Prediabetes: you can turn it around
Prediabetes means your blood sugar is higher than normal but not yet diabetes. In large studies, modest lifestyle changes cut the risk of progressing by more than half. Here is what the numbers mean and what works.
By Dr. Pankaj Kumar · MBBS, DNB (Family Medicine) · physician and author of The 90-Day Prediabetes Turnaround
What the numbers mean
A1C (HbA1c) 5.7–6.4%
Your average blood sugar over about 3 months is raised. In the UK this is often written as 39–47 mmol/mol, with the NHS using 42–47 for 'non-diabetic hyperglycaemia'.
Fasting glucose 100–125 mg/dL
That's 5.6–6.9 mmol/L after an overnight fast. Called impaired fasting glucose.
2-hour glucose test 140–199 mg/dL
That's 7.8–11.0 mmol/L two hours after a glucose drink. Called impaired glucose tolerance.
Why it matters
Without changes, many people with prediabetes develop type 2 diabetes within 5–10 years. Heart and blood-vessel risk is already higher.
Who should test
Adults over 35, anyone with excess weight around the waist, a family history of diabetes, PCOS, past gestational diabetes, or South Asian, Black or Hispanic heritage.
The good news
In the Diabetes Prevention Program, losing about 7% of body weight and walking 150 minutes a week cut progression to diabetes by 58%.
Five changes that move the numbers
None of these need special foods or supplements. They work because they improve how your body responds to insulin.
Lose 5–7% of your weight
For someone weighing 90 kg (198 lb), that's about 5–6 kg (11–14 lb). Waist size often matters more than the scale.
Move after meals
A 10–15 minute walk after your main meals lowers the sugar spike. Build up to 150 minutes of activity a week, plus strength exercise twice a week.
Change the plate, not just the portion
Half vegetables, a quarter protein, a quarter whole-grain or legume carbohydrate. Cut sugary drinks and refined white flour first.
Protect sleep
Less than 6 hours of sleep raises blood sugar and appetite. Snoring with daytime sleepiness may be sleep apnoea, which is worth checking.
Retest in 3 months
Repeat the A1C after 3 months. Some people, especially with a BMI over 35 or past gestational diabetes, may benefit from metformin. Ask your doctor.
Frequently asked questions
Can prediabetes be reversed?
Often, yes. Many people bring their A1C or fasting glucose back to the normal range with weight loss, activity and better sleep. Keeping it normal means keeping the habits.
How long does it take to lower A1C?
A1C reflects about 3 months of blood sugar, so retest after 12 weeks of consistent change. Fasting glucose can improve within weeks.
Do I need medication for prediabetes?
Most people don't. Metformin is sometimes considered for those at highest risk, such as people under 60 with a BMI over 35 or women with past gestational diabetes.
Is fruit allowed with prediabetes?
Yes. Whole fruit with its fibre is fine in sensible portions. Juice and dried fruit raise blood sugar faster, so keep them small.
I'm South Asian and not overweight. Can I still have prediabetes?
Yes. South Asian people often develop insulin resistance at lower weights, with fat stored around the waist and liver. Testing is worth it even at a 'normal' BMI.
Can I get a consultation from outside India?
Yes. Dr. Pankaj Kumar offers online consultations for adults in other countries to review reports and plan lifestyle changes. Medicines are prescribed by your local doctor where required.
Read more from Dr. Pankaj Kumar
Borderline blood sugar: 7 steps before it progressesPrediabetes symptoms most people missLifestyle changes for prediabetes that lastWalking after meals: how much helps
The 90-Day Prediabetes Turnaround
A practical, week-by-week plan to bring borderline blood sugar back to normal: meals, movement, sleep and tracking.
Get it on Amazon Also: The Indian Diabetes Diet Reset →This page gives general information and is not a substitute for a consultation. Treatment is decided after examination and tests. Last reviewed by Dr. Pankaj Kumar, MBBS, DNB (Family Medicine), on 21 October 2026.