Prediabetes: Symptoms, Causes and How to Reverse It
Prediabetes means that blood glucose levels are higher than normal but not yet high enough to meet the criteria for diabetes. It is an important warning sign because people with prediabetes have a higher risk of developing Type 2 diabetes and cardiovascular disease.
The encouraging part is that prediabetes does not inevitably progress to Type 2 diabetes. Early identification gives people an opportunity to make changes that can reduce their risk.
Because prediabetes often causes no obvious symptoms, testing is especially important for people with risk factors.
What Is Prediabetes?
Prediabetes describes an intermediate level of blood glucose between normal glucose regulation and diabetes.
It usually reflects problems with how the body responds to insulin. The cells become less responsive to insulin, making it harder for glucose to move from the bloodstream into cells.
Prediabetes can be identified using blood tests such as HbA1c, fasting plasma glucose or an oral glucose tolerance test (OGTT).
It is not the same as diabetes.
However, it should not be ignored because it is associated with an increased risk of progressing to Type 2 diabetes and developing cardiovascular problems.
What Blood Sugar Level Is Prediabetes?
Healthcare professionals can identify prediabetes using several laboratory measurements.
According to the American Diabetes Association’s 2026 diagnostic criteria, prediabetes includes:
| Test | Prediabetes range |
|---|---|
| HbA1c | 5.7%–6.4% |
| Fasting plasma glucose | 100–125 mg/dL (5.6–6.9 mmol/L) |
| 2-hour OGTT | 140–199 mg/dL (7.8–11.0 mmol/L) |
These ranges apply to nonpregnant individuals.
A healthcare professional should interpret your results in the context of your overall health. One test result should not automatically be interpreted as a diagnosis without appropriate clinical assessment.
What Is HbA1c?
HbA1c is a blood test that provides an estimate of average blood glucose over approximately the previous two to three months.
Unlike a fasting glucose test, you generally do not need to fast before an HbA1c test.
An HbA1c result between 5.7% and 6.4% falls within the prediabetes range according to ADA criteria.
The higher the HbA1c within the prediabetes range, the greater the risk of progressing to diabetes.
However, HbA1c is not suitable for every person or every clinical situation. Certain conditions affecting red blood cells or haemoglobin can affect the reliability of the result.
Your healthcare professional can determine which test is most appropriate.
Does Prediabetes Have Symptoms?
Usually, prediabetes does not cause obvious symptoms.
Someone can have elevated blood glucose and feel completely well.
That is why waiting for symptoms is not a reliable way to detect prediabetes.
If you have risk factors for diabetes, ask a healthcare professional whether you should have your blood glucose tested.
What Causes Prediabetes?
Prediabetes develops when the body begins having difficulty regulating blood glucose.
Insulin resistance is an important part of this process.
Several factors can increase the likelihood of developing prediabetes, including:
- A family history of Type 2 diabetes
- Physical inactivity
- High blood pressure
- Previous gestational diabetes
- Polycystic ovary syndrome (PCOS)
- Overweight or obesity
- Abnormal cholesterol or triglyceride levels
- Other conditions associated with insulin resistance
The ADA recommends risk-based screening for adults with overweight or obesity who have one or more additional risk factors.
Prediabetes is therefore not simply about eating sugar. Genetics, metabolic health, physical activity, age and other factors can all contribute.
Who Should Be Tested for Prediabetes?
Screening decisions depend on age, risk factors and personal circumstances.
The ADA recommends considering testing in adults with overweight or obesity who have additional risk factors. For adults without those risk factors, the ADA recommends beginning screening at age 35.
People who already have prediabetes should generally be tested at least annually, with the frequency adjusted according to individual risk.
If you have previously been told that your blood glucose is elevated, speak with a healthcare professional about an appropriate monitoring schedule.
Can Prediabetes Be Reversed?
In many cases, blood glucose can return to the normal range when people make sustained changes to their health and lifestyle.
However, it is better to think of prediabetes as a modifiable risk state rather than assuming that it has been permanently “cured.”
If blood glucose returns to a healthier range, continuing the habits that helped achieve that improvement remains important.
Lifestyle interventions can significantly reduce the risk of progressing to Type 2 diabetes.
Can Physical Activity Help?
Yes.
Regular physical activity improves the body’s ability to use insulin and can help with blood glucose management.
WHO recommends at least 150 minutes of moderate-intensity physical activity per week for diabetes prevention, while individual needs may vary.
You do not necessarily need to start with an intensive exercise programme.
Activities such as:
- Brisk walking
- Cycling
- Swimming
- Dancing
- Recreational sports
- Other enjoyable forms of movement
can contribute to an active lifestyle.
If you have a medical condition or have not exercised for a long time, discuss an appropriate activity plan with a healthcare professional.
What Should You Eat If You Have Prediabetes?
There is no single “prediabetes diet” that everyone must follow.
A healthy eating pattern can include:
- Non-starchy vegetables
- Whole fruits
- Legumes
- Whole grains
- Lean protein sources
- Nuts and seeds
- Appropriate dairy or alternatives
The ADA recommends focusing on overall nutritional quality, appropriate energy intake and individual metabolic goals while limiting sugar-sweetened beverages, sweets, refined grains and highly processed foods.
The aim is not to eliminate carbohydrates completely.
Instead, learning how different foods affect your blood glucose can help you make sustainable choices.
Does Weight Loss Help Prediabetes?
For people with overweight or obesity, modest weight reduction can improve metabolic health and reduce the risk of Type 2 diabetes.
The ADA recommends considering interventions that aim for at least 5–7% weight reduction for appropriate people with overweight or obesity who are at high risk of Type 2 diabetes.
This should be approached as a health goal rather than a requirement to achieve a particular body shape.
A healthcare professional or registered dietitian can help create an appropriate plan.
Do You Need Medicine for Prediabetes?
Lifestyle intervention is an important part of preventing or delaying Type 2 diabetes.
However, medication may be considered for some people at particularly high risk.
Metformin has long-term evidence for diabetes prevention in people with prediabetes and may be considered in selected individuals.
Medication is not automatically required for everyone with prediabetes.
A healthcare professional should consider factors such as age, blood glucose levels, weight, previous gestational diabetes, other health conditions and overall risk before recommending medication.
Do not start diabetes medicine simply because a blood test shows prediabetes.
What Happens If Prediabetes Progresses?
Prediabetes can progress to Type 2 diabetes, although progression is not inevitable.
As blood glucose rises, the risk of diabetes and cardiovascular complications also increases.
This is why early action matters.
Regular testing allows healthcare professionals to identify changes and adjust prevention strategies when necessary.
Prediabetes and Heart Health
Prediabetes is not only about future diabetes.
It is also associated with increased cardiovascular risk. The ADA recommends assessing and addressing modifiable cardiovascular risk factors in people with prediabetes.
Your healthcare professional may therefore review factors such as:
- Blood pressure
- Cholesterol
- Physical activity
- Smoking
- Blood glucose
- Other cardiovascular risk factors
Managing these factors can support overall health while reducing future diabetes risk.
How Often Should You Check Your Blood Sugar?
There is no single testing schedule for everyone with prediabetes.
The ADA recommends monitoring for progression to diabetes at least annually, with more frequent testing when individual risk is higher.
Your doctor may recommend a different schedule depending on your test results and other risk factors.
Routine HbA1c or glucose testing is generally more useful for diagnosing and monitoring prediabetes than buying a glucose meter and checking randomly without professional guidance.
Prediabetes in Nigeria
Prediabetes is particularly important to identify early because many people may not know that their blood glucose is already elevated.
A simple blood test can help identify abnormal glucose levels.
If you have a family history of diabetes, have previously had gestational diabetes, have high blood pressure, are physically inactive or have other risk factors, speak with a healthcare professional about whether diabetes screening is appropriate for you.
Early detection creates an opportunity to act before Type 2 diabetes develops.
How HubPharm Can Help
At HubPharm Africa, we believe early detection can play an important role in preventing complications from chronic conditions.
If you have concerns about your blood glucose, our pharmacists can help you understand your medication-related questions and guide you on when professional medical assessment may be appropriate.
HubPharm also provides access to diabetes-related medicines and monitoring products for patients who have been appropriately assessed and prescribed treatment.
Talk to a HubPharm pharmacist →
If you have received a laboratory result showing prediabetes, you can discuss it with your healthcare professional and ask about appropriate follow-up.
Frequently Asked Questions
Is prediabetes the same as diabetes?
No. Prediabetes means blood glucose is above the normal range but below the diagnostic threshold for diabetes.
Can prediabetes go away?
Blood glucose can return to the normal range with appropriate lifestyle changes and, in some cases, treatment. However, continued healthy habits and monitoring remain important because the underlying risk may remain.
Does prediabetes always become Type 2 diabetes?
No. Progression is not inevitable. Lifestyle changes and appropriate monitoring can help prevent or delay Type 2 diabetes.
Can I have prediabetes without symptoms?
Yes. Most people with prediabetes do not have obvious symptoms. Testing is therefore important for people at increased risk.
What HbA1c level means prediabetes?
An HbA1c of 5.7% to 6.4% falls within the ADA’s prediabetes range for nonpregnant individuals.
Do I need medicine if I have prediabetes?
Not necessarily. Lifestyle intervention is a key part of prevention. Medication such as metformin may be considered for selected people at higher risk.
How often should someone with prediabetes be tested?
The ADA recommends testing at least annually, with the frequency adjusted according to individual risk.
The Bottom Line
Prediabetes is a warning, not a certainty that you will develop Type 2 diabetes.
Because it often causes no symptoms, testing is one of the best ways to identify it early. If your results show prediabetes, there is an opportunity to take action through physical activity, healthy eating, appropriate weight management and regular medical follow-up.
For some people at particularly high risk, medication may also be considered.
If you have risk factors for diabetes or have received a prediabetes result, speak with a healthcare professional about your next steps.
Medical note: This article is for health education and does not replace diagnosis or individual medical advice. Do not start diabetes medication based solely on information in this article.
References
- American Diabetes Association Professional Practice Committee. 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1):S27–S49.
- American Diabetes Association Professional Practice Committee. 3. Prevention or Delay of Diabetes and Associated Comorbidities: Standards of Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1):S50–S60.
- World Health Organization. Diabetes — Fact Sheet.
- Centers for Disease Control and Prevention. Preventing Type 2 Diabetes.
- American Diabetes Association Professional Practice Committee. 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes—2026.