Your top questions about prediabetes answered

Here’s what you need to know about the condition that can raise your risk for type 2 diabetes – and what you can do to help reverse it.
Woman with prediabetes and doctor

No one wants to find out they’re not as healthy as they thought. But learning you have prediabetes might be helpful. Why is that? Because it gives you a heads-up that you’re at higher risk for type 2 diabetes before any complications can arise – and it also gives you a real shot at preventing it.

“During this time of slowly increasing blood sugar levels, you can reverse the progression,” says Kirsten Ward. She’s a certified diabetes care and education specialist.

Here’s what you need to know to take charge of prediabetes and set the course for a healthier future. 

What exactly is prediabetes?

Think of prediabetes as a warning: Your blood sugar is higher than it should be – but not high enough for a type 2 diabetes diagnosis, according to the American Diabetes Association (ADA). That means your fasting blood sugar level is 100 mg/dL to 125 mg/dL. Your A1C, which is an average measure of your blood sugar over the past three months, is probably between 5.7% and 6.4%. Anything above those upper ranges is considered type 2 diabetes, according to the Centers for Disease Control and Prevention (CDC).

How diabetes is diagnosed graphic

Here’s what normally happens inside the body: The food eaten gets broken down into sugar, which gives a person energy. That sugar travels to all the tissues through the bloodstream. An organ called the pancreas then makes insulin, which is a hormone that helps the cells absorb the sugar.

But when the body can’t use insulin the right way, the sugar can’t move into cells. It stays in the blood instead. And it’s this buildup of sugar in the blood that causes prediabetes.

People who have these risk factors are more likely to get prediabetes:

  • Overweight
  • Not physically active
  • A family history of diabetes
  • A history of gestational diabetes (diabetes during pregnancy) 

About 96 million U.S. adults – more than 1 in 3 – have prediabetes, according to the CDC. Among those, 84% don’t even know they have it. That’s a big problem, because prediabetes ups the risk of developing type 2 diabetes (which is harder to treat), heart attack, and stroke.

Is it just a matter of time before I develop type 2 diabetes? 

No. Progressing from prediabetes to type 2 diabetes isn’t automatic. For some people with prediabetes, taking healthy steps such as losing weight (if needed) can return blood sugar levels to the normal range, according to the ADA.

What should I do now?

To reverse prediabetes, the first step is to talk with your healthcare provider. There’s a very good chance they’ll recommend some or all of the following: 

Lose some weight. If you’re overweight, even a relatively small loss can help prevent type 2 diabetes. How small are we talking? Just 10 to 14 pounds for a 200-pound person. That translates to 5% to 7% of total body weight, according to the CDC.

If you need help losing weight, you may be eligible to join the CDC-certified program Betr Health® at no additional cost. Betr Health focuses on the big benefits of eating healthier. Those not only include losing weight, but also just feeling better overall. The app helps you track food, weight, and blood sugar. You also get expert coaching and community support. 

CDC research has shown that people diagnosed with prediabetes who follow a structured lifestyle-change program such as Betr Health can lower their risk of developing type 2 diabetes by 58%. People 70 and older can cut theirs by 71%.

Move your body more. The recent Physical Activity Guidelines for Americans CDC recommends at least 150 minutes per week of brisk walking or similar activity. Just half an hour, five days a week, covers that. Talk to your doctor before beginning any new exercise routine.

Blue Shield Medicare members may have access to in-person and virtual exercise classes free of charge through SilverSneakers®. If you’re under 65, you might be eligible for low-cost gym memberships through Fitness Your Way™.* 

Keep up with your screening tests. Monitoring your A1C results over time will help you and your provider know if your efforts are paying off in better blood sugar control. Your doctor may also recommend regular oral glucose tolerance tests too, says Ward. Based on your screening results, you can make more adjustments if needed. 

Ask if medication might be right for you. The ADA recommends that certain people with prediabetes take a medication called metformin along with making those healthy lifestyle changes. Metformin can help keep blood sugar down, but it isn’t for everyone. Speak with your healthcare provider about whether metformin pills should be a piece of your puzzle, based on your age, A1C, and other factors.


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