Q. How can a blood test determine if I have prediabetes? How much weight do I need to lose to bring my numbers down?
A. Doctors typically perform one of three blood tests to diagnose prediabetes, a condition marked by blood sugar (glucose) levels that are higher than normal but not high enough to qualify as diabetes. While prediabetes often leads to full-fledged Type 2 diabetes, many people can hold the condition in check if they lose a relatively small amount of weight and increase their physical activity, said Dr. Rhonda Bentley-Lewis, an assistant professor of medicine at Harvard Medical School. “I stress to my patients that we’re not talking about a huge amount of weight,” she said, “just 5 to 7 percent of one’s body weight” — or 10 to 14 pounds for someone who weighs 200 pounds.
Two of the tests require fasting, which helps prevent results being distorted by a prior meal and provides “an even baseline,” Dr. Bentley-Lewis said. One, the fasting plasma glucose test, checks blood glucose levels after an 8 to 10 hour fast; results of 100 to 125 milligrams per deciliter indicate prediabetes. The other, the oral glucose tolerance test, is the most sensitive. It checks blood glucose levels after fasting and then two hours after you consume a sweetened drink; levels of 140 to 199 after the drink indicate prediabetes.
A third test, the A1C test, may be the most convenient because it doesn’t require fasting. It measures your average blood glucose levels over the past two to three months; results of 5.7 percent to 6.4 percent, which indicate the percentage of red blood cells that have glucose attached to them, indicate prediabetes.
Though doctors often repeat a test to confirm a diabetes diagnosis, they do not always do so for a prediabetes diagnosis, Dr. Bentley-Lewis said.
Doctors can treat prediabetes with medication, but many patients prefer to try weight loss and exercise first, Dr. Bentley-Lewis said. Among thousands of people with prediabetes who participated in a national study called the Diabetes Prevention Program, 58 percent of those who adopted lifestyle changes, like losing a modest amount of weight, stepping up physical activity and reducing the amount of fat and calories in their diets, were able to prevent progression to full-blown diabetes.