It’s not a very sweet statistic, but diabetes was the 8th leading cause of death in the United States in 2020. Adults 50 years or older with diabetes die 4.6 years earlier, develop disability 6 to 7 years earlier, and spend about 1 to 2 more years in a disabled state than adults without diabetes.

About 37.3 million people—or 11.3% of the US population—had diabetes (diagnosed or undiagnosed) in 2019. This total included 37.1 million adults 18 or older, or 14.7% of all US adults. About 8.5 million of these adults had diabetes but were not aware that they had it or did not report that they had it.

Prediabetes is a category of increased risk for developing type 2 diabetes. With prediabetes, blood glucose levels are higher than normal, but not high enough to be diagnosed with diabetes.

Approximately one in three American adults can be classified as having prediabetes right now. Of those with prediabetes, more than 80% don’t know they have it. If you have prediabetes, you also have insulin resistance and the cells in your body don’t respond normally to insulin.

Insulin resistance and prediabetes usually have no symptoms and most people with prediabetes have it for years without knowing it.

How are Prediabetes and Diabetes Diagnosed?

There are several blood tests that help doctors determine if you have prediabetes or diabetes.

One-time blood sugar test, either random or fasting

A random, or non-fasting, test will determine your blood sugar at a given point during the day. A normal random blood sugar level is between 70 and 140 mg/dL.

A fasting blood sugar test is a blood test done after not eating or drinking for 8 to 12 hours (usually overnight). A normal fasting blood sugar level is less than 100 mg/dL.

Hemoglobin A1C

A Hemoglobin A1C, or A1C for short, is a blood test that measures your average blood sugar level over the past two to three months. Hemoglobin AIC is not only one of the commonly used tests to diagnose prediabetes and diabetes but is also the main test health care teams use to manage diabetes.

What Does the A1C Test Measure?

When sugar enters your bloodstream, it attaches to hemoglobin, a protein in your red blood cells. Everybody has some sugar attached to their hemoglobin, but people with higher blood sugar levels have more. The A1C test measures the percentage of your red blood cells that have sugar-coated hemoglobin. The life cycle of red blood cells is approximately 3 months, which is why the A1C test can determine an average of your blood sugar over the past 3 months.

Who Should Get an A1C Test, and When?

Adults over age 45, or under 45 and overweight, who have one or more risk factors for prediabetes or type 2 diabetes should get a baseline A1C test.

Risk factors for prediabetes and type 2 diabetes include:

• Being obese or overweight
• Having a parent, brother, or sister with type 2 diabetes
• Participating in physical activity less than 3 times a week
• Being of certain ethnic groups, including African American, Hispanic/Latino American, American Indian, Pacific Islander, and some Asian American groups

Diagnosing Prediabetes or Diabetes with Hemoglobin A1C

• Normal = Below 5.7%
• Prediabetes = 5.7% to 6.4%
• Diabetes = 6.5% or above

Within the 5.7% to 6.4% prediabetes range, the higher your A1C, the greater your risk is for developing type 2 diabetes.

Although the rate of progression varies, approximately 25% of people with either impaired fasting glucose or elevated hemoglobin A1C will go on to develop type 2 diabetes over three to five years.

The Bottom Line:

If your one-time blood sugar level or hemoglobin A1C are above ideal levels, you’re far from alone. Many Americans are overweight or obese and have bigger-than-healthy bellies, both risk factors for developing insulin resistance, prediabetes, and eventually type 2 diabetes. Excess weight and waist circumference also affect blood pressure, LDL cholesterol, and triglycerides.

To discover your blood sugar numbers, call Amaze. One of our experienced providers will talk to you about how to obtain these values and will not only discuss and explain the results, but they will also help you determine a path to the healthiest version of yourself; whether that is a visit with our nutrition team, regular visits with our primary care team, or referral to a specialist in your area.