Prediabetes: What It Means and How to Prevent Type 2 Diabetes

You go in for routine bloodwork and discover your blood sugar is higher than normal. Your healthcare provider tells you that you have prediabetes.

But what does that actually mean? Do you have diabetes? Will you eventually develop it? And most importantly, can you do anything to prevent it?

The good news is that prediabetes does not mean type 2 diabetes is inevitable.

Understanding your blood sugar and making sustainable lifestyle changes can significantly reduce your risk.

What Is Prediabetes?

Prediabetes means your blood sugar levels are higher than normal but not high enough to meet the criteria for diabetes. Your body uses a hormone called insulin to help move glucose (sugar) from your bloodstream into your cells, where it can be used for energy.

With prediabetes, your body may become less responsive to insulin, a condition called insulin resistance. Over time, the pancreas may struggle to produce enough insulin to keep blood sugar within a healthy range.

Some people with prediabetes eventually develop type 2 diabetes. Others maintain stable blood sugar levels or return to the normal range.

What Are Normal Blood Sugar Levels?

Two common blood tests used to identify prediabetes are hemoglobin A1C and fasting blood glucose.

Test	Normal	Prediabetes	Diabetes
Hemoglobin A1C	Below 5.7%	5.7%–6.4%	6.5% or higher
Fasting glucose	Below 100 mg/dL	100–125 mg/dL	126 mg/dL or higher

A1C reflects your average blood sugar over approximately the past two to three months.

Fasting glucose measures your blood sugar after you have gone without calories for at least eight hours.

A diabetes diagnosis generally requires confirmatory testing unless there is clear evidence of elevated blood sugar with characteristic symptoms. Certain medical conditions can affect A1C accuracy, so your healthcare provider may recommend additional testing.

What Are the Symptoms of Prediabetes?

One of the challenges with prediabetes is that most people have no noticeable symptoms.

You may feel perfectly healthy while your blood sugar gradually increases. Some people may have signs associated with insulin resistance, such as darkened, velvety skin around the neck or armpits, known as acanthosis nigricans.

Symptoms such as increased thirst, frequent urination, unexplained weight loss, or blurry vision can suggest more significant blood sugar elevation and should be evaluated.

Because prediabetes often develops silently, screening is particularly important for people with risk factors.

Who Is at Risk for Prediabetes?

Several factors can increase your likelihood of developing prediabetes or type 2 diabetes:

• Having excess body weight, particularly around the abdomen

• Being physically inactive

• Having a parent or sibling with type 2 diabetes

• Being age 35 or older

• Having a history of gestational diabetes

• Having polycystic ovary syndrome (PCOS)

• Having high blood pressure or abnormal cholesterol levels

• Belonging to a population with a higher prevalence of type 2 diabetes

Prediabetes can also develop in younger adults and people who do not have excess body weight.

Can Prediabetes Be Reversed?

For many people, blood sugar levels can return to the normal range.

However, returning to a normal A1C doesn't necessarily mean the underlying risk has disappeared.

The goal is to improve insulin sensitivity, support metabolic health, and reduce the likelihood of developing type 2 diabetes over time. The most effective approach usually involves consistent, sustainable changes rather than extreme diets or temporary fixes.

5 Ways to Reduce Your Risk of Type 2 Diabetes

1. Focus on Balanced Nutrition

You don't necessarily need to eliminate carbohydrates to improve blood sugar.

Instead, focus on the quality and quantity of the carbohydrates you eat and how you combine them with other nutrients.

Helpful strategies include:

• Choosing fiber-rich vegetables, fruits, beans, and whole grains

• Including lean proteins with meals

• Replacing sugary beverages with water or unsweetened alternatives

• Limiting highly processed foods and refined carbohydrates

• Including healthy fats from foods such as nuts, seeds, olive oil, and avocado

• Paying attention to portions and eating patterns

Fiber, protein, and healthy fats can help support fullness and a more gradual rise in blood sugar after meals.

2. Move Your Body Regularly

Physical activity helps your muscles use glucose and can improve insulin sensitivity.

A useful goal for many adults is at least 150 minutes of moderate-intensity physical activity per week, such as brisk walking.

Resistance training is also beneficial because muscle tissue plays an important role in glucose metabolism. You don't have to start with an intense exercise program. Even short walks after meals can be a practical way to become more active.

The most effective exercise routine is one you can maintain consistently.

3. Consider Weight Management

For people with excess body weight, modest weight loss can significantly improve metabolic health.

Research from the Diabetes Prevention Program found that an intensive lifestyle intervention targeting approximately 7% weight loss and 150 minutes of weekly physical activity reduced the incidence of type 2 diabetes by 58% over approximately three years among high-risk participants.

Weight loss is not the only goal, however.

Improving fitness, nutrition, sleep, and other metabolic risk factors matters even when the scale changes slowly.

4. Don't Overlook Sleep

Sleep and blood sugar regulation are closely connected.

Insufficient sleep and untreated sleep disorders, including obstructive sleep apnea, can contribute to insulin resistance and make blood sugar management more difficult.

If you regularly wake up tired, snore loudly, or experience excessive daytime sleepiness, it may be worth discussing your sleep quality with your healthcare provider.

At Avaly Direct Health, we offer at-home SleepImage sleep studies for $45 when evaluating suspected sleep apnea is appropriate.

Identifying sleep-related breathing problems may help address an important contributor to overall metabolic health.

5. Manage Stress and Other Health Conditions

Chronic stress can influence sleep, eating habits, physical activity, and blood sugar regulation.

Conditions such as high blood pressure, abnormal cholesterol, and sleep apnea may also occur alongside insulin resistance. Addressing these factors together is often more effective than focusing on a single laboratory number.

Do You Need Medication for Prediabetes?

Not everyone with prediabetes needs medication.

Lifestyle changes remain a foundational approach to preventing type 2 diabetes.

However, metformin may be considered for certain individuals at higher risk, particularly those with more significant blood sugar elevation, a history of gestational diabetes, or other risk factors.

Medication decisions should be individualized based on your medical history, laboratory results, and overall health.

What About GLP-1 Medications?

You may have heard about GLP-1 medications used for diabetes treatment or chronic weight management.

Certain medications in this category can improve blood sugar regulation and support significant weight loss in eligible patients.

However, prediabetes alone does not automatically mean someone needs a GLP-1 medication.

These treatments have specific indications, potential side effects, costs, and considerations that should be discussed with a healthcare provider.

For many people, lifestyle changes remain an appropriate first step.

How Often Should You Recheck Your A1C?

If you have prediabetes, your healthcare provider will generally recommend monitoring your blood sugar periodically.

Testing at least annually is commonly recommended, although some individuals may benefit from more frequent follow-up depending on their results, risk factors, and treatment plan.

Tracking changes over time can help determine whether your current approach is working.

When Should You Talk to Your Healthcare Provider?

Consider discussing diabetes screening if you:

• Have a family history of type 2 diabetes

• Have been told your blood sugar is borderline

• Have high blood pressure or abnormal cholesterol

• Have a history of gestational diabetes or PCOS

• Have other risk factors for insulin resistance

• Are due for age-appropriate preventive screening

You don't have to wait until symptoms appear to start evaluating your metabolic health.

Your Health, Your Next Step

A prediabetes diagnosis can feel concerning, but it also provides an opportunity to take action before type 2 diabetes develops.

At Avaly Direct Health in Englewood, Colorado, we help patients understand their bloodwork, evaluate cardiovascular and metabolic risk factors, and develop personalized plans for long-term health.

We serve patients throughout Englewood, Littleton, Denver, and surrounding communities.

Learn more: https://www.avalyhealth.com

Schedule a free Meet & Greet: https://www.avalyhealth.com/meet