Prediabetes vs. Diabetes – Key Differences

Dr. Tashko explains the difference between prediabetes and diabetes, covering A1C, glucose levels, prevalence, risks, and therapy options.

Introduction – Prediabetes and Diabetes Care in Montgomery County, Maryland

As a diabetes specialist based in Montgomery County, Maryland, my focus lies in offering personalized care for individuals grappling with prediabetes and diabetes. I employ a comprehensive, evidence-based approach to address my patients’ unique needs and conditions.

Conveniently located in Rockville, my practice offers virtual and in-person services, extending support to nearby areas such as Chevy Chase, Bethesda, North Bethesda, Potomac, North Potomac, Gaithersburg, Germantown, Frederick, Silver Spring, Northern Virginia, Howard County, Anne Arundel, and the Eastern Shore of Maryland, ensuring comprehensive care.

Without further ado, let’s delve into the key differences between prediabetes and diabetes, including risk factors, diagnosis, prevention, treatment, and more.


Diabetes is a common health condition that affects millions worldwide. However, many people are unaware of prediabetes, a precursor to diabetes. Knowing the differences between prediabetes and diabetes is essential for early intervention and effective management.

What is Prediabetes?

Prediabetes is when blood sugar levels are higher than normal but not high enough to be diagnosed as diabetes. It is a warning sign that you are at risk of developing type 2 diabetes. Prediabetes usually has no symptoms, so many people do not know they have it. It is diagnosed through one of the following tests:

  1. Fasting Blood Glucose Test: Measures blood sugar after an overnight fast. Levels between 100 and 125 mg/dL indicate prediabetes.
  2. Oral Glucose Tolerance Test (OGTT): Measures blood sugar before and two hours after consuming a sugary drink. Levels between 140 and 199 mg/dL suggest prediabetes.
  3. A1C Test: Reflects average blood sugar levels over the past two to three months. Levels between 5.7% and 6.4% signal prediabetes.

What is Diabetes?

Diabetes is a chronic condition where the body either does not produce enough insulin (type 1 diabetes) or cannot use insulin properly (type 2 diabetes). Insulin is a hormone that helps cells absorb glucose from the bloodstream. Without proper insulin function, blood sugar levels remain high, leading to various health problems.

Diabetes is diagnosed when:

  1. Fasting Blood Glucose: Blood sugar level is 126 mg/dL or higher.
  2. OGTT: Two-hour blood sugar level is 200 mg/dL or higher.
  3. A1C Test: A1C level is 6.5% or higher.
  4. Random Blood Glucose Test: Blood sugar level of 200 mg/dL or higher, with symptoms like frequent urination, increased thirst, and unexplained weight loss.

Key Differences Between Prediabetes and Diabetes

  1. Blood Sugar Levels: As mentioned above, prediabetes involves blood sugar levels that are higher than normal but not high enough to be classified as diabetes. Diabetes involves consistently high blood sugar levels that require medical intervention.
  2. Risk and Progression: Prediabetes indicates a higher risk of developing type 2 diabetes but is reversible with lifestyle changes. Diabetes, especially type 2, often develops from prediabetes if preventive measures are not taken. Once diagnosed, diabetes may require lifelong management.
  3. Symptoms: Prediabetes usually does not have symptoms, making regular screening important. Diabetes often has noticeable symptoms such as frequent urination, excessive thirst, fatigue, blurred vision, and slow-healing wounds.
  4. Management and Treatment: Prediabetes management focuses on lifestyle changes like healthy eating, regular physical activity, and weight loss. These measures can prevent or delay diabetes. Diabetes management includes lifestyle changes but also may require medication or insulin therapy to control blood sugar levels.
  5. Complications: Prediabetes does not usually cause complications but increases the risk of developing type 2 diabetes, which in turn can lead to serious health issues such as heart disease, nerve damage, kidney disease, and vision problems. Early intervention can prevent these complications.

Prevalence of Prediabetes vs. Diabetes

Prediabetes is more common than diabetes. According to the Centers for Disease Control and Prevention (CDC), about 97 million American adults have prediabetes, which is more than 1 in 3 adults. However, 80% of people with prediabetes do not know they have it. In contrast, about 38 million Americans have diabetes, which is roughly 11% of the population. These statistics highlight the importance of awareness and early detection.

Importance of Early Detection

Early detection of prediabetes is key. Regular screenings are recommended for individuals over 45, those who are overweight, and those with a family history of diabetes. Ethnic groups such as African Americans, Hispanics, Native Americans, and Asian Americans are at higher risk and should consider earlier screening.

Take Action

If diagnosed with prediabetes, take it as a wake-up call. Adopting a healthier lifestyle can significantly lower your risk of developing diabetes. Engage in regular physical activity, maintain a healthy diet, and aim for a healthy weight. If diagnosed with diabetes, work closely with your endocrinologist to manage the condition and prevent complications.


Understanding the differences between prediabetes and diabetes can lead to early intervention and improved health benefits. Recognize the risk factors and make necessary lifestyle changes to reverse or prevent the progression from prediabetes to diabetes. Proactive approach to health and regular monitoring with an endocrinologist are key to managing both conditions effectively.

Dr. Tashko