The first step for managing prediabetes is understanding what a prediabetes diagnosis means. Treatment may include lifestyle changes, such as diet, exercise, and medication.

If you receive a prediabetes diagnosis, it means you have a higher-than-normal blood sugar level. But it’s not high enough to qualify as a diagnosis of diabetes.

According to a 2014 review, long-term data suggest that lifestyle changes may decrease the risk of prediabetes progressing to diabetes for as long as 10 years. An earlier study showed that 5% to 10% of people’s prediabetes progresses to diabetes every year.

Prediabetes can also lead to other health conditions, including heart disease and stroke.

But you can reverse prediabetes. Read on to learn more about this diagnosis and what you can do.

Other names

A doctor or healthcare professional may refer to prediabetes as the following:

  • impaired glucose tolerance (IGT), which means you have higher-than-normal blood sugar after a meal
  • impaired fasting glucose (IFG), which means you have higher-than-normal blood sugar in the morning before eating
  • hemoglobin A1C level between 5.7% and 6.4%

Prediabetes has no clear symptoms. Some people may experience a condition called acanthosis nigricans, which is a sign of insulin resistance. It involves the development of dark, thick, and often velvety patches of skin. It can be associated with polycystic ovary syndrome (PCOS).

This discoloration usually occurs around your:

  • elbows
  • knees
  • neck
  • armpits
  • knuckles

If you’ve received a diagnosis of prediabetes, it’s important to talk with a doctor if you experience:

These are symptoms typical of type 2 diabetes and may indicate that your prediabetes has progressed to type 2 diabetes. A doctor can order a series of tests to confirm this.

Your pancreas releases a hormone called insulin when you eat so that sugar from your blood moves into the cells of your body and serves as an energy source. That’s how insulin helps lower your blood sugar level.

The causes of prediabetes are similar to those of diabetes, though they’re at an earlier stage. They primarily consist of:

  • Insulin resistance: Insulin resistance occurs when your cells don’t respond properly to insulin.
  • Increased metabolic disturbance: Increased metabolic disturbance is a result of both worsening hyperglycemia (high blood sugar) and insulin resistance.

A normal fasting blood glucose level is 99 mg/dL or less, while hypoglycemia (low blood glucose) is under 70 mg/dL.

If you have prediabetes, your blood glucose levels will rise to 100 to 125 mg/dL. Once your blood glucose level goes above 125 mg/dL, you’ll receive a diagnosis of diabetes.

Prediabetes can occur in anyone, but certain factors can increase your chances of developing the condition.

Research suggests that prediabetes is strongly linked to lifestyle factors and genetics. Here are some of the main risk factors for prediabetes:

  • Age: People older than 45 years of age are at a higher risk of prediabetes.
  • Body weight: If you have a body mass index (BMI) of more than 25, a doctor may want to screen for prediabetes.
  • Waist size: Having more fat around your waist than your hips can increase your risk of prediabetes. You can measure this risk factor by checking if your waist is 40 in. or more if you’re a person assigned male at birth and 35 in. or more if you’re a person assigned female at birth.
  • Race and ethnicity: Research has shown that prediabetes occurs at higher rates in people who are African American, Asian American, Hispanic, or Native American. Resource disparities, such as access to care, may likely factor into this higher prevalence, according to the Centers for Disease Control and Prevention (CDC).
  • Diet: Regular consumption of red meat, processed meat, and sugar-sweetened beverages could increase your risk of developing prediabetes.
  • Physical inactivity: Not only can getting regular exercise help you keep up a moderate weight, but it can also lower your risk of prediabetes.
  • Family history: If you have an immediate relative with type 2 diabetes, you may be at a higher risk of developing prediabetes.
  • Tobacco use: In addition to increasing your risk of insulin resistance, smoking may also be associated with an increase in waist size, which is another risk factor of prediabetes.
  • Medical history: Certain conditions, including sleep apnea, gestational diabetes, PCOS, high blood pressure, and increased cholesterol or triglyceride levels may be linked to a higher risk of insulin resistance and prediabetes.

According to the CDC, losing even just 5% to 7% of your body weight if you have overweight can significantly lower your risk of developing type 2 diabetes.

Other factors, including high stress levels and smoking, can also contribute to the development of type 2 diabetes.

Making lifestyle changes is one of the most effective ways to keep up a moderate weight and prevent type 2 diabetes.

Here are a few tips to get started:

  • Eat more fiber-rich foods, such as fruits, nonstarchy vegetables, nuts, seeds, whole grains, and legumes.
  • Limit your intake of sweets and sugary beverages, including soda, sweet tea, and sports drinks.
  • Aim for at least 150 minutes of physical activity per week, or about 30 minutes daily for 5 days per week.
  • If you smoke, consider quitting.
  • Manage your stress levels with meditation, yoga, deep breathing, and other techniques to lower stress.

A doctor will need to order a blood test for an accurate diagnosis. This means drawing a blood sample to send to a lab.

Results can vary depending on the type of test. You should take the same test twice to confirm the diagnosis, according to the National Institutes of Health (NIH).

Devices that measure your glucose levels, such as the finger-stick test, aren’t used for diagnosis. Instead, a doctor will use one or two of these tests:

Hemoglobin A1C test

The hemoglobin A1C test, which is also called the A1C test or glycosylated hemoglobin test, measures your average blood sugar level over the last 2 to 3 months. This test doesn’t require fasting and can be done any time.

An A1C value of 5.7% to 6.4% is diagnostic for prediabetes. A second A1C test is recommended to confirm the results. The higher the A1C, the higher the risk that your prediabetes will progress to type 2 diabetes.

Fasting plasma glucose test

During a fasting plasma glucose (FPG) test, a doctor will ask you to fast for 8 hours or overnight. Before you eat, a healthcare professional will take a blood sample for testing.

A blood sugar level of 100 to 125 mg/dL indicates prediabetes.

Oral glucose tolerance test

An oral glucose tolerance test (OGTT) also requires fasting. A doctor will check your blood glucose levels twice, once at the beginning of the appointment and then 2 hours later after you drink a sugary drink.

If your blood sugar level reads 140 to 199 mg/dL after 2 hours, then the test indicates IGT, or prediabetes.

Treating prediabetes can also be thought of as preventing type 2 diabetes. If a doctor gives you a diagnosis of prediabetes, they’ll recommend certain lifestyle changes.

A study called the Diabetes Prevention Program showed an approximate 58% reduction of risk in people who kept up with these changes in the long term.

The most common ways to manage prediabetes are:

Some people with diabetes choose to use complementary and alternative medicine (CAM) treatments to manage their condition. CAM treatments can include taking supplements, meditation, and acupuncture.

Always check with a doctor before starting any CAM treatments because they may interact with your medication.

Low carbohydrate diet

Research suggests that a low-carbohydrate diet could help improve your blood glucose management, insulin resistance, and weight.

Although most available research is focused on type 2 diabetes rather than prediabetes specifically, it may be fair to assume that a low carbohydrate diet could also be beneficial for those with prediabetes.

Low-carbohydrate diets generally restrict your carbohydrate intake to less than 26% of total daily calories, or about 130 g of carbohydrates per day.

Talk with a doctor before making major changes to your diet.

If you don’t get treatment, prediabetes can develop into type 2 diabetes and other conditions, such as:

The good news is that prediabetes is reversible with long-term lifestyle changes.

Have more:

  • fish with omega-3 fatty acids, such as salmon and tuna
  • vegetables
  • fruits
  • high-fiber foods, such as whole grains

Have less:

  • than 1,500 mg of sodium per day
  • alcohol, or limit to one drink per day
  • foods with added sugar and unhealthy fats

Prediabetes is reversible. You can prevent or slow the development of prediabetes and diabetes by making lifestyle changes, including keeping up a moderate weight.

According to one 2017 review, each 2.2 lbs. of weight loss could lower the risk of type 2 diabetes by 16% for people with IGT, or prediabetes.

A heart-healthy lifestyle includes the following:

Eating nutrient-rich foods

Be sure to include plenty of nutrient-dense, whole foods in your diet and limit your intake of highly processed foods and sugar-sweetened beverages.

Fiber-rich foods, such as fruits, vegetables, and whole grains, can be especially beneficial to help you reach your health goals.

Exercising

You can lower your risk of diabetes by regularly staying active. Doing 30 minutes of any activity that raises your heart rate to your target rate, such as walking, most days of the week is recommended.

Ways to incorporate physical activity into your daily schedule can include:

  • riding a bike to work
  • walking instead of riding the bus or driving
  • going to a gym
  • participating in recreational sports with a team

Getting 30 minutes of exercise per day and losing 5% to 7% of your weight can lower your risk of type 2 diabetes progression by more than 58%, according to the CDC.

If left untreated, prediabetes can cause several health issues, including type 2 diabetes, heart disease, and stroke.

But it’s reversible and can be treated by making lifestyle changes.

In addition to following a health-promoting, well-rounded diet, getting regular physical activity and taking medications as prescribed by a doctor can help prevent prediabetes from progressing.