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Pre-Diabetes [Podcast]

Posted July 21, 2025

Fruits, vegetables, glucose monitor

Listen in as we dive into the often-overlooked condition of pre-diabetes—what it is, how it's different from diabetes, and most importantly, how it can be managed or even put into remission. You'll hear from Summa Health's Vera Bartasavich, a diabetes educator at Summa Health, here to share expert insights and practical tips.

Featured Speaker: 

Vera Bartasavich, M.Ed., NDTR, MCHES 

Diabetes Educator

Scott Webb (Host): Pre-diabetes can lead to type 2 diabetes, but remission is possible through diet and lifestyle modification. Joining me today to tell us more about pre-diabetes is Vera Bartasavich. She's a diabetes educator with Summa Health. This is Healthy Vitals, a podcast from Summa Health. I'm Scott Webb. 

Vera, it's nice to have you here today. We're going to talk about pre-diabetes. And I have a lot of conversations about diabetes, type 1, type 2, but I like when we talk about pre-diabetes, because I think it's something that's sort of in and of itself. It's its own thing and we should talk about it. So, what is pre-diabetes and is it different than diabetes?

What is pre-diabetes and is it different than diabetes?

Vera Bartasavich: Yes, there's a difference. Pre-diabetes means your blood sugars are elevated, they're higher than normal, but not as high as a type 2 diabetes. Why does blood sugar tend to be higher in people with pre-diabetes? There's really two different main reasons. First, the pancreas, our body's insulin factory starts to slow down. The pancreas is not making as much insulin as it used to, and insulin is the hormone that helps move glucose out of the blood and into our body's cells, where it can be used for energy. And glucose is our preferred energy for our body.

Second, the body starts to develop what is called insulin resistance. This means the cells do not respond to insulin the way they should, it's like the cells are ignoring insulin's knock on the door. With both of these happening, less insulin is being made, and insulin that is there is not working as efficiently. Glucose builds up in the bloodstream instead of getting into the cells. So, the good news is that pre-diabetes, these two issues are not as advanced as with type 2 diabetes. Pre-diabetes is the early warning a chance to make changes before things get more complicated.

Host: Right. Yeah. And as you say, it is that early warning. So, let's talk about that then. Like what are the symptoms, if there are any, of pre-diabetes, and how do you diagnose?

What are the symptoms of pre-diabetes?

Vera Bartasavich: Most people with pre-diabetes do not feel any symptoms at all. Some individuals have symptoms that a type 2 is diagnosed with. But for the most part, there are no outstanding symptoms. That is why pre-diabetes is often called the silent condition, and many do not know that they have the condition. It is projected that there are approximately 98 million people in the U.S with pre-diabetes, which is astounding. And eight out of ten do not even know they have it.

So, let's go into the symptoms of type 2 diabetes. That can be fatigue, frequent urination, thirst, blurred vision, slow healing of cuts or infections, tingling of the hands or feet, dark patches on the skin, often on the neck, the armpits or the groin, and even skin tags.

So, diagnosis for pre-diabetes or diabetes is just a simple blood test, such as fasting glucose, A1c or glucose tolerance test. Fasting glucose requires not eating for more than eight hours, while the A1c does not even require fasting. The glucose tolerance test requires drinking a sugary drink, then testing the blood glucose two hours later. Fasting glucose for non-diabetics is less than a hundred milligrams per deciliter. Pre-diabetes is ranked from a hundred to 125 milligrams per deciliter, and anything above 125 is a diabetes diagnosis. A1c requires no fasting because it is the average of the blood glucose over two to three months versus a point in time. So, what happens is the blood cell is coated with glucose, and they're able to measure that. The cell only lasts for two to three months, so that's why that test is two to three months out. If blood is drawn, that shows less than 5.7%, so A1c is in a percentage versus the fasting, which is actually a number, a full number. If it's less than 5.7%, that means there's no diabetes or pre-diabetes. If it's 5.7 to 6.4%, that indicates there is pre-diabetes, and greater than 6.4% is a diabetes diagnosis.

Host: Okay. So then, let's talk about prevention, if you will. You know, you said that basically that, pre-diabetes is this warning for folks. So, can we prevent pre-diabetes from progressing to diabetes?

Can we prevent pre-diabetes from progressing to diabetes?

Vera Bartasavich: Research shows that even small changes in the daily habits can lower your risk by more than 50% of moving into type 2 diabetes. And that's what we're trying to stop, is having pre-diabetes move into diabetes. There's some proven steps. Eating more whole foods, fewer processed foods, managing carbohydrate intake and pairing proteins with healthy proteins such as eggs, nuts, cheese, seeds, chicken, beef, pork, fish, or tofu. Carbohydrates are in all foods except protein and fat. So, there can be a learning curve of how to eat the right amount of carbs. Following portion control is a big win when fighting pre-diabetes. Moving more, exercise, getting our heart rate up. Aim for about 30 minutes a day, five days a week. Add resistant activities two times a week to your routine, like small weights or resistance bands.

If somebody has mobility issues, try chair yoga or chair exercises, which you can easily find on YouTube videos or books from the library. Just move your body, just get moving, right? Also, losing just 5-10% of your body weight if needed. And managing stress. Stress is a culprit for increasing blood glucose. Exercise and adequate sleep can help manage that stress. Deep breathing. Taking time for reflection, finding a hobby that you enjoy, asking help from family and friends can really help manage stress, because we can never be stress-free. Sleep management. Lack of sleep can affect glucose levels because cortisol, which is a hormone can disrupt and increase the insulin resistance. Loss of sleep means less healthy eating, because we make bad food choices or not exercising as much because we're just tired. So, we want to set small goals and change slowly, because this is a lot. You know, if we've been doing things for years and years, this is a lot to take in. So, set small goals and change slowly, so these behaviors become habits.

Host: Right. So then, Vera, what are the risks if we don't manage pre-diabetes? Is it automatically become type 2? How does that work?

What are the risks if we don't manage pre-diabetes?

Vera Bartasavich: Pre-diabetes has a lower risk for complications, but an increased risk if we don't have intervention, meaning, you know, those healthier lifestyles, pre-diabetes can turn into type 2 diabetes, that carries greater chances for complications. So, diabetes complications include heart disease, stroke, kidney damage; nerve damage, eyes and feet; osteoporosis, periodontal disease, Alzheimer's disease, and higher rates of depression.

In fact, high blood sugars affect every part of our body, every cell in our body. So, taking pre-diabetes seriously is important, because you do not feel any symptoms. That does not mean you should ignore the condition.

Host: Yeah, I want to ask you about reversal and whether or not that's the correct word, right? So, I want to ask basically, can pre-diabetes be reversed? And is that how we should think of it as we're reversing pre-diabetes? Or is there another way of thinking about it?

Can pre-diabetes be reversed?

Vera Bartasavich: I like to think of it as remission. I do see reversal in many different publications, but remission is, I think, a little bit more accurate, because your blood sugar can go back to normal levels. However, if someone goes back to those less healthy lifestyles, too many carbs, sedentary behavior, not managing stress or sleep or whatever, your glucose level numbers can rise again. So, management often happens through consistent, healthy habits like eating well, being active and losing a little weight. It's not always easy, but it is possible. So, it is remission.

Host: Yeah, remission sounds right. And as you say, you know, it is possible. It's a lot to take in, a lot to absorb, a lot to deal with, but it is possible we just need to do our part, as you mentioned earlier, kind of get moving, right? The things that we can do to help. 

Vera Bartasavich: Correct.

Host: Yeah. Things we can do to help ourselves. Let's finish up here today and just give folks some resources, ways that they can connect with other folks maybe who have pre-diabetes or experts like yourself. What can they do?

Vera Bartasavich: The best thing is to first speak with your physician. Sometimes they can give you a recommendation to someone to see, just different groups. But at Summa Health, we do hold group classes for pre-diabetes and diabetes. We hold them at Chapel Hill Medical Center and Barberton Hospital.

We have a staff that consists of registered nurses, a registered dietician, health and diabetes educator that lead the classes. And all staff are trained in teaching self-management for the person living with high glucose levels. Because you cannot see your doctor or your nurse 24/7, you have to self-manage. Knowledge is power, especially when managing this condition. The group classes are free to the public, and you do not have to be a Summa Health client. The best way to figure out, I know it's hard, you know, on a podcast here, if you Google Summa Health Diabetes Education, you can get the full information. Again, that's Summa Health Diabetes Education, for more information and for registration.

Host: That's perfect. Well, I appreciate your time today. You know, a lot of what we do here is about educating and encouraging folks if they have the signs, symptoms, whatever it might be, or maybe a family history, reach out to their own providers. You gave us some great resources there. So, thank you so much. 

Vera Bartasavich: Thank you, Scott, for this opportunity. Take care.

Host: And visit summahealth.org/diabetes to learn more, or call 888.470.6962 to ask about appointments with Caroline and the team of diabetes experts at Summa Health. And if you enjoyed this episode of Healthy Vitals, we'd love it if you'd leave us a review. Your review helps others find our educational content. I'm Scott Webb. Thanks for listening, and we'll talk again next time. 


About the Author

Vera Bartasavich

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Reviewed July 2025

Did you know skin cancer is the most common form of cancer in the United States? According to the American Academy of Dermatology, one in five Americans will develop skin cancer in their lifetime, and men 65 or older are twice as likely to develop melanoma — the deadliest form of skin cancer — than women.

As we head into the summer months, most of us know the importance of wearing sunscreen in the hot, blazing sun. But what you may not realize is…

Best and worst foods for your next sizzling cookout

Nothing says summer like the classic American barbeque: hamburgers, hot dogs and macaroni salad with berry pie for dessert. Cookouts with family and friends are a favorite summer pastime to enjoy good food, the great outdoors and warmer temperatures.

But considering on average a person consumes upwards of 2,000 calories on typical barbeque fare, it’s not a bad idea to switch up this year’s cookouts to include healthier options. Who said cookouts had to be unhealthy…

Food allergy vs. food intolerance: How to tell the difference

Chances are good at one time or another you have experienced unpleasant symptoms — an upset stomach, diarrhea, nausea or bloating — after eating a delicious meal. Reactions from food are common, but it can be challenging to understand the cause.

Food intolerance can trigger some of the same physical symptoms as a food allergy. But, understanding the difference is vital to your health. Eating a food that your body is intolerant to can leave you feeling uncomfortable, but eating…

Weight Loss Options Built for Your Needs

Obesity and the need to lose weight is a deeply personal journey. With many new medical options available, it can be difficult to select the best individual approach to be successful with long-term weight loss.

Obesity is the second-highest cause of preventable deaths in the United States. The rate at which obesity has worsened over the past 20 years, especially in the state of Ohio is alarming, and there is now a growing amount of national attention focused on the problem. In…

7 ways to reduce sodium without sacrificing flavor this holiday season

With so many celebrations centered on food, it’s easy to lose track of how much we’re consuming — including our sodium intake. In fact, it’s not unusual for a typical holiday meal to meet or exceed our recommended daily value for sodium.

But, what’s all the fuss about? Sodium, or salt, is a mineral that’s essential for life. It’s regulated by your kidneys and is required for nerve and muscle function and maintaining your body’s…

All About Sleep Apnea [Podcast]

Dr. James Bavis & Dr. Ketan Deoras explain sleep apnea as well as signs, symptoms, and what to expect.

Breast Cancer: The Importance of Knowing Your Risk [Podcast]

Dr. Keristen Brantley & Dr. Victoria Van Fossen discuss Breast Cancer Prevention and Treatment.

Alzheimer’s Awareness: Symptoms, Stages, and Support [Podcast]

Amanda Harvan sheds light on the symptoms, stages and support of Alzheimer's.

Are veggie burgers really a healthier choice?

It’s no secret that meatless meals are becoming more popular. While this is certainly not anything new for our vegan or vegetarian consumers, terms like “plant based” and “meat alternatives” are quickly becoming more mainstream. Wildly popular, meatless burgers are even entering the fast food market with Burger King’s addition of the “Impossible Whopper” to their regular menu. But, are veggie burgers actually healthier than a…

Men’s Well-Being: All About Prostate Health [Podcast]

Dr. Kevin Spear discusses men's health and different risk factors and how to ensure optimal well-being.

Good vs. Bad: Understanding your cholesterol levels

Cholesterol normally gets a bad rap, but is it really as bad as it sounds? 

Cholesterol is essential for your body — in healthy doses, of course. Cholesterol is a waxy, fat-like substance produced by the liver, which your body needs to build cells and produce certain hormones and vitamin D. 

Your body produces all the cholesterol it needs to function. The problem is many people don’t only get cholesterol from their liver. They also get high amounts of…

The Latest Updates on COVID-19 [Podcast]

Dr. Thomas File shares the latest updates on COVID-19.

Can Obesity be Considered a Disease [Podcast]

Dr. Adrian Dan discusses obesity as a metabolic disease.

Can Obesity be Considered a Disease [Podcast]

Dr. Adrian Dan discusses obesity as a metabolic disease.

Breaking the Stigma of Mental Illness [Podcast]

Emily Hionides-Horner discusses 7 ways to overcome mental health stigma.

The Modern Guide to Heart Health [Podcast]

Dr. Peter Bittenbender shares his insight on the modern guide to heart health.

Tips on Maintaining Fitness and Physical Health During the Pandemic [Podcast]

Dr. Cipriani discusses tips on maintaining physician health during the pandemic.

Tips on Maintaining Fitness and Physical Health During the Pandemic [Podcast]

Dr. Cipriani discusses tips on maintaining physician health during the pandemic.

Tips for Managing Anxiety [Podcast]

Dr. Leslie Zaynor discusses tips for managing anxiety.

4 Impactful Lifestyle Changes That Help Improve Your Cholesterol

Cholesterol is a waxy, fat-like substance that is produced by the liver and has many important functions in your body. Your body uses it to protect nerves, make cell tissues, keep your cells flexible and produce certain hormones. In addition to your liver making cholesterol, there are many foods that contain cholesterol, including eggs, meats and dairy products. Eating too much of these foods can add too much cholesterol to your body and have negative side effects. 

Too…

Your Options for Weight Loss

The desire to lose weight and the process chosen to go about it is a deeply personal journey. With many new options on the market, it can be tough to understand the best approach to reaching long-term weight loss.

Obesity is now ranked as the second-highest cause of preventable deaths in the United States. The rate at which obesity has worsened over the past 20 years is alarming, and there is now a growing amount of national attention focused on the problem. It is also important to note that Obesity has been proven to increase the risk for cancer including Colon and Breast cancers. Weight loss is an important cancer risk reduction effort for many patients at higher risk for cancer and a component of cancer survivorship plans as well.

Breaking Down Protein Powders

In the last decade or two, protein powders have become increasingly popular among physically active and health-conscious individuals.

Protein powders are concentrated sources of protein — the essential building block for muscle, tissue, bones and blood — made from either animal or plant sources. While whole foods come complete with the essential vitamins, minerals and fiber you require, protein powders are an easy, convenient way to bolster your protein intake when…

First Unified World Obesity Day

Obesity has been deemed a disease of worldwide epidemic proportions. In the United States, obesity directly affects 40% of the adult population and an additional 30% are considered overweight. Obesity is now ranked as the second-highest cause of preventable deaths in the United States. The rate at which obesity has worsened over the past 20 years is alarming, and there is now a growing amount of national attention focused on the problem.

When talking about obesity, it is very…

5 Ways to Make Healthy Eating a Piece of Cake

Eat healthy. Exercise. Lose the extra holiday L-Bs. These are some of the most common goals many of us try to accomplish each year. But, it’s just about the time of year when these all-too familiar New Year’s Resolutions start to fall by the wayside.

Life can get in the way, temptations arise and we can default to old habits. So this year, let’s try something different. Instead of listing the same goals year after year, let’s put to practice lifestyle…

Are short workouts effective?

As a general goal, it is recommended that we get at least 30 minutes of physical activity every day, more if you’re looking to lose weight. However, some people find it hard to carve out those 30 minutes every day. Some may only have time for a short 10-minute workout. So, is it still worth exercising even if it’s only for a few minutes at a time?

Studies have shown that short workouts throughout the day are just as beneficial as long continuous ones.

 

In this…

How to Successfully Manage Your Diabetes During the Holidays

The holidays can be tough for anyone on a diet with all the celebrating, snacking and treats. Those with diabetes have to be especially careful around the holidays because gaining weight or rising blood sugar could be dangerous to your health.

If you slip into bad eating habits and they extend well into the New Year, you can do long-term damage to your body. Just a little preparation can go a long way towards keeping your weight and blood sugar down – check out these…

Here's the scoop on intermittent fasting

This recent weight loss trend places more of an emphasis on WHEN you eat than WHAT you eat (but keep in mind that both are important for success). Intermittent fasting (IF) is an eating pattern that cycles between periods of fasting and eating.

Depending on the type of intermittent fasting pattern you choose, your fasting time may be a few hours or a whole day a few times per week. During the fasting periods, you eat either very little or nothing at all.

Here are some of the…

What Does A Fast Food Meal Do To Your Body?

It’s quick, fast, and cheap; it also tastes really good! Americans spend roughly $50 billion on fast food each year. With the availability of food “on-demand” more and more people are opting for prepared foods, whether through a drive thru or delivered to your door.

But have you ever felt not-so-great after eating fast food--maybe a little tired or bloated? Did you notice you became hungry again pretty soon after eating? That’s because although most…

Battle it Out: Artificial Sweetener v. Sugar

The sweeter things in life are present at most celebrations...weddings, birthdays, work promotions, new baby, office parties...you get the idea. But if you are like many Americans trying to cut back on your refined sugar intake for health reasons and/or weight management, you may think opting for sugar replacements might be a healthier choice.

When it comes to real sugar (sucrose) versus artificial sweeteners, like the ones found in diet sodas and ‘zero-calorie”…

Myths vs. Facts: Binge Eating

According to the American Psychiatric Association, eating disorders affect millions of Americans, mostly women between 12 and 35 years old. There are three main types of eating disorders: anorexia, bulimia and binge eating disorder (BED). The focus of this blog post will be on BED.

BED is the most common eating disorder in the US. It can be characterized by recurring episodes in which large quantities of food are consumed (more food than most people would consume over the same…

Sugar: It may be an Addiction

Most of us know that too much sugar is not good for our overall health. But what you may not know is that growing research is showing what’s bad for the body may also be bad for the brain.

A recent study published in Scientific Reports found that a group of men between 35 and 55 who consumed more than 67 grams of sugar daily from sweetened foods and beverages were more likely to develop anxietydepression, and other common mental disorders after 5 years, compared with men with a lower daily sugar intake. In no way does this imply that excess sugar causes mental disorders in the general population; rather this was a select study which also found no similar correlation for the women who participated in the research.

What are macros?

Paleo, keto, macros, carbs, complex carbs, clean eating, plant-based...we could keep going but I think you get the idea. With so many buzzwords out there, it can be difficult to analyze which ones would be a good addition to your weight loss journey or can help maintain a healthy lifestyle. Let’s explore one of these nutrition buzzwords: Macros.

Macros are short for macronutrients. These nutrients include protein, carbohydrates and fats and make up the caloric content of food.

Controversial Use of E-cigarettes and Vaping- A "Heated" Debate

Electronic Nicotine Delivery Systems (ENDS) first entered the US market around 2007.  Wells Fargo Securities analysts now claim that these products have grown into a $4.4 billion industry. These products have many names including e-cigarettes, vapes, vaporizers, vape pens, hookah pens, and e-pipes among others. Most use a heating mechanism to turn liquid into a vapor that is then inhaled as an aerosol. E-cigs differ from traditional cigarettes because they do not “burn” or contain the 7,000 chemicals present in traditional combustible cigarettes. The tobacco industry continues to develop and market new nicotine delivery devices and without question the controversy over these products is still a heated debate.

Carbs: The Good, the Bad and the Yummy

Atkins, paleo, low-carb, no carb, how do you choose? If weight loss is a priority for you, or if you are just looking to eat healthier, there is an abundance of diets, meal plans and fads out there.

But what exactly are carbohydrates (carbs) and why are some of them so “bad” for us? Below is a breakdown of the types of carbohydrates, what they do to our bodies, which ones we can eat and those to avoid.

The Gift of Heart Health

When you think of February, you may think of Valentine's Day, chocolate and flowers. February also marks American Heart Month, a great time to commit to a healthy lifestyle and make small changes that can lead to a lifetime of heart health. Heart disease is the leading cause of death for men and women in the United States. But the good news is it's also one of the most preventable.

Making heart-healthy choices, knowing your family health history and the risk factors for heart…

Medical Nutrition Therapy or Nutrition Education?

Medical Nutrition Therapy or Nutrition Education?

Obesity currently affects 34% of all Americans. It contributes to many other conditions, including Type 2 Diabetes, GERD, Sleep Apnea, Hypertension, Hyperlipidemia, Joint Disorders, and a variety of cancers. Improving or eliminating obesity often can improve or cure these conditions, including Type 2 Diabetes.

A registered dietitian can approach obesity through either medical nutrition therapy or nutrition education.

Medical…

Eating-Mindfully

We eat for many reasons beyond hunger, which is why learning to eat mindfully helps you maintain or even lose weight if desired. As we celebrate Healthy Weight week this week, here are ten tips that provide some food for thought.

1. Reject the Diet Mentality.Throw out the diet books and magazine articles that offer you false hope of losing weight quickly, easily and permanently. Get angry at the lies that have led you to feel as if you were a failure every time a new diet…

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