Prediabetes Treatments and Tips: Medications, Lifestyle Changes, and Blood Testing

So your healthcare provider told you that you have prediabetes. You may feel overwhelmed and scared about what this means for your health. Or maybe you feel like it’s not so bad because it’s not “full-blown” diabetes. Either way, you’re probably wondering about what happens next and what can you expect from here on out.

Here are the key things to know about prediabetes, treatment, and how to take care of yourself if you’ve been diagnosed with it.

What is prediabetes?

Prediabetes is when your blood sugar (glucose) is higher than normal, but not high enough for a diagnosis of Type 2 diabetes (T2D). With prediabetes, you’re in the beginning stage of diabetes. 

Prediabetes is a common condition. About 1 in 3 adults have prediabetes, and 80% of people don’t know they have it. This is because it can take some time for symptoms to develop. When a healthcare provider sees that you’re at high risk for developing it, blood testing can detect prediabetes. Or you can take this 1-minute test to figure out your risk of prediabetes. 

 Prediabetes is diagnosed with one (or more) of the following blood tests and results:

• Fasting blood sugar: 100 mg/dL to 125 mg/dL

• HbA1C (hemoglobin A1C): 5.7% to 6.4%

• Oral glucose tolerance: 140 mg/dL to 199 mg/dL

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Many people think the “pre” in prediabetes means that it’s not something to worry about. While it has fewer health risks than T2D, it still carries its own set of complications. And if you have prediabetes, you’re at a higher risk for developing T2D in the near future. 

Unlike T2D, you may be able to reverse prediabetes. With the right changes, you can still bring your blood sugar and A1C back to normal.

How do you treat prediabetes? 

Most people manage prediabetes with lifestyle changes, including diet and exercise. Awareness is key with prediabetes. Knowing what causes your blood glucose to go up or down can help to shape your changes. 

The CDC has lifestyle change programs by trained lifestyle coaches. You can meet others who are working to prevent diabetes while benefiting from CDC-approved education.

Diabetes-friendly diet

Talk to your healthcare provider or meet with a dietitian to learn about helpful dietary changes. It’s not just about what you eat, but how much you eat, and in what combinations.

Changes may be as simple as adding more veggies or whole grains to your daily routine. Or it might include measuring serving sizes and counting calories. Necessary changes vary from person to person.

To eat a diabetes-friendly diet, start with these steps:

• Take a closer look at what you’re eating and drinking every day.

• Create a balanced plate.

• Eat to prevent diabetes. You can do this with minimally processed whole foods, fiber-rich fruits and vegetables, lean proteins, healthy fats, and moderate amounts of complex carbohydrates.

• Incorporate suggested changes from your care team.

Build in regular exercise

To lower your risk of T2D, the American Diabetes Association (ADA) recommends 150 minutes of physical activity per week (a little over 20 minutes a day). If you’re wondering why movement is so important with prediabetes, here’s why:

• Your muscles use glucose for energy when you’re exercising.

• Exercise improves your body’s sensitivity to the insulin it makes. 

Together, these factors help to lower your blood glucose level. With the help of your care team, you’ll decide on a plan that’s best for you. As long as the exercise gets your heart pumping a little harder, you’ll be getting the benefits you need.

If you smoke, stop

If you smoke, you’re 30% to 40% more likely to get T2D. This is because nicotine increases blood sugar levels and increases insulin resistance.

It’s plain and simple — smoking is bad for your health. It causes damage to your heart and lungs and raises your risk for a heart attack or stroke. If you don’t smoke, don’t start. If you do, consider stopping. 

• Get support by talking to your healthcare provider.

• Identify your smoking triggers.

• Ask about medications that can help you stop smoking.

• Join a smoking cessation program.

Consider weight loss

If you have a BMI that’s considered overweight or obese, losing weight can reverse prediabetes. 

Get started with these healthy steps:

• Create realistic goals.

• Monitor and improve your sleeping habits.

• Be mindful of your eating habits.

• Begin (or continue to) move your body every day. And track your steps.

• Identify the cause of your stress, and take actions to reduce it.

• Speak with your healthcare provider about whether medications may be an option for you. 

Prediabetes medications: What are your options? 

Prediabetes isn’t a medical condition that’s treated with medications. In fact, no medications are FDA approved for the treatment of prediabetes. 

But, for some people with prediabetes, healthy eating and exercise are not enough to prevent prediabetes from progressing to Type 2 diabetes. This includes people who weigh more than what’s considered healthy for their height (this means people with a BMI that’s considered overweight or obese). 

So if you have prediabetes, and you also have excess weight, weight loss medications can be helpful to lower your risk of T2D. That’s because prediabetes and T2D are considered medical complications of being overweight. 

Put another way, if you have prediabetes and a BMI that’s higher than normal, you have a higher risk for developing T2D. And weight-management medications can help prevent that. 

Keep in mind: These are not medications that treat prediabetes. They’re weight-loss medications that can help prevent T2D in certain at-risk groups.  

Here are a few medications that are commonly used “off-label” for weight management in people at risk of T2D.

Metformin

Metformin is one of the oldest diabetes medications. And it’s still one of the most commonly prescribed treatments for T2D. It’s a prescription medication that you take by mouth. 

Metformin can lower blood sugar levels by helping the body to make less glucose, use its natural insulin better, and reduce the amount of glucose absorbed from your diet. It’s the only medication the ADA recommends to prevent T2D. It’s available as a lower-cost generic, which makes it a great option for many people. 

GLP-1 agonists

There’s a growing class of medications for T2D that also help with weight loss — glucagon-like peptide-1 (GLP-1) agonists. Most are FDA approved to treat T2D, and some are also approved for weight loss. 

None are approved for the treatment of prediabetes. But healthcare providers may turn to one of these medications to help people at risk for T2D manage their weight. 

For example, Wegovy (semaglutide) is an injectable GLP-1 agonist that you take once a week. It works by mimicking a natural hormone in your body — GLP-1 — to lower your appetite, slow your digestion, and reduce your food intake. Semaglutide, the active ingredient in Wegovy, is also available as a lower-dose version for T2D treatment called Ozempic.

Wegovy is approved for adults with a BMI of 30 and above. It’s also approved for adults with a BMI of 27 and above who have one or more weight-related complications, like high blood pressure, high cholesterol, or diabetes. Wegovy is also FDA approved for use in children ages 12 and older who meet certain requirements. 

Not all Medicare and insurance plans cover Wegovy — it depends on your health conditions and why you’re taking it. And it’s not available as a generic, so cost can be an issue. But there are ways to save with manufacturer copay savings cards and patient assistance programs.

You may be able to stop taking medication if your blood sugar and A1C return to normal. Always talk to your healthcare provider before stopping anything you’ve been prescribed.

Blood testing

Besides lifestyle changes and medications, your healthcare provider may ask you to get regular blood tests — and it’s important to do them when they’re ordered. This is the only way you’ll know if your lifestyle changes are improving your glucose levels. You can expect to test about every 3 to 6 months while your levels are above normal.

If you’re taking metformin, your provider will run additional tests from time to time to make sure your body is still healthy enough to tolerate it. For example, if your tests show that you’re starting to have kidney problems, you may have to stop taking metformin. While metformin doesn’t cause kidney damage, you need healthy kidneys to filter the medication out of your body. To avoid future complications, keep up to date with any tests your provider orders.

If you reverse your prediabetes, chances are your provider will monitor your blood sugar levels to make sure you don’t develop it again. It’s important to have tests done even if you seem and feel healthy. It’s possible for your blood glucose to change throughout your life. Once you achieve normal in-range blood sugars, it’s important to stick with your healthy lifestyle changes.

Other tips for treating prediabetes

You may be wondering about alternative ways to treat prediabetes. Here are some tips:

• Consider trying a continuous glucose monitor (CGM) to understand how your lifestyle choices affect glucose levels.

• Consider trying other options like acupuncture, biofeedback, massage, yoga, and others. 

If you’re interested in exploring alternative options, talk to your diabetes care team to discuss options that might work for you.

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Written by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Reviewed by:

Jewels Doskicz, RN, BA

Jewels Doskicz, RN, BA, is an Arizona-based registered nurse with 22 years of hospital-wide clinical nursing experience and 11 years of medical writing and editing experience. She was a former healthcare content creator for a digital health tool at HealthLoop and director of clinical content operations at GetWellNetwork.

Reviewed by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

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