Diabetes

Prediabetes: Early Warning Signs and Prevention

Prediabetes means blood sugar levels are higher than normal but not yet diabetes. Learn about risks, symptoms, prevention, and treatment.

4 min read

Intro

Prediabetes is a condition where blood sugar levels are higher than normal but not high enough to be diagnosed as type 2 diabetes. It’s a warning sign that the body is starting to lose its ability to regulate glucose effectively. The good news: lifestyle changes at this stage can prevent or delay progression to type 2 diabetes.

Key Points

  • Prediabetes affects hundreds of millions globally — many don’t know they have it.
  • Blood sugar levels are above normal but below the threshold for diabetes.
  • Strongly linked to overweight, obesity, and inactivity.
  • Often silent — symptoms are rare.
  • Early intervention can cut the risk of developing type 2 diabetes by 40–70%.

Background

Glucose (blood sugar) fuels the body. In prediabetes, insulin becomes less effective at moving glucose into cells — known as insulin resistance. Over time, this can damage the pancreas and lead to type 2 diabetes. Prediabetes also increases risk for heart disease and stroke, even before diabetes develops.

Causes or Mechanisms

  • Weight and obesity: Excess body fat, especially around the waist.
  • Diet: High intake of sugary drinks, refined carbs, and processed foods.
  • Physical inactivity: Sedentary lifestyles increase insulin resistance.
  • Genetics: Family history of type 2 diabetes.
  • Age and ethnicity: Higher prevalence with age, and in certain groups (e.g., South Asian, Pacific Islander, Hispanic, African ancestry).

Symptoms

  • Often no symptoms.
  • Sometimes subtle signs: fatigue, increased thirst, frequent urination.
  • Many are diagnosed only through blood tests.

Diagnosis / Screening

  • Fasting plasma glucose (FPG): 100–125 mg/dL (5.6–6.9 mmol/L).
  • HbA1c: 5.7–6.4%.
  • Oral glucose tolerance test (OGTT): 2-hour plasma glucose 140–199 mg/dL (7.8–11.0 mmol/L).
  • Screening is recommended for overweight adults and at-risk children/adolescents.

Treatment / Options

  • Lifestyle first:
    • Weight reduction (5–10% of body weight).
    • Healthy diet (whole grains, fruits, vegetables, lean proteins).
    • 150+ minutes per week of moderate physical activity.
  • Medical support:
    • Metformin may be considered in high-risk individuals (young, obese, strong family history).
  • Monitoring: Regular blood sugar checks to catch early progression.

Risks / Prognosis

  • Up to 70% of people with prediabetes eventually develop type 2 diabetes if untreated.
  • Early lifestyle changes can reverse prediabetes in many cases.
  • Even without diabetes, prediabetes increases the risk of heart disease, kidney problems, and nerve damage.

Action Plan: What You Can Do Today

Small steps add up. Here are practical ways to take action against prediabetes — starting now:

Daily Habits

  • 🚶 Move more: Aim for a 10–15 minute walk after meals. It helps lower blood sugar immediately.
  • 🥗 Swap smart: Replace one sugary drink or snack today with water, fruit, or nuts.
  • 🛏 Prioritize sleep: 7–9 hours of quality sleep supports insulin sensitivity.

Weekly Goals

  • 📅 Activity target: Work toward 150 minutes of moderate activity per week (e.g., brisk walking, cycling, swimming).
  • 🍳 Meal planning: Cook at least 3 balanced meals at home instead of relying on fast food or takeout.
  • 📉 Track progress: Weigh yourself once per week — losing even 5% of body weight can cut diabetes risk significantly.

Bigger Actions

  • 🧪 Get tested: If you’re at risk (overweight, family history, inactive), ask your doctor for a fasting glucose or HbA1c test.
  • 📏 Check your waist–hip ratio: This simple measure helps identify health risks earlier than weight or BMI alone. Use our Waist–Hip Ratio resource to calculate yours today.
  • 👨‍👩‍👧 Family approach: Make healthy eating and activity a household routine — kids learn by example.
  • 👩‍⚕️ Follow up: Schedule regular check-ins with your healthcare provider to track blood sugar and risk factors.

⚡ Bottom line: You don’t need to overhaul your life overnight. Small daily changes, consistently applied, can prevent or delay type 2 diabetes — and improve your overall health.

FAQ

Q: Can prediabetes be reversed?
A: Yes — with weight loss, healthy eating, and regular activity, many people return to normal glucose levels.

Q: Is medication always needed?
A: Not usually. Lifestyle changes are the cornerstone, though metformin may be prescribed for those at very high risk.

Q: Should children be screened?
A: Yes — especially if overweight or obese with additional risk factors (family history, inactivity, certain ethnic backgrounds).

Further Reading

References

American Diabetes Association. (2023). Classification and diagnosis of diabetes: Standards of Medical Care in Diabetes. Diabetes Care, 46(Suppl. 1), S19–S40. https://doi.org/10.2337/dc23-S002