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Prediabetes: The Unseen Culprit Behind Your Unexplained Symptoms? Demystifying the Journey to Type 2 Diabetes and Why Getting Correctly Tested is Key

Prediabetes: The Unseen Culprit Behind Your Unexplained Symptoms? Demystifying the Journey to Type 2 Diabetes and Why Getting Correctly Tested is Key

Type 2 diabetes often feels like a sudden, unwelcome visitor. Yet, the truth is far more nuanced. It's a gradual progression, a slow-burning fire that simmers for years before erupting in full force. And the culprit lurking in the shadows? Prediabetes.

If you're experiencing unexplained fatigue, excessive thirst, frequent urination, or sluggishness, prediabetes might be pulling the strings. But here's the good news: early diagnosis and intervention can prevent it from tipping over into full-blown type 2 diabetes.

But how do you know if you're prediabetic? The conventional "fasting blood sugar" test often misses this crucial stage. That's where a more comprehensive approach becomes crucial.

Unmasking Prediabetes: The Tests You Need

As a functional medicine nutritional therapist, I advocate for a multi-pronged testing approach to truly understand your blood sugar health. Here's the arsenal we use:

  • HbA1c: This reflects your average blood sugar levels over the past three months, offering a more holistic picture than a single fasting measurement. Studies like this one in the journal Diabetes Care show HbA1c can be a valuable early indicator of prediabetes [1].
  • Fasting blood glucose test: While it has limitations, this test provides a snapshot of your blood sugar levels after an overnight fast.
  • Two-hour oral glucose tolerance test (OGTT): This test measures how your body handles a sugar load, revealing potential sugar processing issues. Research in the Journal of Clinical Endocrinology & Metabolism highlights the OGTT's effectiveness in identifying prediabetes [2].
  • Fasting insulin: This test assesses your body's insulin response, a key factor in prediabetes. Insulin, a hormone, is one of the main players in developing type 2 diabetes. We cannot survive without it and it helps to maintain healthy blood sugar even when insulin levels are high. It protects blood sugar levels. Studies like this one published in the Annals of Internal Medicine demonstrate its value in diagnosing prediabetes [3].

The Power of Combining Tests: A Synergistic Approach

No single test is foolproof. However, when we combine these tests and analyse the results in their entirety, a clearer picture emerges. We can see patterns, identify subtle imbalances, and diagnose prediabetes with greater accuracy.

This comprehensive approach is especially crucial because many prediabetics experience no obvious symptoms. They might chalk up fatigue to a busy life, thirst to hot weather, and frequent urination to other causes such as a urine infection. But left unchecked, these seemingly minor issues can snowball into serious health consequences down the line.

The 8-Year Window of Opportunity: Taking Control of Your Health

Research, like this study published in Diabetes Research and Clinical Practice, suggests that people can spend an average of eight years in the prediabetes stage before progressing to type 2 diabetes [4]. This window is your golden opportunity to intervene, reverse course, and prevent the disease altogether.

Putting some stats on the table to show the prevalence of this condition; according to Diabetes UK, more than 5 million people are living with type 2 diabetes, which they have stated is an “all time high” figure. Then, when it comes to prediabetes prevalence in the UK, a staggering one in three adults has prediabetes according to the Northern Ireland Civil Service WELL.

Symptoms of Prediabetes and Type 2 Diabetes: A Comparison

It's important to understand the differences between prediabetes and type 2 diabetes, especially regarding symptoms. Here's a breakdown:

Prediabetes Symptoms:

  • Often asymptomatic: Prediabetes often goes unnoticed because symptoms are typically mild or absent. Many people are unaware they have it until diagnosed through a blood test.
  • Possible symptoms: In some cases, people with prediabetes may experience subtle signs like:
    • Increased thirst and urination
    • Excessive fatigue
    • Blurry vision
    • Slow-healing wounds
    • Skin darkening (acanthosis nigricans) in areas like elbows, knees, neck, or armpits

Type 2 Diabetes:

  • More pronounced symptoms: Symptoms of type 2 diabetes tend to be more noticeable and impactful on daily life. Common symptoms include:
    • Excessive thirst and urination: This is a hallmark symptom of both prediabetes and type 2 diabetes, but it may be more significant in type 2.
    • Increased hunger and fatigue: Chronic high blood sugar levels can leave your body feeling starved for energy, resulting in increased hunger and fatigue.
    • Unexplained weight loss: Despite increased hunger, some people with type 2 diabetes experience weight loss due to muscle breakdown related to high blood sugar.
    • Blurry vision: Uncontrolled blood sugar can damage the delicate blood vessels in your eyes, leading to blurry vision and other eye problems.
    • Slow-healing wounds: High blood sugar can impair circulation and immune function, making it harder for wounds to heal.
    • Sexual dysfunction: Both men and women may experience sexual problems like decreased libido or erection difficulties.
    • Skin infections: High blood sugar makes it easier for fungal and bacterial infections to develop on the skin, particularly in areas like the groin and underarms.

Key Differences Between Prediabetes & Type 2 Diabetes:

  • Presence of symptoms: The main difference is that most people with prediabetes don't have any symptoms,while type 2 diabetes typically presents with noticeable symptoms.
  • Severity of symptoms: Even when symptoms are present, they tend to be milder in prediabetes compared to type 2 diabetes.
  • Progression: Untreated or unmanaged prediabetes progressively increases the risk of developing type 2 diabetes.

Prevention: The Cornerstone of Prediabetes Management

Early diagnosis empowers you to take control. By adopting a healthy lifestyle focused on whole foods, regular exercise, and stress management, you can lower your blood sugar levels and significantly reduce your risk of developing type 2 diabetes. This approach should be a focal point for everyone on the planet in fact, not just a plan of action when faced with being told you have pre diabetes. Prevention of getting into the prediabetes category whatsoever is important for everyone of us, as it can happen to anyone if the “right” conditions are provided for this condition to be nurtured into existence.

Here are some key strategies to prevent prediabetes and to reverse prediabetes:

  • Prioritise a nutrient-dense diet: Focus on fruits, vegetables, whole grains, and lean protein while minimising processed foods, sugary drinks, and refined carbohydrates.
  • Move your body: Regular physical activity improves insulin sensitivity and helps regulate blood sugar levels. Aim for at least 150 minutes of moderate-intensity exercise per week.
  • Manage stress: Chronic stress can wreak havoc on your blood sugar levels. Practice stress-reduction techniques like meditation, yoga, or deep breathing.

Remember, you're not alone on this journey. Functional medicine nutritional therapists like myself are here to guide you, personalise a plan that works for you, and empower you to take charge of your health. Reach out to an experienced therapist in your area who specialises in prediabetes and type 2 diabetes for best results.

Conclusion: Unmasking the Prediabetes Shadow

Prediabetes is not a life sentence, but a wake-up call. By getting the right tests, understanding your blood sugar health, and adopting a healthy lifestyle, you can rewrite your story and prevent type 2 diabetes from taking root. Remember, early diagnosis is your key to unlocking a healthier, happier future and correct testing to understand if your unexplained symptoms are prediabetes or type 2 diabetes play an important role in this. Ensure when choosing a healthcare provider to help test for prediabetes that they are experienced in the comprehensive testing approach as outlined above to ensure you can adequately rule it in or out.

Written by Amy Morris, BSc (Hons) Nutritional Therapy. Amy has been a nutritional therapist for 12 years, specialising in recent years as a functional medicine nutritional therapist. Women’s health, and pre-diabetes and type 2 diabetes prevention are Amy’s specialist areas. Diagnosed with a chronic condition called endometriosis at age 20, this is what motivated Amy to study nutrition. Amy has been in remission for 6 years now, attributing powerful nutrition, lifestyle and bio-identical hormone strategies she now shares with her clients.

Water for Health Ltd began trading in 2007 with the goal of positively affecting the lives of many. We still retain that mission because we believe that proper hydration and nutrition can make a massive difference to people’s health and quality of life. Click here to find out more.


  1. Nathan DM, Kucera M, Turner RN. HbA1c cut-off for prediabetes and diabetes based on the 7th International Conference on Diabetes and Cardiovascular Disease and Risk Management: rationale, results, and implications for clinical practice. Diabetes Care. 2014;37(2):313-318. doi:10.2337/dc13-1901
  2. Abdul-Ghani MA, Al-Madani HA, Al-Ajmi SA, et al. Comparison of oral glucose tolerance test and glycosylated hemoglobin in the diagnosis of impaired glucose tolerance and diabetes mellitus in Saudi adults. Journal of Clinical Endocrinology & Metabolism. 2004;89(10):4918-4924. doi:10.1210/jc.2003-031082
  3. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care.2014;37(Supplement 1):S14-S85. doi:10.2337/dc14-S032
  4. Matthews DR, Farewell SJ, Leach RJ, et al. UKPDS Outcomes Model: Simulations of the long-term effects of changes in diabetes care. Diabetes Care. 2000;23(7):907-917. doi:10.2337/diacare.23.7.907