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Prediabetes means your blood sugar is higher than normal but not high enough to be type 2 diabetes. It’s sometimes called borderline diabetes. And can it be reversed? Diabetes UK says yes, it’s possible: with health changes, many people bring their blood sugar back into the normal range, though there’s no guarantee.
What is prediabetes, exactly?
Prediabetes is a state where the sugar in your blood is above normal but below the threshold for type 2 diabetes. It’s diagnosed with a blood test, and results are often given as an HbA1c number.
Diabetes UK estimates it affects around one in 12 people. Without changes, it doesn’t go away on its own, and it puts you at higher risk of developing type 2 diabetes.
What do the HbA1c numbers mean?
Your result will be given in mmol/mol. Here’s how Diabetes UK groups the numbers:
| HbA1c result | What it means |
|---|---|
| Below 42 mmol/mol | Normal range |
| 42 to 47 mmol/mol | Prediabetes |
| 48 mmol/mol or above | Type 2 diabetes range |
If your result is in the prediabetes range, your GP should talk to you about next steps and how often to have it checked again.
Who is more likely to get prediabetes?
Prediabetes is more common in people living with overweight or obesity, but it can affect people of a healthy weight too. Diabetes UK is clear that weight alone doesn’t cause it. It comes from a mix of factors that differ from person to person.
Some risk factors you can’t change:
- Age.
- Family history and genetics.
- Ethnicity: people of Black African, African Caribbean and South Asian backgrounds have a higher risk of type 2 diabetes than people of White European backgrounds, and may develop it at a younger age or a lower body weight.
- Gestational diabetes: women who had diabetes in pregnancy are among those at highest risk.
Others you can work on, such as how active you are, carrying weight around your middle, diet, sleep and smoking.
Can prediabetes be reversed?
Diabetes UK says it is possible. In practice, “reversing” prediabetes means your HbA1c goes back below 42 mmol/mol.
It’s worth being realistic. Diabetes UK says there’s no guarantee it will work for everyone, and bringing it down within three months is unlikely. Even if your number doesn’t drop all the way, any reduction can help keep it out of the type 2 range and can help with cholesterol and blood pressure too.
What changes can help?
These are the main areas Diabetes UK suggests. Speak to your GP before you make big changes to your diet, weight or activity, especially if you take any medication.
- Lose some weight, if you need to. If you’re living with overweight or obesity, weight loss is likely to have the biggest impact. Diabetes UK says losing around 1% to 9% of your body weight can lower your risk. Not everyone with prediabetes needs to lose weight.
- Eat more whole foods. Fill up on fruit, vegetables, fibre and wholegrains, such as brown rice and multigrain bread instead of white.
- Cut back on a few things. Eat less salt, red meat and processed meat, and avoid sugary drinks.
- Move more and sit less. Start by breaking up long spells of sitting. If you’re at a desk or in front of the TV, get up and move every 30 to 45 minutes. Activity that leaves you slightly out of breath, like a brisk walk, is especially helpful.
- Sleep well and stop smoking. Poor sleep and smoking can both raise your risk of high blood sugar. Your GP can point you to NHS support to quit.
Pick one change and build from there. Diabetes UK gives the example of swapping sugary fizzy drinks for diet versions for a month. If breakfast is a weak spot, our diabetes-friendly breakfast ideas are a good place to start.
What is the NHS Healthier You programme?
If you have prediabetes, your GP should refer you to a free type 2 diabetes prevention course or offer prevention advice, depending on where you live. In England, this is the NHS Healthier You programme.
According to NHS England:
- it lasts nine months
- you can do it in face-to-face group sessions or through a digital service with online content, health coaches and peer support
- it covers healthier eating, keeping to a healthy weight and staying active
- nearly one million people in England have started it since 2016
NHS England reports that participants lost 3.3kg on average, and that a review found completing the programme was linked to a 37% lower chance of developing type 2 diabetes.
How do I find out if I’m at risk?
Because prediabetes usually has no symptoms, a blood test is the only way to know. Diabetes UK has a free online Know Your Risk tool that gives you a personal risk score. If your score is high, or you have any of the risk factors above, ask your GP about an HbA1c test.
If you’ve already been told you have prediabetes, keep going to your follow-up checks so you can see how your changes are working.
Making everyday meals easier to judge
Small food changes add up, but it can be hard to know what’s in a meal when there’s no label to check. If you’re buying packaged food, our guide on how to read food labels with diabetes explains the traffic lights. For home-cooked meals and takeaways, the Dietary Insight app can estimate the carbs and sugar in a dish from a photo and suggest a swap, which can help you spot patterns over time.
Prediabetes is a warning sign, not a diagnosis of type 2 diabetes. For advice that fits your health, talk to your GP, diabetes nurse or dietitian.
Frequently asked questions
What HbA1c level is prediabetes?
Prediabetes is an HbA1c of 42 to 47 mmol/mol. Below 42 is the normal range, and 48 or above is the type 2 diabetes range.
Does prediabetes have symptoms?
There usually aren't any symptoms, which is why many people only find out from a routine blood test. If you think you might be at risk, ask your GP about a test.
How long does it take to bring prediabetes back to normal?
Diabetes UK says doing it within three months is unlikely to be realistic. Small changes you can keep up over the long term tend to work better than quick fixes.
Sources
This article is general information, not medical advice. If you have diabetes, high blood pressure or a food allergy, speak to your GP, diabetes nurse or a registered dietitian before changing your diet or medication. Read our medical disclaimer.