What is Prediabetes? A Clinician’s Perspective

What is Prediabetes? A Clinician’s Perspective

At Sheen Vein (Aesthetics and Functional Medicine) in St. Louis, one of the most common metabolic conditions we diagnose is prediabetes. Many people are surprised to learn they have it, because they feel relatively well and have no obvious symptoms. Unfortunately, prediabetes is often a “silent” condition—and without intervention, it can progress into type 2 diabetes, with much greater health risks.

The good news is that prediabetes is also one of the most reversible conditions we treat. With the right approach, it’s possible to restore healthy blood sugar balance and prevent long-term complications. In this article, I’ll explain what prediabetes is, how it develops, what warning signs to look for, and how both conventional and functional medicine address it.

What is Prediabetes?

Prediabetes is a state where your blood sugar levels are higher than normal, but not yet high enough to qualify as diabetes. It reflects a growing problem with insulin resistance—the body’s inability to use insulin effectively to move sugar out of the bloodstream and into cells.

Think of it as the “yellow light” on the traffic signal. It’s your body’s warning sign that your metabolism is under stress, and action is needed before things worsen.

How is Prediabetes Diagnosed?

Doctors typically use three tests to diagnose prediabetes:

  • Fasting blood sugar:
    • Normal: < 100 mg/dL
    • Prediabetes: 100–125 mg/dL
    • Diabetes: ≥ 126 mg/dL
  • Hemoglobin A1c (average blood sugar over 3 months):
    • Normal: < 5.7%
    • Prediabetes: 5.7–6.4%
    • Diabetes: ≥ 6.5%
  • Oral glucose tolerance test (2-hour value after drinking glucose):
    • Normal: < 140 mg/dL
    • Prediabetes: 140–199 mg/dL
    • Diabetes: ≥ 200 mg/dL

Many patients discover prediabetes during routine annual lab work, even though they don’t feel unwell.

Symptoms of Prediabetes

Prediabetes often causes no symptoms at all, which is why it can go unnoticed for years. However, some subtle clues may include:

  • Fatigue or afternoon energy crashes
  • Brain fog or difficulty concentrating
  • Increased thirst or frequent urination
  • Blurred vision
  • Sugar or carbohydrate cravings
  • Tingling in hands or feet

We often see patients in St. Louis who thought these were “normal aging changes” when in fact, they were early signs of blood sugar imbalance.

Why Does Prediabetes Happen?

The primary driver of prediabetes is insulin resistance. Normally, insulin acts like a key, unlocking cells so glucose (sugar) can enter and be used for energy. In insulin resistance, the “locks” on the cells don’t respond well to insulin, so glucose builds up in the bloodstream.

Several factors contribute to insulin resistance:

1. Excess Weight and Abdominal Fat

Fat cells, especially those around the abdomen (visceral fat), release inflammatory chemicals that interfere with insulin signaling.

2. Poor Diet

Diets high in processed carbohydrates, sugary beverages, and low in fiber worsen blood sugar control.

3. Sedentary Lifestyle

Muscles are major consumers of glucose. Without regular movement, the body’s ability to handle sugar declines.

4. Stress and Cortisol

Chronic stress raises cortisol, which increases blood sugar and worsens insulin resistance.

5. Sleep Deprivation

Lack of quality sleep disrupts hormones that regulate appetite and blood sugar.

6. Genetics and Family History

A family history of type 2 diabetes increases risk, though lifestyle still plays a powerful role.

7. Gut Health

Emerging research shows that gut dysbiosis (imbalances in gut bacteria) may promote inflammation and metabolic dysfunction, contributing to insulin resistance.

Risks of Prediabetes

Prediabetes is not “benign.” Even before diabetes develops, elevated blood sugar can cause harm. Risks include:

  • Cardiovascular disease: Prediabetes increases risk of heart attack and stroke.
  • Nerve damage (neuropathy): Tingling and numbness may develop.
  • Kidney stress: Elevated sugars strain kidney function.
  • Eye disease: Higher risk of retinopathy and vision changes.
  • Progression to type 2 diabetes: Up to 70% of people with prediabetes will eventually develop diabetes without intervention.

This is why addressing prediabetes early is critical.

Conventional Treatment Approaches

Most conventional physicians recommend:

  • Lifestyle changes: Diet, exercise, weight loss
  • Metformin: Sometimes prescribed to improve insulin sensitivity, especially if risk factors are high

While these steps help, many patients need more personalized strategies to succeed long-term.

A Functional Medicine Approach to Prediabetes

At Sheen Vein (Aesthetics and Functional Medicine), we view prediabetes as a signal of deeper metabolic imbalance. Rather than waiting for diabetes to develop, we work proactively to reverse the process.

Comprehensive Evaluation

We often look beyond standard labs to assess:

  • Insulin levels (not just glucose)
  • Inflammatory markers (CRP, homocysteine)
  • Thyroid and adrenal function
  • Nutrient deficiencies (magnesium, vitamin D, chromium)
  • Gut microbiome health

Nutrition and Lifestyle Support

  • Low-glycemic diet: Emphasizing whole foods, lean proteins, vegetables, and healthy fats
  • Reducing processed sugars and refined carbs
  • Fiber-rich foods: To slow glucose absorption and improve gut health
  • Balanced meal timing: Avoiding constant snacking and late-night eating
  • Weight optimization: Targeting abdominal fat reduction through sustainable methods

Exercise and Movement

  • Strength training and aerobic activity: Improve insulin sensitivity
  • NEAT (non-exercise activity thermogenesis): Walking, standing, and moving more throughout the day

Stress and Sleep Management

  • Breathing techniques, yoga, and mindfulness to calm cortisol
  • Improving sleep hygiene to restore metabolic balance

Targeted Supplements

Depending on labs and needs, we may recommend:

  • Magnesium: Supports insulin sensitivity
  • Omega-3 fatty acids: Reduce inflammation
  • Berberine: Shown to improve blood sugar control
  • Alpha-lipoic acid: Supports nerve health and glucose metabolism
  • Vitamin D: Critical for immune and metabolic function

Advanced Therapies

  • IV nutrient therapy for deficiencies
  • Red light therapy (PBM) to support mitochondrial function and reduce inflammation
  • Hormonal balancing if thyroid or sex hormones are contributing to metabolic dysfunction

Can Prediabetes Be Reversed?

Yes—and that’s the most empowering message. Studies show that with consistent lifestyle and functional medicine interventions, many patients can return to normal blood sugar levels and dramatically reduce their risk of diabetes.

We’ve seen countless patients in St. Louis improve their lab markers, lose weight, and regain energy after addressing the root causes of their prediabetes.

Final Thoughts

Prediabetes is a warning sign, but it is also an opportunity. It tells us your metabolism is under stress, but it gives us time to intervene before permanent damage occurs. By addressing nutrition, lifestyle, stress, gut health, and hormonal balance, we can not only prevent diabetes but also restore overall vitality.

At Sheen Vein (Aesthetics and Functional Medicine) in St. Louis, we specialize in uncovering the root causes of metabolic dysfunction and building personalized treatment plans that fit your life.

If you’ve been told you have prediabetes—or suspect you might—don’t wait. Schedule a consultation with us today through our contact page. Let’s take control of your health before diabetes develops.

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