Prediabetes is a condition where blood sugar levels are higher than normal but not high enough for a type 2 diabetes diagnosis. Often called a “warning stage,” prediabetes allows you to take action before permanent damage occurs.
According to the American Diabetes Association, more than 96 million American adults—over 1 in 3—have prediabetes. Yet over 80% don’t even know they have it.
Prediabetes Diagnosis: Know Your Numbers
Prediabetes is diagnosed with one or more of the following tests:
| Test | Normal | Prediabetes | Diabetes |
|---|---|---|---|
| Fasting Blood Glucose | 70–99 mg/dL | 100–125 mg/dL | ≥126 mg/dL |
| 2-Hour OGTT (after 75g glucose) | <140 mg/dL | 140–199 mg/dL | ≥200 mg/dL |
| Hemoglobin A1C | <5.7% | 5.7%–6.4% | ≥6.5% |
A fasting glucose of 100–125 mg/dL or a 2-hour glucose level of 140–199 mg/dL is a strong indicator of prediabetes.
Early detection is vital. Studies show that by the time diabetes is diagnosed, as much as 50% of insulin-producing beta cells may already be non-functional. But in prediabetes, most beta cells are still healthy, so reversal is possible.
Why Prediabetes Matters
Prediabetes significantly increases your risk for:
- Type 2 diabetes
- Heart disease and stroke
- Kidney disease
- Nerve damage and vision loss
Fortunately, multiple clinical trials—including the landmark Diabetes Prevention Program (DPP)—have proven that lifestyle changes can prevent or delay diabetes by up to 58%.
Prediabetes Risk Factors
You are more likely to develop prediabetes if you:
- Are overweight or have abdominal obesity
- Are physically inactive
- Have a family history of type 2 diabetes
- Are over age 45
- Had gestational diabetes during pregnancy
- Have polycystic ovary syndrome (PCOS)
- Have high blood pressure or an abnormal cholesterol profile
- Have been diagnosed with fatty liver disease or sleep apnea
These risk factors increase insulin resistance, making it more difficult for your body to regulate blood sugar levels.
How to Reverse Prediabetes
Prediabetes is often reversible through lifestyle changes. The earlier you start, the greater the chance you can return your blood sugar to normal and protect your pancreas.
1. Check Your Blood Sugar
Use a blood glucose meter or continuous glucose monitor (CGM) to learn how your body responds to different foods and activities. Track:
- Fasting levels (first thing in the morning)
- Two hours after eating (postprandial)
2. Eat Better, Not Less
- Focus on whole, minimally processed foods
- Choose carbs lower on the glycemic index (beans, whole grains, non-starchy veggies)
- Limit sugar-sweetened drinks and processed snacks
- Read labels for added sugars, fiber content, and serving sizes
3. Move More—Your Way
Aim for at least 150 minutes/week of moderate-intensity activity (like brisk walking). Even simple actions, such as dancing, gardening, or walking your dog, can help improve insulin sensitivity.
4. Lose 5–7% of Your Body Weight
Losing even a small amount of weight can significantly improve blood sugar control and insulin sensitivity.
5. Monitor Other Health Markers
- Blood pressure: Keep it below 130/80 mmHg
- Cholesterol: Aim for higher HDL and lower LDL and triglycerides
- Consider regular fasting lipid panels
6. Consider Medication If Needed
For those with high risk (e.g., BMI ≥35, age <60, history of gestational diabetes), medications like metformin may be recommended. Clinical trials also suggest that GLP-1 receptor agonists (like semaglutide) could be helpful, though they’re not yet standard for prediabetes.
Final Thoughts
Prediabetes is your body’s early warning system. If ignored, it can silently progress to type 2 diabetes and its complications. But with knowledge, support, and action, you can take control.
Talk to your diabetes healthcare team about screening, and don’t wait for a formal diagnosis to start improving your habits. The best time to act is now.
Want to learn more?
Visit Diabetes.org/prediabetes to take a free risk assessment and explore more resources.