Illustrative case: Marcos, 42 years old, merchant, began noticing that he woke 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 sets in, the body usually gives warnings, often subtle ones, that go unnoticed for months or even years. Recognizing 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 characterize diabetes. It is a stage of warning, 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 a night to urinate is one of the most common and most ignored signs.

Excessive thirst The loss of fluid through excess urine leads to mild and constant dehydration, generating thirst outside the usual pattern.

Persistent fatigue Even sleeping enough, the person feels fatigue, because the cells are not taking advantage of glucose as an energy source.

Frequent hunger Despite eating normally, there is a sensation of recurring hunger, since the body cannot use glucose efficiently.

Blurred vision Changes in glucose can temporarily affect the eye's lens, 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 or skin infections may be related to elevated glucose levels, which favor 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
  • Excess weight, especially 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 apnea

It is worth noting that prediabetes can also appear in younger people and without evident excess weight, especially when there is strong family history.

How the Body Usually Presents the Condition

Most of the time, prediabetes does not hurt and does not prevent daily activities. Signs appear gradually and discreetly, which causes many people to delay seeking medical evaluation. This is exactly why routine exams, even without evident symptoms, are so important from ages 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 breads, and industrialized foods rapidly raise blood glucose.

Prioritize foods with fiber Leafy vegetables, legumes, beans, oats, and fruits with skin help control glucose absorption and prolong satiety.

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 good 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 linked 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 relevant impact on prediabetes reversal.

Manage stress Chronic stress elevates 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
  • Already had a prediabetes diagnosis and do not follow up
  • Noticed weight loss without apparent reason, associated with other symptoms
  • Have frequent episodes of blurred vision or recurrent infections

Medical follow-up allows for requesting appropriate tests, such as fasting blood glucose, glycated hemoglobin, and glucose tolerance test, in addition to defining an individualized 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 viable to prevent progression to type 2 diabetes and recover health balance.

This content is informational and educational in nature, not replacing individual medical consultation, diagnosis, or treatment. Each person should be evaluated uniquely, considering their medical history, exams, and health context. In case of questions or symptoms, seek medical care.

Dr. Rebeca Soares Andrade CRM-GO 39335