes.

Why should you be concerned about pre-diabetes?

Left unmanaged, pre-diabetes can develop into Type 2 diabetes within five to ten years. The Australian Institute of Health and Welfare reports nearly 950 000 Australians aged 25 or above had diabetes in 1999-2000.  Unfortunately, this trend is an upwards one, with Diabetes Australia revealing there are now around 1.7 million cases of diabetes in Australia.

The best way to put the brakes on these dramatic figures is through early diagnosis and treatment of those at risk for pre-diabetes. Studies in diabetes prevention have shown if people are diagnosed and treated for pre-diabetes, their chances of developing Type 2 diabetes decrease dramatically. For some people with pre-diabetes, intervention can actually reverse the clock and return elevated blood glucose levels to within the normal range. This is why it’s so important to get checked out if you think you’re at risk.

Testing and diagnosis

If you suspect you may have pre-diabetes, speak with your doctor, who can order a fasting plasma glucose test (FPG). As the name suggests, you’ll need to fast before this test.

The FPG test will show three possible diagnoses:

1.Diabetes unlikely – if you have a reading of less than 5.5 millimoles of glucose per litre of blood (mmol/l);

2.Pre-diabetes – between 5.5 mmol/l and 6.9 mmol/l;

3.Type 2 diabetes – 7mmol/l or more.

If your FPG test returns a reading of between 5.5 and 6.9mmol/l, your doctor will perform a further test, an Oral Glucose Tolerance Test (OGTT). You’ll be given a glucose-rich drink and, two hours afterwards, the changes in your glucose levels will be measured.

If either glucose test indicates you have diabetes, and you hadn’t shown symptoms of diabetes before the test, your doctor will perform a confirmation test on a separate day.

Should you take the test?

If you are more than 45 years old and:

  • are obese, or
  • have high blood pressure (hypertension), or
  • have a family history of diabetes,

it’s recommended you have your blood glucose level checked every three years.

If you are younger than 45, but have one or more risk factors for pre-diabetes, you should also have your blood glucose level tested.

If your FPG test showed you were within the range for pre-diabetes, but the follow-up (OGTT) test failed to confirm it, you should be retested after one year.

If you’re diagnosed with pre-diabetes, you should have a FPG test every year.


The good news about pre-diabetes is that it can be treated, with effective treatment able to delay or even prevent the onset of Type 2 diabetes.

Whether you want to prevent pre-diabetes or reduce your chances of it progressing into Type 2 diabetes, the advice from Diabetes Australia is the same: You need to make changes to your lifestyle by doing regular physical activity and eating healthily.

Here are some tips for making these lifestyle changes:

  • Eat foods that are low in fat and high in fibre, such as fruits and vegetables, beans, wholegrain breads and cereals
  • Space your meals evenly throughout the day
  • Aim for at least 30 minutes of moderate physical activity most days of the week
  • Remember to talk to your doctor before starting any new type of exercise to ensure it’s suitable for you
  • Reduce your weight by 5 to 10% – even minor weight loss has been found to make a big difference to the impact of pre-diabetes
  • Maintain your weight loss
  • Include the whole family in your lifestyle changes – look after the future health of your children by teaching them healthy behaviours and habits.

Remember, if you have pre-diabetes, you can take action to manage your blood glucose now and prevent Type 2 diabetes from ever developing. It’s in your hands!


This article was compiled in consultation with health experts and in reference to the following sources:

Diabetes Australia, ‘What is diabetes?’


Diabetes Australia, ‘National Evidence-Based Guidelines for the Management of Type 2 Diabetes Mellitus’

Australian Institute of Health and Welfare, ‘Australia’s Health 2006’

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