Understanding Prediabetes And Why It Leads To Type 2 Diabetes

A diagnosis of prediabetes doesn’t mean you’ll spend the rest of your life jabbing a needle in your thigh before every meal. Because let’s face it, that’s a distressing thought. And we probably all know someone for whom that is their reality.

Marie couldn’t hear a single word her daughter was saying.

Behind the wheel of her small SUV as she drove her kids home from school, all she could hear were the words her doctor had said just 2 hours ago. Repeating themselves. Over and over. In her head.

“Marie, you have prediabetes. And if you don’t take action now, you could end up with type 2 diabetes…”

“How could this be?” she thought to herself.

I mean, she’s not that overweight. Or that unhealthy… is she?

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As her daughter’s voice continued unabated from the back seat, Marie reflected on the last decade or so of her life. It had certainly changed over the years. A busy job and two kids sure make life different!

If she wanted to be totally honest with herself, she’d be the first to admit that her weight has crept up with each passing year. It probably didn’t help that the odd trip through the drive-thru had somehow turned into one or two, or maybe even three weekly meals. But everyone eats fast food! And a couple meals a week isn’t so bad, right?

But then there’s the fries. Which she often gets at lunch. They smell so good when she walks into the cafeteria at her work. She’s friends with the chef and he always flags her down when he makes a fresh batch and hooks her up with a sizable portion. How can she refuse? 

Plus, with two kids to get ready for school and make lunches for, Marie almost never has time to make lunch for herself. 

And I’m sorry, but that salad bar certainly doesn’t hold a candle to the smell over by the deep fryer. Or that yummy chicken tostada with extra cheese, sour cream and tortilla chips with a regular soda. And she learned at a young age to clear her plate. Because we can’t waste food, can we?

And speaking of the kid’s lunches, stealing a cookie here and there while packing them up  to snack on was getting to be routine. It took the edge off her stress. She’s managing so much. All of the responsibility falls on her as she is divorced. She’s the matriarch and has to hold it together for everyone – so she short changes herself.

And exercise? Pfft! That’s pretty much gone out the window, too.

Marie used to love going for long morning walks and attending her local Pilates class. But that was before the kids. Now she’s so tired in the morning she barely gets out of bed in time to prep the kids for school, drop them off, and get to work on time!

And forget about the after-work Pilates class. That’s been replaced with dinner prep, helping the kids, household chores, and time in front of the TV or on her phone. Or worse, nose deep in her laptop because who doesn’t take a little bit of work home? Especially on the weekends.

Marie thinks, “I chase kids around all day. Isn’t that enough?”

Unfortunately, it’s not. And all these little things. These little cut corners and carb-based coping methods, well, they’re sneaky little buggers and they can add up over time.

Sadly, I hear stories like Marie’s from clients all the time. It’s the little things that seem innocent on their own, but when combined and compounded over time – have a very big impact on our health.

So if you’ve found yourself in a similar situation to Marie, don’t despair. You are far from alone and it doesn’t have to mean you’re speeding down a one-way street that ends with type 2 diabetes.

But, you knew there was a “but” coming, right? It means you COULD be heading down that road.

With a diagnosis of prediabetes, you’ve found yourself pointed in that direction. But you can change that. If you can take the time now to understand what prediabetes is, why you have it, and how you can reverse it. Which is exactly what we’re going to explore here today.

Understanding Prediabetes

A diagnosis of prediabetes doesn’t mean you’ll spend the rest of your life jabbing a needle in your thigh before every meal. Because let’s face it, that’s a distressing thought. And we probably all know someone for whom that is their reality.

It scares us, and it should. But not for the reason you may think. Most people freak out about needing insulin when prediabetes progresses to type 2 because they fret over needing to take the hormone and that it can causes weight gain or low blood sugars. 

What you’re most likely not considering, is the significant amount of more time, and resources to juggle and manage it all. That kind of time commitment and brain space needed to think like a pancreas is intense.

Instead, if you do learn that you have prediabetes, count yourself lucky!

Yeah, lucky! Lucky in the sense that you have received an early warning that not everyone gets the benefit of. You now have the option to modify your lifestyle and reverse the symptoms – all because you know about your risk early… before it becomes life-altering.

Because prediabetes generally has no signs or symptoms it’s easy to skip right over it like it’s nothing and move straight into type 2 diabetes (which we’ll talk about later in the post). It’s why I recommend regular checkups with blood work. Particularly if you notice your pants getting tighter or you’ve had to jump up a few sizes in the last year or so. 

But also, if you have a first degree relative with type 2 (think parents, sibling) or you were ever diagnosed with gestational diabetes or high blood pressure, or are over the age of 45, or are a person of color, or aren’t physically active.

It’s also why I recommend that if you do have prediabetes, that you keep on reading. 

Because with a bit of work and gentle guidance, you can turn things around. You can regain control. And you can change your future outlook when it comes to prediabetes.

Now hold on. Because I know it’s tempting to drink a soda mid-afternoon to beat the 3pm lull. It’s so satisfying to pull back the tab and hear that carbonated sizzle. To feel the bubbles tickle your throat as you take your first sip. It’s the high that gets you through the afternoon, right?

And once evening rolls around. It’s just easier to grab something quick, like a couple of pizzas on the way home because the kids are starving and you ran out of time to pop into the grocery store during your lunch. Plus, it’s pizza! And pizza is de-l-i-cious! And your kids think you’re a superhero when you bring home pizza! Who doesn’t want to enjoy a few pieces and feel like you’ve won Most Awesome Parent?

Unfortunately, the reality is that these little habits are what lead to prediabetes and ultimately leave you asking, just like Marie, where it all went off the rails.

What Exactly Is Prediabetes?

Well, it’s not type 2 diabetes. Yet. And it has no outward signs or symptoms. So what is prediabetes if it’s not diabetes-lite?

The language can be confusing so I’ll explain it as simply as I can.


Your body converts all food. We use this for energy. That’s how we move, it’s how we think, it’s what enables us to get up from the couch and head out for an after-dinner stroll.

In your abdomen, you have an organ called a pancreas. Its job is to release the hormone called insulin. When insulin is released by the pancreas, it helps move the sugar from your blood into your cells which lowers your blood sugar. That’s why people with diabetes or high blood sugar often need to take supplemental injections of insulin. They need additional insulin to lower their elevated blood sugar levels.

But what happens when you have prediabetes? One of two things:

  • your body becomes resistant to the insulin in your system (meaning, the
    insulin you have isn’t working like it should)
  • your body then makes extra insulin for a limited amount of time to try to overcome this resistance.

When this is happening in your body those sugars stay in your bloodstream (which is not good for you!) and can eventually damage other organs like your heart, brain and kidneys. Prolonged high blood sugar can also destroy the tiny blood vessels in your eyes which if left undetected can lead to blindness, and can cause nerve damage which can lead to serious problems with your extremities, especially your feet.

As you may be able to tell by now, it really is critical to take your prediabetes diagnosis seriously. The potential complications that can develop are troublesome to treat and manage so your best defense is to be proactive now.

If you’ve been diagnosed with prediabetes for a while, don’t dwell on anything you may not have done to this point. It won’t help. Focus instead on what you can start doing to care for yourself today and tomorrow. That’s where the positive changes can be found.

Possible Effects Of Diabetes On The Body

How Did You Get Prediabetes?

The exact cause of prediabetes is unknown, but there are several factors that can lead to it. And just like it did for Marie, prediabetes can creep up fast.

A decade can pass swiftly when you’ve got a busy life with kids, a demanding job, and relationships to manage, bills to pay, problems to solve, people to care for.

Suddenly you realize you haven’t done intentional exercise in years, your waistline has expanded, and you honestly can’t remember the last time you ate a salad for dinner.

Let’s explore some possible risk factors that often herald the arrival of prediabetes.

Too Much Sugar Leading to Weight Gain

I mentioned earlier in this article you have an organ called the pancreas that releases a hormone called insulin. If you eat too much sugar, your pancreas works overtime to try to keep up with oozing out insulin. 

And if you bring in more calories from high sugary and fatty foods, and you’re not getting enough exercise, your weight will go up. That’s what causes your body to not use your own insulin well and  you end up with high blood sugar.

When this is happening and you’re still consuming more high sugar or processed foods, like Marie’s daily afternoon soda, you can quickly end up with prediabetes because the extra sugar has nowhere to go. It just hangs out in your bloodstream causing damage with every pump of your blood.

Think of high sugar kind of like syrup (not that your blood is syrup but so you get the concept). It does not cause damage immediately. 

But as your thickened blood flows through your body over time, it can increase the amount of plaque that lays down in your blood vessels. If you eat a high fat diet, it can add to that, and if you have high blood pressure, yikes – the trifecta risk for heart attacks and strokes.

That is, in essence the long-term effect of high blood sugar, which is what prediabetes and diabetes is in its simplest form. The difference between the two being that diabetes is just more so.

Little to No Exercise

It happened to Marie and it happened without her even noticing.

One missed morning walk soon turned into two. 

And two turned into three. 

And ultimately, three missed morning walks turned into ten years of missed walks. It can happen to any one of us.

No one is faulting Marie for missing a walk or two. Life got busy and it’s hard to fit it all in. Sometimes something has to give. Sometimes you need to choose your child’s assembly at school or an extra hour of sleep over a workout. 

But it’s when those “sometimes” become “all the time” that you start running into trouble. And very hard to see that when it’s happening to you over an extended period.

A gradual decline in exercise while still consuming the same amount of food or replacing home-cooked meals with fast food burgers, fries, and pizza can transform your life. 

And suddenly you wake up one morning and wonder where that extra 25 pounds came from?

Putting regular exercise on the back burner is too easy. We all do it from time to time. You promise yourself you’ll get back to it later or next week or after the holidays. When work slows down for sure! Or the kids get a bit older. But when you’ve been diagnosed with prediabetes putting exercise on the backburner can put you at risk for type 2 diabetes.

And what if you don’t even know you have prediabetes? What if you’re one of the 84 million Americans have prediabetes who don’t even know they have prediabetes? How are you supposed to know if you don’t know? Know what I mean?

Blame Your Parents

The role of genetics in prediabetes and type 2 diabetes can be a bit confusing. That’s mostly because it’s not as cut and dry as other clearly genetically-based diseases. 

And just to be clear, type 1 diabetes is different altogether. We’re focusing on type 2 and prediabetes specifically.

So yes, you can be born with a higher susceptibility for prediabetes and diabetes. But, even if you are in that group, it doesn’t guarantee you’ll get either one. Lifestyle has a tremendous influence on both of these conditions.

Let’s say you have the genetic predisposition and you don’t get much exercise, you carry some extra weight, eat a lot of processed or fast food, and experience a lot of stress in your daily life. Then both factors – genetics and lifestyle – are working against you and your likelihood of developing prediabetes is much higher.

And if left unchecked, your risks for advancing from prediabetes to type 2 diabetes also increases.

In Marie’s case, it could be a that two-fer combo, but based on what we know about her habits, lifestyle most likely played the biggest role in her prediabetes diagnosis.

How Likely Is It You’ll Develop Type 2 Diabetes?

According to the Centers for Disease Control, up to 70 percent of people who have prediabetes will eventually develop type 2 diabetes.

If you’re looking to determine who likely it is that your own prediabetes will advance to diabetes, complete our checklist to see how many of the risk factors you have right now. The more items you check, the greater your risk.

  • You’re over age 45
  • You get little or no physical activity
  • You have a family history of diabetes
  • You have high blood pressure or high cholesterol, or a family history of it
  • You have been diagnosed with heart disease or polycystic ovary syndrome (PCOS)
  • You had gestational diabetes during one or more pregnancies or you delivered a baby weighing more than nine pounds
  • You have more than 2 alcoholic drinks a day if you’re male, or one if you’re female
  • You’re overweight
  • You’re male
  • You belong to any one or more of the following ethnic groups: African American, Native American, Hispanic, Asian American, Native Hawaiian or Pacific Islander
  • You smoke or vape cigarettes or are exposed to second hand smoke
  • You belong to the sexual minority (LGBT)

Even if you checked off a few boxes, that’s okay.

You can still choose to make positive changes to the things you can control and see a reduction in your risk and improvement in your health. I know that’s important to you. Because you’re here reading this.

So to get started with those changes, I’ve put together a quick overview of the 3 biggest, most impactful changes you can make. Address these 3 areas and you’ll have the best possible chance of reversing your prediabetes or postponing the onset of type 2 diabetes.

  1. Replace unhealthy processed food with real, whole foods.
    Sure it might take a bit of extra work to shop and prepare, but your health depends on it. And there are plenty of grocery delivery options and even full-on meal preps services to help you get started.
  2. Incorporate exercise into your daily routine.
    Whenever possible, walk to work or opt for the stairs instead of the elevator. Start off small and slowly increase the frequency and intensity. Exercise is beneficial beyond helping to reverse prediabetes. It also releases dopamine which makes you feel happy and helps you manage your weight.
  3. Manage your weight.
    You knew this one was coming, right? But even losing just a few pounds, especially around your waist, can greatly help to reduce the chances of developing type 2 diabetes. And focusing on actions 1 and 2 above will help you accomplish number 3 naturally!

I hope this article helps you understand how your prediabetes came to be, what it is, and how you can manage and reverse it before it progresses into a more permanent condition. Remember, being diagnosed with prediabetes gives you a heads up that over 75 million other Americans who have prediabetes don’t get. So take that advantage and turn it into a winning game plan for yourself and your family.

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3 Comments on “Understanding Prediabetes And Why It Leads To Type 2 Diabetes

September 13, 2019 at 9:17 am

Very insightful, Theresa. Thank you so much for being an eye opener. Your strategy of sending this on a Friday is great because most of us have come to the end of a work week where plans are coming for the weekend to enjoy time with families. I guess it’s high time to take back some of the time for myself! I only have one daughter, already an adult, yet still not having enough time for myself. Nevertheless I salute moms for sacrificing a lot…

Marlene Maxwell
January 4, 2021 at 4:50 pm

Thank you Theresa for the motivation and the knowledge. I am a Registered Nurse and didn’t know that I was pre diabetic until approximately one year ago. I managed to lose 13.5 pounds over 2020 and exercise 30 minutes at least 5 days per week. I struggle with knowing what I can or cannot eat. To complicate things 6 months ago I learned I have chronic kidney disease. Now I’m stressing over what I should eat so I don’t hurt my kidneys. I am motivated to do whatever will help. Thank you again. I am interested in recipes that I can follow to change my menu up.

Theresa Garnero
January 7, 2021 at 12:47 pm

Thanks for writing, Marlene. I hope given your new diagnosis, you’re working with a registered dietitian to get you a specific plan to keep your kidneys safe!


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