An overwhelming 1 in 4 Australians aged 25 years and over suffer from pre-diabetes (impaired glucose metabolism), and if left untreated it can develop into Type 2 diabetes. However, it’s a condition that doesn’t show warning signs or symptoms!


Pre-diabetes is a condition where blood glucose (sugar) levels are higher than normal, but not high enough to be classified as Type 2 diabetes. It affects nearly 1 in 4 Australians aged 25 and over. People with Pre-diabetes have a higher risk of developing Type 2 diabetes and Cardiovascular disease. Without lifestyle changes, approximately 1 in 3 people with pre-diabetes will develop Type 2 diabetes.

Type 2 diabetes is a condition in which blood glucose levels are higher than normal because the body is unable to produce sufficient insulin, or the insulin it produces is unable to work as effectively in the body (insulin resistance). Insulin is the hormone that is needed to move glucose from the blood into the cells for energy. A lack of insulin leads to raised blood glucose levels. Type 2 diabetes is a serious and chronic medical condition that over time can lead to long-term damage of nerves and blood vessels, kidneys, heart, eyes and feet.


Pre-diabetes can be divided into two conditions – Impaired Fasting Glucose (IFG) and Impaired Glucose Tolerance (IGT).

Impaired Fasting Glucose is a pre-diabetes condition that occurs when too much glucose is released into the bloodstream from the liver overnight. The liver is mainly responsible for keeping a proper supply of glucose in the blood and to the body when we have not eaten for several hours (after food has been absorbed). In IFG the liver does not respond normally to insulin and this is called ‘hepatic insulin resistance’

Impaired Glucose Tolerance is a pre-diabetes condition that occurs when the rise in blood glucose after eating carbohydrate foods is greater than normal. The fasting blood glucose level is normal or moderately raised.



Pre-diabetes is diagnosed by pathology tests to check blood glucose levels. Any glucose test, fasting or not, that shows higher than normal blood glucose levels, needs to be checked further.

Generally, an Oral Glucose Tolerance Test (OGTT) is performed to find out more about the patient’s glucose metabolism. The results of this laboratory test show four possible diagnoses: normal glucose levels, impaired fasting glucose, impaired glucose tolerance, type 2 diabetes.

An Oral Glucose Tolerance Test (OGTT) involves:

* Taking adequate carbohydrates (150g) for 3 days prior to the test  

* After not eating for 8 hours, a blood sample is taken from the vein, usually in the arm  

* A sweet drink that contains 75g of glucose is given  

* Blood glucose is checked, again by taking blood from the arm, 2 hours after taking the glucose drink.


IFG is diagnosed when the fasting blood glucose level is 6.1mmol/L or more but less than 7mmol/L and the blood glucose level 2 hours after having the glucose drink is less than 7.8mmol/L. IGT is diagnosed when blood glucose levels 2 hours after having the glucose drink is more than 7.8mmol/L but less than 11mmol/L. A result above 11mmol/L indicates diagnosis of diabetes.



Pre-diabetes has no signs or symptoms. It is important to be aware of the risk factors and have your blood glucose levels checked by a blood test ordered by your doctor if you are at risk.

Risk factors for developing Pre-diabetes are similar as for Type 2 diabetes and include:


* A family history of Type 2 diabetes and/or heart disease  

* Being overweight and obese, especially those who have excess weight around the waistline (i.e. more than 94cm for men and more than 80cm for women).  

* Low level of physical activity  

* Smoking  

* High blood pressure  

* High triglycerides and low HDL-C (good cholesterol and/or high total cholesterol  

* Cardiovascular disease  

* People of Indigenous and Torres Strait Islander backgrounds  

* People of certain ethnic backgrounds such as the Pacific Islands, Asia and the Indian sub-continent.  

* Women who have had diabetes in pregnancy (gestational diabetes) or given birth to a baby more than 4.5kg  

* Women with Polycystic Ovary Syndrome




Evidence shows that people with pre-diabetes are at high risk of progressing to type 2 diabetes. However, by adopting a number of lifestyle changes, pre-diabetes can be reversed and/or the risk of type 2 diabetes reduced or delayed. A diagnosis of pre-diabetes should thus be seen as a warning sign that allows lifestyle changes to be made before developing into a more serious condition.

Healthy Eating - A healthy eating plan for losing weight and reducing the risk of type 2 diabetes should include a reduction in total energy (kilojoule) and fat intake, particularly saturated fat foods such as butter, full fat dairy products, fatty meats, takeaway foods, biscuits, cakes and pastries. Instead choose a wide range of high fibre, low GI carbohydrate foods such as wholegrain breads and cereals, legumes and fruit. To work out a meal plan that’s right for you, see a dietician.


Regular physical activity - Regular physical activity helps your body to use insulin better and uses more glucose for energy limiting the sugar from building up in your blood. Aim to do at least 30 minutes of moderate intensity physical activity (such as brisk walking or swimming) on most, if not all, days of the week OR three 20-minute sessions of vigorous intensity exercise per week (such as jogging, aerobics class, strenuous gardening). Try to include some resistance training twice a week to improve the way your muscles work, such as body weight exercises or lifting weights.


Losing weight (if necessary) – Losing as little as 5-10% of your body weight and keeping it off can help reduce the risk of Type 2 diabetes. Weight reduction helps the body to become more sensitive to insulin and use glucose more effectively. Find weight loss products here.


Stop smoking – Smoking causes insulin resistance and increases the risk of vascular disease. Smoking cessation can be aided by nicotine replacement therapy such as Nicorette and Nicabate