Published: December 2022
Last updated: September 21, 2026
Next review: September 2027, or sooner if major diabetes guidance changes.
Written and source checked by: Adel Galal, Founder and Lead Writer at NextFitLife
Medical review status: This article has not been medically reviewed by an endocrinologist, doctor, registered dietitian, pharmacist, diabetes educator, or other licensed healthcare professional.
Prediabetes means your blood glucose is higher than normal but has not reached the diabetes range. Most people have no obvious symptoms, so a blood test is the only reliable way to know.
This is not a reason to panic. It is a reason to act.
Prediabetes raises the chance of type 2 diabetes and is linked with higher heart and metabolic risk. Food changes, movement, weight care when needed, better sleep, smoking cessation, and medical treatment for selected people can lower that risk.
This page is the main NextFitLife guide to prediabetes. For deeper help with specific topics, you can also read Prediabetes Causes, Prediabetes Diet, and Prediabetes Information and FAQs.
Medical Notice
This content is for general educational purposes and does not replace professional medical advice, diagnosis, or treatment. Consult an appropriately qualified healthcare professional for personal medical concerns. This article explains published guidance and does not provide a personal clinical assessment. Always consult qualified medical professionals for diagnosis and treatment of any health condition.
Prediabetes needs proper laboratory testing. A home glucose meter, smartwatch, or continuous glucose monitor should not be used alone to diagnose prediabetes.
Do not start, stop, or change metformin, weight management medicine, steroids, blood pressure medicine, cholesterol medicine, or another prescription based on this article.
Table of Contents
- Quick Answer
- 15 Essential Prediabetes Facts
- Prediabetes Is an Intermediate Glucose Range
- Most People Have No Symptoms
- Three Main Tests Can Diagnose It
- The Tests Do Not Always Agree
- Insulin Resistance Is a Key Process
- Millions of Adults Do Not Know They Have It
- Risk Is About More Than Weight
- Screening Often Starts by Age 35
- Heart Risk Matters Too
- Food Does Not Need to Be Extreme
- Movement Has Strong Evidence
- Modest Weight Loss Can Help
- Metformin Helps Selected People
- Glucose Can Return to Normal
- Follow Up Should Continue
- Simple Prevention Plan
- What to Eat
- Exercise
- Sleep and Stress
- Supplements
- Medicine and Weight Treatment
- When to See a Clinician
- References and Sources
- Conclusion
- Internal Links and Hub
- About the Author
- Frequently Asked Questions
Quick Answer: What Is Prediabetes?
Prediabetes is a blood glucose range between normal and diabetes. In nonpregnant adults, it can mean an A1C from 5.7% to 6.4%, fasting glucose from 100 to 125 mg/dL, or a two hour glucose result from 140 to 199 mg/dL during a 75 gram oral glucose tolerance test.
Most people have no obvious symptoms.
Prediabetes increases the chance of type 2 diabetes and is also linked with heart and metabolic risk. The good news is that early treatment can delay or prevent type 2 diabetes in many people.
15 Essential Facts About Prediabetes
1. Prediabetes Is an Intermediate Glucose Range
The word “prediabetes” describes glucose levels that are above normal but below the level used to diagnose diabetes.
You may also see older terms such as borderline diabetes, impaired fasting glucose, or impaired glucose tolerance.
“Borderline diabetes” can sound mild, but the condition deserves attention.
Prediabetes is a warning that glucose regulation is already changing.
2. Most People With Prediabetes Have No Clear Symptoms
This is one of the most important facts.
Prediabetes often causes no obvious symptoms.
Strong thirst, frequent urination, unexplained weight loss, blurry vision, repeated infections, and slow healing wounds are more concerning for diabetes or higher glucose rather than mild prediabetes.
Some people with insulin resistance develop dark, thick skin around the neck, armpits, or other skin folds. This is called acanthosis nigricans.
It can be a clue, but it does not diagnose prediabetes.
3. Three Main Blood Tests Can Find Prediabetes
| Test | Normal | Prediabetes | Diabetes |
|---|---|---|---|
| A1C | Below 5.7% | 5.7% to 6.4% | 6.5% or higher |
| Fasting plasma glucose | Below 100 mg/dL | 100 to 125 mg/dL | 126 mg/dL or higher |
| Two hour glucose after 75 gram OGTT | Below 140 mg/dL | 140 to 199 mg/dL | 200 mg/dL or higher |
A1C does not require fasting.
A fasting glucose test does.
The oral glucose tolerance test checks how your body handles a measured glucose drink.
4. The Three Tests Do Not Always Give the Same Answer
A1C, fasting glucose, and the two hour glucose test measure different parts of glucose control.
One person can have a normal fasting glucose but an abnormal two hour glucose result.
The ADA notes that the two hour test finds more people with prediabetes or diabetes than A1C or fasting glucose in some groups.
This does not mean one test is always best.
Your doctor chooses the test based on your health and situation.
A1C can also be less reliable in some people with anemia, blood disorders, pregnancy, recent blood loss, kidney failure, or conditions that affect red blood cells.
5. Insulin Resistance Is a Key Process
Insulin resistance means your cells do not respond to insulin as well as they should.
Insulin helps glucose move from the blood into cells.
When cells resist insulin, the pancreas tries to make more.
This can keep glucose controlled for a while. Over time, the pancreas may not keep up and glucose starts to rise.
Prediabetes can also involve a gradual loss of the pancreas's ability to make enough insulin.
6. Prediabetes Is Very Common and Often Hidden
CDC data updated in 2026 estimate that 115.2 million U.S. adults have prediabetes.
That is more than 2 in 5 adults.
About 8 in 10 adults with prediabetes do not know they have it.
The numbers are a strong reminder that screening matters because symptoms are not a reliable warning.
7. Prediabetes Risk Is About More Than Body Weight
Overweight and obesity can raise risk, especially when more fat is stored around the abdomen.
This deep abdominal fat is sometimes called visceral fat.
But a person can have prediabetes at any body size.
Other risk factors include:
- A parent, brother, or sister with diabetes
- Low physical activity
- High blood pressure
- High triglycerides
- Low HDL cholesterol
- PCOS
- Past gestational diabetes
- Heart or blood vessel disease
- Metabolic fatty liver disease
- Some medicines that raise glucose
- Past pancreatitis
- HIV
- Signs of severe insulin resistance
Smoking and poor sleep can also add to the wider metabolic risk picture.
For a detailed breakdown, read Prediabetes Causes.
8. ADA Screening Usually Begins by Age 35
The 2026 ADA Standards recommend testing adults of any age when they have overweight or obesity plus at least one added risk factor.
For other adults, screening should begin at age 35.
If the result is normal, repeat testing at least every three years is reasonable, with earlier testing when risk changes.
The U.S. Preventive Services Task Force uses a narrower population rule. It recommends screening adults ages 35 to 70 who have overweight or obesity.
These recommendations come from different screening frameworks, so they are not identical.
9. Prediabetes Is Also a Heart and Metabolic Warning
Prediabetes is not only about future diabetes.
The 2026 ADA Standards describe it as a risk factor for diabetes and several cardiovascular risk and metabolic outcomes.
Prediabetes often occurs with:
- High blood pressure
- High triglycerides
- Low HDL cholesterol
- Abdominal obesity
- Fatty liver
This group of problems can overlap with metabolic syndrome.
Your care plan should look at blood pressure, cholesterol, smoking, kidney health, weight, activity, and family history too.
For more detail, read Diabetes and Heart Diseases.
10. A Prediabetes Diet Does Not Need to Ban Carbohydrates
There is no one perfect diet for prediabetes.
The 2026 ADA guidance specifically supports evidence based eating patterns such as a Mediterranean diet or a lower carbohydrate pattern.
A useful meal pattern can include:
- Nonstarchy vegetables
- Whole fruit
- Beans and lentils
- Lean protein
- Whole grains when they fit your plan
- Nuts and seeds
- Plain dairy or suitable alternatives
- Olive oil and other unsaturated fats
- Water and other unsweetened drinks
Limit sugary drinks, sweets, large amounts of refined grain, processed meat, and heavily processed food more often.
You do not need to fear fruit, bread, rice, or every food containing carbohydrate.
Food quality and portion size matter.
Read the full Prediabetes Diet Guide for practical meal ideas.
11. Movement Is One of the Best Studied Prevention Tools
Physical activity helps muscles use glucose and can improve insulin sensitivity.
The 2026 ADA prevention guidance recommends at least 150 minutes of moderate activity per week for adults at high risk who can safely do it.
Brisk walking is a simple example.
The original Diabetes Prevention Program used a goal of 150 minutes per week.
Even people who reached the activity goal without reaching the weight loss goal had a lower rate of type 2 diabetes in the study.
Strength work can help too because muscle uses glucose.
If you have not exercised for a long time, start slowly.
12. Losing 5% to 7% of Starting Weight Can Help When Weight Loss Is Needed
Weight loss is not needed for every person with prediabetes.
For adults with overweight or obesity who are at high risk of type 2 diabetes, the ADA recommends a diabetes prevention program with a goal of losing at least 5% to 7% of starting body weight.
If you weigh 100 kilograms, 5% is 5 kilograms.
If you weigh 200 pounds, 5% is 10 pounds.
That is very different from promising a dramatic body change.
The goal is better metabolic health and lower diabetes risk.
For broader weight guidance, visit the Weight Loss and Metabolism Hub.
13. Metformin Can Help Selected Higher Risk People
Metformin has the strongest long term evidence among medicines used for diabetes prevention in people with prediabetes.
The 2026 ADA Standards say it should be considered especially in people at higher risk, including adults who:
- Are age 25 to 59
- Have BMI of 35 or higher
- Have fasting glucose around 110 mg/dL or higher
- Have A1C around 6.0% or higher
- Have a history of gestational diabetes
Not everyone with prediabetes needs metformin.
Long term metformin use can also lower vitamin B12 in some people. Periodic B12 testing may be advised, especially when anemia or nerve symptoms are present.
14. Glucose Can Return to the Normal Range
Yes, this can happen.
Healthy food, regular activity, weight loss when needed, better sleep, and treatment of other health risks can help some people move from the prediabetes range back into a normal glucose range.
I prefer this wording over promising a permanent “cure.”
Prediabetes risk can return later if weight, activity, illness, medicine, age, or other metabolic factors change.
Keep the habits that helped.
15. Prediabetes Needs Ongoing Follow Up
The 2026 ADA Standards recommend checking people with prediabetes for progression to diabetes at least once each year.
Testing may happen sooner when risk is high.
Closer follow up can make sense when:
- A1C is close to 6.5%
- Fasting glucose is close to 126 mg/dL
- Glucose has been rising
- You start a medicine known to raise glucose
- Your weight changes quickly
- You are planning pregnancy
- You had gestational diabetes
- Symptoms of diabetes appear
The goal is to catch a change early.
A Simple Prediabetes Prevention Plan
| Area | Simple Goal | Why It Matters |
|---|---|---|
| Food | Build most meals from vegetables, suitable protein, high fiber foods, and healthy fats. | Supports glucose, heart health, and weight goals. |
| Activity | Work toward 150 minutes of moderate activity each week. | Helps muscles use glucose and improves insulin response. |
| Weight | If needed, work toward at least 5% to 7% loss. | Can lower diabetes risk in people with overweight or obesity. |
| Sleep | Keep a steady sleep routine and ask about sleep apnea symptoms. | Sleep affects appetite, energy, glucose, and activity. |
| Smoking | Quit tobacco and nicotine use when possible. | Protects heart, blood vessels, lungs, and metabolic health. |
| Follow up | Check glucose at least yearly once prediabetes is diagnosed. | Finds progression early. |
What Is a Diabetes Prevention Program?
A diabetes prevention program is more than a diet plan.
CDC recognized programs use trained lifestyle coaches, an approved curriculum, and ongoing support.
The program works on food, activity, weight, problem solving, motivation, and habits that can last.
The landmark Diabetes Prevention Program found that the intensive lifestyle group reduced the chance of developing type 2 diabetes by 58% compared with placebo over about three years.
Metformin also reduced risk, but the lifestyle program had the larger overall effect in the original study.
That 58% figure applies to the DPP study population and intervention. It should not be treated as a personal guarantee.
What Should You Eat if You Have Prediabetes?
Start with normal food.
You do not need “diabetic food,” detox drinks, or a shelf of supplements.
A simple plate can work well.
Half the plate: nonstarchy vegetables such as broccoli, spinach, peppers, tomatoes, cabbage, cauliflower, or salad.
One quarter: protein such as fish, chicken, eggs, tofu, beans, lentils, or plain yogurt.
One quarter: a higher fiber carbohydrate such as oats, brown rice, barley, quinoa, beans, potato, or whole grain bread.
Add: a small amount of olive oil, nuts, seeds, or avocado when useful.
Drink: water or another unsweetened drink.
This is a guide, not a prescription.
Pregnancy, kidney disease, liver disease, food allergies, eating disorders, and other health problems can change what is right for you.
Can You Eat Fruit?
Yes.
Whole fruit can fit a healthy prediabetes plan.
Berries, apples, oranges, pears, peaches, bananas, grapes, and mango can all fit.
Portion size still matters.
Whole fruit is usually a better everyday choice than juice because it keeps the fiber and takes longer to consume.
Can You Eat Bread, Rice, or Potatoes?
Yes.
These foods do not need to be banned.
Portion size, food quality, and the rest of the meal matter.
Whole grain choices add more fiber, but a smaller portion of white rice or another refined food can still fit within an overall healthy plan.
What Exercise Is Best for Prediabetes?
The best exercise is one you can do safely and repeat.
Walking is a strong place to start.
Other options include cycling, swimming, dancing, gym exercise, and home workouts.
Strength training can also help protect muscle and support glucose use.
If you have heart disease, severe joint pain, balance problems, foot wounds, or another condition that affects exercise, ask your healthcare team how to begin safely.
For a combined food and activity plan, read Prediabetes Diet and Exercise.
Do Sleep and Stress Matter?
Yes, but they should not be blamed for every glucose problem.
Poor sleep can affect hunger, activity, energy, and glucose regulation.
Sleep apnea is also linked with obesity and metabolic problems.
Ask for an assessment if you snore loudly, stop breathing during sleep, wake with headaches, or remain very sleepy during the day.
Long lasting stress can affect sleep, eating, activity, and other daily habits.
Useful coping tools include walking, slow breathing, social support, mindfulness, and solving the problem that is causing the stress when possible.
See Stress Reduction Techniques for a full guide.
Can Supplements Treat Prediabetes?
Do not build a prediabetes treatment plan around cinnamon, berberine, chromium, curcumin, alpha lipoic acid, magnesium, vitamin D, or another supplement unless there is a clear medical reason.
This is an important change from the old version of this page.
There is not enough evidence to recommend routine supplement doses as a replacement for proven diabetes prevention care.
Supplements can also cause side effects or interact with medicines.
Berberine, for example, can affect drug metabolism and is not a simple substitute for metformin.
A nutrient deficiency should be treated based on the nutrient, your health, and appropriate testing.
What About Metformin and Weight Management Medicines?
Metformin
Metformin is the main medicine considered specifically for diabetes prevention in selected higher risk adults.
The strongest candidates include some people with higher A1C, higher fasting glucose, BMI of 35 or higher, younger age, or prior gestational diabetes.
It is not required for everyone.
Weight Management Medicine
Modern obesity care also includes prescription weight management medicines for people who meet medical criteria.
These medicines are not simple prediabetes cures.
When excess weight is a major part of a person's metabolic risk, treating obesity may also improve glucose.
The choice should consider health history, weight, heart risk, pregnancy plans, side effects, cost, and personal goals.
What About Bariatric Surgery?
Metabolic and bariatric surgery can strongly improve weight and glucose in selected people with obesity.
It is major medical treatment, not a routine treatment for everyone with prediabetes.
If surgery is being considered, use a qualified bariatric program.
Can a Continuous Glucose Monitor Diagnose Prediabetes?
No.
The 2026 ADA Standards say there is not enough evidence to use continuous glucose monitoring as a screening or diagnostic test for prediabetes or diabetes.
CGM can provide useful glucose information in other settings, but diagnosis should use accepted laboratory tests.
Can Children Have Prediabetes?
Yes.
Children and teenagers can develop prediabetes, especially when several type 2 diabetes risk factors are present.
Children need age specific assessment. Do not put a child on a restrictive adult diet without guidance from a pediatric healthcare team.
What About Prediabetes During Pregnancy?
Pregnancy uses different glucose testing rules.
The normal nonpregnant prediabetes ranges should not be copied into pregnancy care.
Pregnant people should follow their maternity team's testing and treatment plan.
A history of gestational diabetes also raises future diabetes risk. ADA guidance recommends ongoing testing every one to three years after a pregnancy affected by gestational diabetes.
When Should You See a Healthcare Professional?
Ask about testing if you have risk factors and do not know your glucose status.
If you already have prediabetes, talk with your clinician about your personal target, prevention program options, heart risk, medicines, and follow up schedule.
Seek medical assessment if you develop:
- Strong thirst
- Frequent urination
- Unexplained weight loss
- Marked fatigue
- Blurred vision
- Repeated infections
- Slow healing sores
These signs can occur when blood glucose has moved higher.
Common Prediabetes Myths
Myth: Prediabetes Is Mild Diabetes
No.
Prediabetes and diabetes have different laboratory ranges. Prediabetes means glucose is elevated but has not reached the diabetes threshold.
Myth: Only People With Obesity Get Prediabetes
No.
Weight is one risk factor. Genes, age, family history, PCOS, gestational diabetes, medicine, activity, and other metabolic conditions also matter.
Myth: Thirst and Frequent Urination Are Normal Prediabetes Symptoms
Usually not.
Most people with prediabetes have no clear symptoms. Strong thirst and frequent urination are more concerning for higher glucose or diabetes.
Myth: You Must Give Up Carbohydrates
No.
Healthy carbohydrate foods can fit. Food quality and portion size matter.
Myth: Supplements Can Reverse Prediabetes
No supplement has replaced structured lifestyle care, appropriate weight treatment, or metformin for selected higher risk people.
Myth: Prediabetes Always Becomes Type 2 Diabetes
No.
Some people progress, some remain in the prediabetes range, and some return to normal glucose.
References and Sources
The main medical claims in this guide were checked against current diabetes guidance and open public health sources.
- American Diabetes Association: Diagnosis and Classification of Diabetes, Standards of Care in Diabetes 2026
Current guidance on A1C, fasting plasma glucose, oral glucose tolerance testing, screening, risk factors, annual follow up, and limits of CGM for diagnosis.
Read the ADA 2026 diagnosis and screening guidance - American Diabetes Association: Prevention or Delay of Diabetes and Associated Comorbidities, Standards of Care in Diabetes 2026
Current guidance on diabetes prevention programs, 5% to 7% weight loss, 150 minutes of activity, Mediterranean and lower carbohydrate eating patterns, metformin, and vitamin B12 monitoring.
Read the ADA 2026 prevention guidance - Centers for Disease Control and Prevention: National Diabetes Statistics Report 2026
Current U.S. data showing an estimated 115.2 million adults with prediabetes and other national diabetes statistics.
Read the CDC National Diabetes Statistics Report - National Institute of Diabetes and Digestive and Kidney Diseases: Preventing Type 2 Diabetes
U.S. government guidance on prediabetes, modest weight loss, food changes, activity, long term habits, prevention programs, and metformin.
Read the NIDDK type 2 diabetes prevention guide - U.S. Preventive Services Task Force: Prediabetes and Type 2 Diabetes Screening
Independent screening recommendation for asymptomatic adults ages 35 to 70 with overweight or obesity and referral to effective preventive interventions when prediabetes is found.
Read the USPSTF screening recommendation
Conclusion: Prediabetes Gives You Time to Act
Prediabetes is an early warning that glucose regulation has started to change. It does not mean type 2 diabetes is certain.
Know your real test result. Eat in a way you can keep. Move often. Work toward a healthier weight when that is right for you. Protect sleep, stop smoking, check blood pressure and cholesterol, and keep your follow up appointments.
Medicine can help selected people, but supplements and quick fixes should not replace proven care.
Your next step: if you do not know your A1C or fasting glucose, ask whether screening is right for you. If you already have prediabetes, choose one change you can repeat this week and review the full prevention plan with your healthcare professional.
Internal Links and Hub
Continue with these NextFitLife guides for prediabetes, food, exercise, heart health, weight, stress, and daily diabetes care:
- Prediabetes Causes
- Prediabetes Diet
- Prediabetes Information and FAQs
- Prediabetes NHS
- Prediabetes Diet and Exercise
- Diabetes Lifestyle Routines
- Diabetes and Heart Diseases
- Weight Loss and Metabolism Hub
- Stress Reduction Techniques
Frequently Asked Questions About Prediabetes
What is prediabetes?
Prediabetes means your blood glucose is higher than normal but has not reached the range used to diagnose diabetes.
Is borderline diabetes the same as prediabetes?
“Borderline diabetes” is an informal older term often used to describe prediabetes. Prediabetes is the clearer medical term.
What A1C means prediabetes?
An A1C from 5.7% through 6.4% falls in the ADA prediabetes range.
What fasting glucose means prediabetes?
A fasting plasma glucose from 100 through 125 mg/dL falls in the prediabetes range.
What two hour glucose result means prediabetes?
A two hour value from 140 through 199 mg/dL during a 75 gram oral glucose tolerance test falls in the prediabetes range.
Is A1C 6.5% prediabetes?
No. An A1C of 6.5% or higher reaches the diabetes range. In the absence of clear high glucose symptoms or a glucose emergency, diagnosis normally needs confirmation.
Does prediabetes cause symptoms?
Most people have no obvious symptoms. Strong thirst, frequent urination, unexplained weight loss, or blurry vision should lead to medical testing because glucose may be higher.
What causes prediabetes?
Insulin resistance is a major process. Genes, family history, abdominal fat, activity, age, PCOS, past gestational diabetes, medicines, and other metabolic conditions can affect risk.
Can a thin person have prediabetes?
Yes. Higher weight is one risk factor, but it is not required.
Can children get prediabetes?
Yes. Children and teenagers can develop prediabetes, especially when several type 2 diabetes risk factors are present.
Does eating sugar cause prediabetes?
Sugar is not the single cause. Diet, excess calories, body fat, genes, activity, sleep, medicine, age, and other metabolic factors all affect risk.
Can stress cause prediabetes?
Stress is not normally the sole cause. Long lasting stress can affect sleep, food, activity, hormones, and weight, which may add to metabolic risk.
Can poor sleep affect prediabetes?
Poor sleep can affect appetite, glucose regulation, energy, and activity. Sleep disorders such as sleep apnea can also be linked with metabolic risk.
Does PCOS raise prediabetes risk?
Yes. PCOS is often linked with insulin resistance and higher type 2 diabetes risk.
Does gestational diabetes raise future risk?
Yes. A history of gestational diabetes raises future risk even if glucose returns to normal after pregnancy.
Can prediabetes return to normal?
Yes. Many people can return glucose to the normal range through lifestyle changes and, when appropriate, medical treatment.
Does prediabetes always become type 2 diabetes?
No. Some people progress, some remain in the prediabetes range, and some return to normal glucose.
What diet is best for prediabetes?
There is no single best diet. Mediterranean style and lower carbohydrate eating patterns are two evidence based options. The plan should be nutritious and realistic for you.
Can I eat fruit?
Yes. Whole fruit can fit a healthy prediabetes plan.
Can I eat rice or bread?
Yes. Portion size, food quality, and the rest of the meal matter more than banning these foods.
How much exercise helps?
A common prevention goal is at least 150 minutes of moderate activity each week for people who can safely do it.
How much weight loss can help?
For people with overweight or obesity who are at high risk, ADA guidance recommends aiming for at least 5% to 7% loss of starting body weight.
Does everyone with prediabetes need metformin?
No. Metformin is considered more often for people with higher risk of developing diabetes.
Can supplements reverse prediabetes?
No supplement has replaced proven lifestyle treatment or appropriate medical care. Do not use cinnamon, berberine, chromium, or another product as a substitute for your prevention plan.
Do I need a CGM?
Usually not for diagnosis. The 2026 ADA Standards say there is not enough evidence to use CGM alone to screen for or diagnose prediabetes.
How often should prediabetes be checked?
The ADA recommends testing people with prediabetes for progression to diabetes at least once each year.
When should I see a doctor?
Ask for medical advice if you have an abnormal blood test, strong diabetes risk factors, or symptoms such as frequent urination, strong thirst, unexplained weight loss, blurry vision, repeated infections, or slow healing sores.
Health & wellness writer with 30+ years of experience in nutrition, fitness, and healthy aging. Founder of NextFitLife.com — evidence-based health guidance.
