Prediabetes is common, often has no symptoms and can progress to type 2 diabetes, but federal health officials say modest weight loss and regular physical activity can sharply reduce that risk.
More than two in five U.S. adults have prediabetes, according to the Centers for Disease Control and Prevention. The condition means blood glucose is above normal but not yet high enough for a diabetes diagnosis. It also raises the risk of heart disease and stroke.
Insulin helps glucose move from the bloodstream into cells for energy. In prediabetes, cells do not respond normally to insulin, and the pancreas works harder to keep glucose under control. Over time, blood sugar can continue rising until it reaches the diabetes range.
A blood test is needed because many people feel well. Common tests include the A1C, fasting plasma glucose and oral glucose tolerance test. The appropriate test and interval depend on age, weight, pregnancy history, family history and other risks, so patients should ask a clinician whether screening is recommended.
The landmark Diabetes Prevention Program found that participants at high risk who pursued structured diet and activity changes reduced their chance of developing type 2 diabetes by 58% over about three years compared with participants who received a placebo. The reduction was 71% among people age 60 and older.
The lifestyle goal was practical rather than extreme: Lose about 5% to 7% of body weight for people with overweight and complete at least 150 minutes of moderate activity each week. For a 200-pound adult, that weight-loss range is about 10 to 14 pounds. Brisk walking for 30 minutes on five days can meet the activity target.
Results vary, and not everyone with prediabetes has overweight. Some patients may need a different plan or medication based on age, glucose level, pregnancy history and other conditions. The federal National Diabetes Prevention Program connects eligible adults with yearlong, coach-led programs focused on eating patterns, movement, stress and maintaining changes.
People can start by replacing sugary drinks, adding fiber-rich foods, planning portions and breaking activity into shorter sessions. Those changes also support blood pressure, cholesterol, sleep and mobility. A crash diet is not required, and sustainable changes are more useful than short bursts followed by weight regain.
Prediabetes is not a moral failing, and prevention is not guaranteed. Genetics, access to healthy food, work schedules, medication and other health conditions influence risk. Regular follow-up helps identify whether glucose is improving, stable or moving toward diabetes.
Source: archived CDC feature. Updated verification: Centers for Disease Control and Prevention, published Dec. 26, 2024, and the National Institute of Diabetes and Digestive and Kidney Diseases.
