According to the Centers for Disease Control and Prevention, more than one in three U.S. adults have prediabetes, but most do not know it. If that sounds hard to believe, many people with the disease do not have any symptoms, making it hard to know when it’s time to see the doctor, especially if you don’t already visit annually. While something with the word “pre-” in it sounds a bit harmless, without intervention prediabetes is likely to become type 2 diabetes within 10 years.

Joni Killen, a registered dietitian and certified diabetes educator at Texas Health Arlington Memorial, says prediabetes’ elusiveness only adds to the confusion many people have regarding the disease, and many don’t know how it differs from a full-blown diabetes diagnosis or what it means for their health now and in the future.

“Prediabetes is a condition that comes before diabetes; your blood glucose is higher than normal, but not as high to be diagnosed with diabetes,” Killen explains. “So it does mean you are at risk in developing type 2 diabetes, but now you can make changes in your lifestyle that will make a big difference to prevent or delay the onset of type 2 diabetes.”

Because prediabetes does not have any clear symptoms, Killen says it can be hard for you to know that you have it. Most often, your health care provider discovers it during routine testing, especially if you have a family history of the disease.

Risk factors for prediabetes and diabetes are the same:

• Family history
• Being overweight
• Leading a sedentary lifestyle
• Hypertension
• High cholesterol
• A history of gestational diabetes
• Women who have delivered a baby over nine pounds
• Polycystic Ovary Syndrome (PCOS)

Patients with the risk factors listed above are commonly tested using their fasting blood glucose levels, those present in the blood when you have not had anything to eat or drink (except water) for at least eight hours. An A1C test may be performed instead of a fasting plasma glucose test, which measures the average blood glucose for the past two to three months.

Since more than 7.1 million Texans have prediabetes and more than 3.2 million have diabetes, chances are you know multiple people with the disease. According to the Centers for Disease Control and Prevention (CDC), Wichita County has the highest percentage per population of diabetics in North Texas, followed by  Navarro, Johnson, Ellis, Tarrant and Dallas counties.

There are multiple explanations as to why Texas may have higher incidence rates of diabetes and prediabetes, like its ethnically diverse population and an appetite for fried or smoked food that could give Big Tex a run for his money.

Diet is a huge contributing factor to the development of diabetes, but contrary to popular belief, consuming excessive amounts of sugar isn’t directly correlated to the disease. Killen explains that it’s the carbs and saturated fats that we consume that are the more likely culprits. Since most Americans’ diet consists of 45 to 65 percent carbs, reducing our carbohydrate intake can be tough, particularly with foods that many Texans love, like rice, pasta, beans, tortillas, bread and sweets, which can also be high in saturated fat.

Although you may need to make some changes in what and how much you eat if you have been diagnosed with prediabetes, you do have some flexibility in deciding what you can eat and nothing is necessarily “off limits.”

“Make healthier choices by cutting back on saturated fats, concentrated sweets, especially in the beverages which will decrease those extra calories,” Killen says. “Following the ‘Diabetes Plate Method’ is a good start. Fill up half the plate with non-starchy veggies, a fourth of the plate with protein and the last fourth with whole grains.”

The American Diabetes Association has an interactive tool, along with lists of diabetes-friendly foods to help you visualize the healthiest meal.

Killen also adds that most everyone can benefit from moving more throughout the day, not just those at risk for developing diabetes.

“Not only do we feel better physically but emotionally as well,” she says. “It is recommended that you move at least 30 minutes, five days a week. And don’t forget your water intake! Try to drink around 80 ounces (10 cups) daily.”

Lifestyle changes play an important role in preventing or delaying the onset of type 2 diabetes, starting with making regular visits to a primary care provider who can partner with you to monitor your glucose levels and answer any questions you may have. In addition, Texas Health has 9 diabetes education centers located across the DFW Metroplex that are staffed with qualified diabetes educators, such as Killen, who can provide education individualized to your specific health, physical activity and lifestyle.

“What you do today makes a difference tomorrow. Many of my patients tell me they wished they would have taken their prediabetes diagnosis more serious, because once you’re diagnosed with diabetes, it cannot be reversed,” Killen says. “We can help educate our patients by managing their blood sugars to avoid complications in the future. We are here to get you started on a better road for health to continue for life.”