Illustrative case: Marcos, 42 years old, a shopkeeper, began to notice that he was waking up two or three times a night to urinate. At first, he thought it was just the afternoon coffee. Months later, he noticed constant thirst, tiredness that didn't go away even with sleep, and occasional blurred vision. He went to the doctor and discovered he had prediabetes.
Type 2 diabetes rarely comes as a surprise. Before the disease develops, the body usually gives warnings, often subtle ones, that go unnoticed for months or even years. Recognising these signs early is one of the most effective ways to prevent the condition from progressing.
"The data and clinical case cited in this article are fictitious and are merely illustrative, serving to facilitate understanding of the topic addressed."
What is Prediabetes
Prediabetes is the stage in which blood glucose is already above normal, but not yet high enough to characterise diabetes. It is a stage of alert, and also of opportunity: with changes in habits, it is possible to reverse the condition and prevent progression to the disease.
Symptoms That Deserve Attention
Frequent urination at night (nocturia) When blood glucose is elevated, the kidneys work harder to filter it, increasing urine production, including during sleep. Waking up several times at night to urinate is one of the most common and most overlooked signs.
Excessive thirst The loss of fluid through excess urine leads to mild and constant dehydration, generating thirst that is out of the ordinary.
Persistent tiredness Even with sufficient sleep, the person feels fatigue, because the cells are not using glucose well as a source of energy.
Frequent hunger Despite eating normally, there is a sensation of recurrent hunger, as the body cannot use glucose efficiently.
Blurred vision Changes in glucose can temporarily affect the lens of the eye, causing episodes of blurred vision.
Tingling or numbness in hands and feet It can be an early sign of alteration in peripheral nerves related to excess sugar in the blood.
Wounds that take a long time to heal Elevated glucose compromises circulation and immune response, making the healing process slower.
Darkening of skin in folds (neck, armpits, groin) Called acanthosis nigricans, this darkening is associated with insulin resistance, a central mechanism of prediabetes.
Recurrent infections Recurrent urinary tract or skin infections may be related to elevated glucose levels, which favour the proliferation of fungi and bacteria.
Who is More Likely to Develop It
Some factors increase the risk of prediabetes and type 2 diabetes:
- Family history of diabetes
- Being overweight, mainly abdominal fat
- Sedentary lifestyle
- Age over 45 years
- High blood pressure
- Altered cholesterol or triglycerides
- Gestational diabetes in previous pregnancies
- Polycystic ovary syndrome
- Poor quality sleep or sleep apnoea
It is worth noting that prediabetes can also appear in younger people and those without evident excess weight, especially when there is a strong family history.
How the Body Usually Presents the Condition
In most cases, prediabetes does not hurt and does not prevent daily routine. The signs appear gradually and discreetly, which causes many people to delay seeking medical evaluation. This is exactly why routine examinations, even without evident symptoms, are so important from the age of 35 to 40 years, or earlier if there are risk factors.
What to Do to Prevent Progression to Diabetes
If a prediabetes diagnosis has already been confirmed, the main objective is to reverse the condition, and this is possible in most cases with consistent lifestyle changes.
Reduce consumption of sugar and ultra-processed foods Soft drinks, sweets, white bread and industrialised foods raise blood glucose rapidly.
Prioritise foods with fibre Leafy vegetables, legumes, beans, oatmeal and fruits with skin help control glucose absorption and prolong the feeling of fullness.
Choose better quality carbohydrates Brown rice, sweet potato, quinoa and other whole grains have less impact on glucose than refined versions.
Include lean proteins and healthy fats Fish, eggs, olive oil and nuts help balance meals and reduce glucose spikes.
Move your body regularly Physical activity, even daily 30-minute walks, significantly improves insulin sensitivity.
Take care of your sleep Poorly slept nights alter hormones related to hunger and insulin resistance.
Lose weight gradually, if necessary Studies show that a reduction of 5 to 10% of body weight already has a significant impact on reversing prediabetes.
Manage stress Chronic stress raises cortisol, a hormone that also influences blood glucose levels.
When to Seek Medical Care
Seek medical evaluation if you:
- Have two or more of the symptoms described above, even if mild
- Have risk factors and have never had glucose tests
- Have already been diagnosed with prediabetes and are not being followed up
- Noticed weight loss without apparent reason, associated with other symptoms
- Have frequent episodes of blurred vision or recurrent infections
Medical follow-up allows appropriate tests to be requested, such as fasting blood glucose, glycated haemoglobin and glucose tolerance test, as well as defining an individualised care plan with you.
Prediabetes is a warning sign, not a sentence. With attention to symptoms and possible changes in daily life, it is entirely feasible to prevent progression to type 2 diabetes and regain health balance.
This content is informative and educational in nature and does not replace individual medical consultation, diagnosis or treatment. Each person should be evaluated uniquely, taking into account their history, examinations and health context. In case of doubts or symptoms, seek medical care.
Dr Rebeca Soares Andrade CRM-GO 39335