You may know that November is American Diabetes Month, but did you know that you or one of your friends or family members could have diabetes without even realizing it? Even more likely is that a person may have prediabetes, but not have any idea his or her body is experiencing physiologic stress. The vast majority of people living with prediabetes do not know they have it. Prediabetes is the calm before the storm — and it may be halted if lifestyle changes happen quickly.

What Is Prediabetes, Anyway?

Prediabetes, also called impaired glucose tolerance, is a health condition with no symptoms. It occurs when blood glucose levels are higher than normal yet still too low to qualify for a diabetes diagnosis (see below). If that sounds like a mild or benign condition, think again. While we've long-known the serious health consequences of diabetes-increased risk for blindness, heart attack, stroke, and amputation among them — having prediabetes is almost always present before a person develops type 2 diabetes — and all the complications that come with it. With some 79 million American adults estimated as living with prediabetes, there's serious cause for concern.

But there's also some encouraging news. If you or someone you know has been diagnosed with prediabetes, the onset of full-blown type 2 diabetes — and its host of potential side effects — can be delayed or prevented. A major research study led by the National Institutes of Health showed that making modest behavior changes, such as improving food choices and increasing physical activity, helped participants lose weight reducing their risk of developing type 2 diabetes by 58 percent in people with diagnosed prediabetes.* Many factors increase your risk for prediabetes and type 2 diabetes. To find out more about your risk, see what characteristics in this list apply to you:

- 45 years or older

- overweight

- a parent or a sibling has diabetes

- family background is African American, Hispanic/Latino, American Indian, Asian American, or Pacific Islander

- had diabetes when pregnant (gestational diabetes), or gave birth to a baby weighing 9 pounds or more

- physically active less than three times a week

Subtle Symptoms of Diabetes

In type 2 diabetes, either the body does not produce enough insulin or the cells ignore the insulin causing very high blood glucose levels. Unlike prediabetes, diabetes does have symptoms but it can often go undiagnosed because many of its symptoms seem so harmless. In the hustle and bustle of daily life, you may not notice small changes in how you feel. Yet these shifts may be your body trying to let you know that things aren't quite right. One small change alone is not necessarily a red flag, but a few of these subtle symptoms should certainly prompt you to see your doctor. Consider asking yourself the following questions:

- Are you suddenly feeling much thirstier, hungrier, and losing weight without trying?

- Do you feel more fatigued or weaker than usual? If you've started exercising significantly more, these changes could be expected. But if your diet and exercise patterns have remained stable, discuss these changes with your doctor promptly.

- Are you experiencing blurred vision or recurring skin or gum infections?

- Have you noticed that cuts and bruises take longer to heal? Are you urinating more often or feeling tingling in your hands, feet, or legs?

These, too, may initially seem insignificant, especially in isolation. But having any combination of these symptoms should not be ignored.

Modifications That Matter

The primary risk factor for developing type 2 diabetes is obesity. Thus, achieving a weight loss of 5 to 7 percent by reducing the fat and calories you consume and increasing physical activity to 150 minutes per week are critical components in helping delay or prevent the onset of this disease.

Not surprisingly, healthful eating helps. Fill your diet with plenty of fresh fruits, vegetables, whole grain, low-fat dairy, and lean sources of protein. Eating a heart healthy, calorie-reduced meal plan can assist your weight loss efforts and may even help lower cholesterol levels and blood pressure as well.

Increasing physical activity such as brisk walking, swimming, or cycling to at least 150 minutes per week is another thing you can do to help reduce your risk. Exercise is another tool to help you in your weight loss efforts and may also be beneficial to your heart, lungs, and emotional health.

*Sources: Centers for Disease Control and Prevention, National Diabetes Prevention Program.