Most people with prediabetes don’t know they have it. That’s not because they’re not getting checked-it’s because prediabetes doesn’t usually cause obvious symptoms. But that silence is dangerous. Without action, 15 to 30% of people with prediabetes will develop type 2 diabetes within five years. The good news? You can reverse it. Not just slow it down-actually reverse it. And the window to do it is wider than you think.

What Exactly Is Prediabetes?

Prediabetes means your blood sugar is higher than normal, but not high enough to be called type 2 diabetes. It’s your body’s way of screaming for help-quietly, usually. The American Diabetes Association defines it by three clear blood test numbers:

• Fasting blood glucose: 100-125 mg/dL
• A1C: 5.7% to 6.3%
• 2-hour glucose test after drinking sugar water: 140-199 mg/dL

If any one of these is in that range, you’re in prediabetes territory. And you’re not alone. In the U.S. alone, 96 million adults-nearly 4 in 10-have it. In Australia, the numbers are rising fast too, especially among people over 45, those with excess weight, or who have a family history of diabetes.

What’s happening inside your body? Your cells are becoming resistant to insulin-the hormone that lets sugar enter cells for energy. So sugar builds up in your blood. Your pancreas tries to keep up by making more insulin. But over time, it gets worn out. That’s when diabetes kicks in. Prediabetes is the pause button. Press it, and you can reset the whole system.

Warning Signs You Can’t Ignore (Even If They’re Subtle)

Yes, most people have no symptoms. But that doesn’t mean there aren’t any. When signs do show up, they’re often mistaken for aging, stress, or just being “tired all the time.” Here’s what to watch for:

• Constant thirst-drinking more than 3 liters of water a day without exercising or being in the heat.
• Frequent urination-more than 8 times a day, especially at night.
• Blurred vision-your vision gets fuzzy after meals or when blood sugar spikes. It’s not just old eyes; it’s your lens swelling from too much sugar.
• Unexplained fatigue-you’re not sleeping poorly, but you still feel drained by mid-afternoon. Your cells aren’t getting the fuel they need.
• Dark patches on skin-velvety, grayish-brown spots on your neck, armpits, or groin. This is called acanthosis nigricans. It’s a visible sign of insulin resistance.
• Increased hunger-you eat, but you’re still hungry. Sugar isn’t getting into your cells, so your body thinks it’s starving.
• Slow-healing cuts or infections-a small scrape takes more than two weeks to close. Yeast infections (in women) or urinary tract infections happen more than twice a year.
• Tingling or numbness-a pins-and-needles feeling in your hands or feet. That’s early nerve damage from high sugar levels.
• Mood swings or low mood-studies show that as A1C rises, depression scores go up too. Sugar affects your brain chemistry.

These aren’t just “maybe” signs. They’re biological signals. If you notice even one of these-and you’re over 35, overweight, or have a family history-get tested. Don’t wait for symptoms to get worse.

Who’s at Risk? (It’s Not Just Obesity)

People assume prediabetes only affects those who are overweight. That’s not true. While excess weight is a major factor, others are just as vulnerable:

• People over 45
• Those with a parent or sibling who has type 2 diabetes
• Women who had gestational diabetes or gave birth to a baby over 9 pounds
• People with polycystic ovary syndrome (PCOS)
• Asian Australians with a BMI over 23
• People with high blood pressure, low HDL (“good”) cholesterol, or high triglycerides

And here’s something surprising: one in three non-Hispanic Black adults and nearly half of Hispanic adults in the U.S. have prediabetes. Genetics, access to healthy food, stress, and systemic health gaps all play a role. This isn’t just about willpower-it’s about environment, biology, and equity.

How to Reverse It-For Real

You don’t need a drug. You don’t need surgery. You need two things: movement and food.

The landmark Diabetes Prevention Program (DPP) study showed that people who lost just 5-7% of their body weight and moved for 150 minutes a week cut their risk of diabetes by 58%. That’s more effective than metformin, the common diabetes drug. And the effects lasted over 10 years.

Here’s how to do it, step by step:

1. Move daily-150 minutes a week isn’t a marathon. That’s 30 minutes, five days a week. Walk after dinner. Take the stairs. Dance while cooking. It doesn’t have to be gym workouts. Just get your heart rate up.
2. Reduce sugar and refined carbs-white bread, pasta, pastries, sugary drinks, even fruit juice. These spike blood sugar fast. Swap them for whole grains, beans, lentils, vegetables, and whole fruits.
3. Eat protein and healthy fats with every meal-eggs, fish, chicken, tofu, nuts, seeds, avocado, olive oil. They slow down sugar absorption and keep you full longer.
4. Don’t skip meals-going too long without eating makes your body hold onto sugar and fat. Eat every 4-5 hours to keep insulin steady.
5. Sleep 7-8 hours a night-poor sleep raises cortisol, which raises blood sugar. Even one bad night can make your body more resistant to insulin.
6. Manage stress-chronic stress = higher blood sugar. Try breathing exercises, walking in nature, or just 10 minutes of quiet every day.

One study found that people who followed a Mediterranean-style diet-lots of vegetables, fish, olive oil, nuts, and whole grains-had a 27.7% chance of reversing prediabetes in just 12 months. That’s better than most drug trials.

What Doesn’t Work (And Why)

There’s a lot of noise out there. Fad diets. Juice cleanses. Detox teas. None of them work long-term.

Here’s what fails:

• Extreme calorie cutting-eating under 1,200 calories a day slows your metabolism and makes weight loss harder. You’ll regain it.
• Going keto without medical guidance-some people benefit, but for others, it raises LDL cholesterol and stresses the liver. Not a one-size-fits-all fix.
• Only focusing on weight-you can improve insulin sensitivity even without losing much weight. Muscle gain, better sleep, and less stress matter just as much.
• Waiting for symptoms to get worse-by the time you feel exhausted all the time or have numb feet, damage may already be happening.

The goal isn’t perfection. It’s progress. One healthier meal. One extra walk. One less sugary drink. That’s how you win.

Testing and Tracking: What to Ask Your Doctor

If you’re over 35, or have any risk factors, ask your doctor for a blood test. Don’t wait for them to bring it up. Say:

• “Can I get an A1C test?”
• “Should I be screened for prediabetes?”
• “If I’m prediabetic, what’s my next step?”

Most doctors will test you every three years if you’re at risk. But if you’ve already been diagnosed with prediabetes, test every year. And consider using a continuous glucose monitor (CGM)-now approved for prediabetes use. Seeing your real-time sugar spikes after meals can be a powerful motivator.

There are also CDC-recognized programs in Australia and online, like Omada Health or the National Diabetes Prevention Program. They offer coaching, group support, and digital tools. Completion rates are high-85%-because they’re designed for real life, not perfection.

It’s Not Just About You

Prediabetes isn’t a personal failure. It’s a public health crisis. In the U.S., it costs $44 billion a year in medical bills and lost work. In Australia, the trend is heading the same way.

But here’s the hope: prediabetes is the easiest stage to fix. Once you become diabetic, you’re managing a lifelong condition. With prediabetes, you can go back to normal. Your pancreas can recover. Your cells can relearn how to respond to insulin. Your future self will thank you.

Don’t wait for a diagnosis. If you’re at risk, get tested. If you’ve been told you’re prediabetic, don’t panic. Start small. Walk today. Swap soda for water. Sleep better tonight. You’re not doomed. You’re just at a turning point-and you have the power to turn the other way.