Prediabetes 101: The Basics

What is Prediabetes?

Prediabetes is a condition where blood sugar levels are higher than normal at an A1C percent between 5.7% – 6.4% (NIDKK, 2018), but not high enough to be considered type 2 diabetes. Prediabetes can progress to type 2 diabetes if adequate action is not taken. According to the CDC, diabetes can put you at risk for other diseases such as heart attack, stroke, and chronic kidney disease. 

What causes Prediabetes?

The pancreas is responsible for making insulin. Insulin is a hormone that allows cells to take in blood sugar which is then used as energy. When the cells don’t respond normally to insulin, the body produces more insulin in an attempt to get cells to respond. Eventually, the pancreas can’t keep up and the cycle continues (CDC, 2020). This sets the stage for prediabetes and type 2 if preventative techniques aren’t taken. The good news is prediabetes can be reversed through lifestyle changes. 

How do I know if I am Prediabetic?

Unlike many bodily diseases, prediabetes doesn’t have indicative symptoms making it difficult for one to know and get treated for prediabetes. The simplest way to check if you are prediabetic is to get a blood test done. Check with your doctor on how to get this done if you believe you are at risk of being prediabetic. The blood test will check your average blood glucose or sugar level. The indicator that is most commonly used in blood tests to test blood glucose levels is known as the Hemoglobin A1C. As reported by the NIDDK, the Hemoglobin A1C is reported as a percentage where 6.4% – 5.7% is considered prediabetic and anything below 5.7% is considered normal. However, the numbers only tell part of the picture. It is important to follow up with your primary care physician to get a proper diagnosis.

DiagnosisHemoglobin A1C
NormalBelow 5.7%
Prediabetic 5.7% – 6.4%
Diabetic Above 6.4%

Reversal and Prevention Techniques

Without lifestyle intervention, prediabetes is almost sure to progress to type 2 diabetes (Tuso, 2014). One of the most significant risk factors for diabetes is low physical activity and obesity. Losing a healthy amount of weight is shown to help the pancreas regulate insulin levels better. In bodies that are overweight, it takes more insulin to process the sugar. Often enough, the pancreas cannot produce the adequate amount of insulin needed, leading to sugar build-up in the blood which spikes blood glucose levels (Bishop, 2012). Maintaining weight is especially important for those who have a family history of diabetes. It is shown that keeping a healthy weight can lower the risk for those with a family history of diabetes by 70 to 90 percent. While losing weight can be hard, it doesn’t have to be impossible. Small lifestyle changes can lead to significant results and will ultimately be the key factor in the prevention and reversal of prediabetes. 

Keeping an active lifestyle and a healthy diet is one way to help lose or maintain weight. The key is to instill these practices slowly to make them easier to keep up with. It is recommended to get around 30 minutes of physical activity every day. A simple way to start incorporating physical activity into your daily lifestyle is to walk regularly. According to the American Heart Association, daily brisk walking is an effective cardio exercise that reduces the risk of diabetes and heart disease by 30 percent. Other changes to lower the risk of diabetes include diet changes. According to MayoClinic, a healthy diet to control diabetes includes incorporating healthy carbohydrates and fibrous foods such as fruits, vegetables, whole grains, and legumes. It is also recommended to eat good fats such as avocado and nuts. When picking out your food it is important to avoid high saturated fats, trans fats, cholesterol, and sodium. Controlling the amount of food you eat enables your pancreas to keep up with the insulin it needs to produce and keep your blood sugar levels in check. A healthy diet that includes the proper amount of fiber and nutrients helps to keep your blood sugar in a healthy range. Eating earlier is also shown to lower blood sugar levels. The recommended time to eat dinner is around 6:00 PM – 7:00 PM. Incorporating these into your lifestyle can effectively reduce the risk for diabetes. 

Being diagnosed with prediabetes doesn’t have to mean that you will be diabetic in the future. By keeping a healthy diet and staying fit, you can reduce your risk of type 2 diabetes and even reverse prediabetes. For specific recommendations regarding lifestyle changes, please talk to your doctor. 

Author: Shaheen Khatua, Student Intern

Apollo Health Care Center and San Mateo Primary Care


Bishop. (2012). Losing weight can have big impact on those with diabetes. Mayo Clinic.

Centers for Disease Control and Prevention. (2020, June 11). What is diabetes? Centers for Disease Control and Prevention.

Tuso, P. (2014). Prediabetes and LIFESTYLE MODIFICATION: Time to prevent a preventable disease. The Permanente journal.

U.S. Department of Health and Human Services. (2018). The A1C test & diabetes. National Institute of Diabetes and Digestive and Kidney Diseases.