Here’s How to Reverse Prediabetes

Many people have heard of diabetes — a health condition where blood glucose (sugar) is too high. But did you know there’s another category that people fall into? Prediabetes is when your blood sugar is too high to be “normal,” but it’s not high enough to be considered diabetes. 

If you have prediabetes, you may have some questions, like if there’s anything you can do to get your blood sugar back to normal. And can you stop prediabetes from turning into full-blown diabetes? The good news is that, in many cases, prediabetes is reversible. In this article, we’ll talk about what prediabetes is, how it’s diagnosed, and what steps you can take to reverse it and stay healthy. 

What is prediabetes?

Prediabetes is when blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. Prediabetes raises your risk of getting Type 2 diabetes (T2D), heart disease, stroke, and other health complications associated with diabetes. In the U.S., around 1 in every 3 of people ages 18 and older and half of people age 65 and older have prediabetes.

Promotional Disclosureinfo_outlined

SPECIAL OFFER

Save on popular GLP-1 Agonists

Take control of your health. With GoodRx, you may be eligible to save even more on popular treatments.

Get Savings

There are usually no symptoms of prediabetes. That means you won’t know you have it unless you get checked for it on a screening blood test.

Get tested for prediabetes if:

• You’re 45 years or older.

• You have a body mass index (BMI) of 25 or higher.

• You have high blood pressure.

• You exercise less than three times a week.

• You have a parent or sibling with Type 2 diabetes.

• You’re African American, Hispanic/Latino American, American Indian, Asian American, or Pacific Islander.

Women should get tested for diabetes if:

• You have polycystic ovary syndrome.

• You had diabetes during pregnancy (gestational diabetes).

• You gave birth to a baby that weighed more than 9 pounds.

Check out this questionnaire from the CDC to get a better idea of your risk for prediabetes.

Prediabetic blood glucose range

Prediabetes is a health condition where your blood sugar is high — but not high enough for you to be diagnosed with Type 2 diabetes. In some people, it can eventually lead to diabetes.

A lab test can diagnose prediabetes. Here’s what to look for:

• Oral glucose tolerance test: This tests your body’s response to drinking a sugary beverage. A normal result is under 140 mg/dL. The prediabetes range is 140 mg/dL to 199 mg/dL.  

• Fasting blood glucose: This tests your blood sugar level after you haven’t eaten for a while. A normal result is less than 100 mg/dL. The prediabetes range is 100 mg/dL to 125 mg/dL.

• Hemoglobin A1C (HbA1C or A1C): This tells you about your blood sugar averages over the past 2 to 3 months. A normal result is below 5.7%. The prediabetes range is 5.7% to 6.4%. And the higher your A1C, the higher your risk of going from prediabetes to Type 2 diabetes. 

Can you reverse prediabetes?

Yes, prediabetes is reversible.

A positive prediabetes test result is like an alarm bell going off, encouraging you to make healthy changes.

Around 3% to 10% of people with prediabetes develop diabetes every year. This means that their blood glucose rises from the prediabetes range into the diabetes range.

But between 15% and 35% of people with prediabetes are able to reverse their prediabetes.

How to reverse prediabetes

You can reverse prediabetes by changing your diet, exercising, and losing weight (if your weight is higher than what is considered healthy for your height). The medication metformin can also help — but it doesn’t work as well as lifestyle changes. Here are some ways you can take action.

Eat a healthy diet 

When it comes to reversing prediabetes, there isn’t a clear winner for the best diet. But eating healthy foods can help keep your blood sugar under control. For many people, this means focusing on:

• Fruits and vegetables

• Whole grains

• Lean proteins, like chicken and fish

• Yogurt and low-fat cheeses

• Nuts, seeds, and beans

• Unsaturated fats, like olive oil and other plant oils

• Water and unsweetened coffee and tea

Other foods aren’t as nutritious. Limiting these foods can be good for your health — and your blood sugar. If you have prediabetes, consider cutting down on:

• Foods or beverages with added sugar

• Alcohol

• Saturated fats, like fried foods and butter

• Red meat

• Trans fats, like margarine, shortening, and processed foods

There’s also evidence that certain diets can lower your risk of Type 2 diabetes by keeping your blood sugar under control. Following one of these diets may make it less likely that your prediabetes will turn into Type 2. These include:

• Low-carbohydrate diet: This means that less than half of your daily calories come from carbohydrates. 

• Low-calorie diet: This is a diet plan where you limit the amount of calories you eat in a day. Some people use this diet to lose weight, but there’s also evidence that a low-calorie diet can be helpful for managing blood sugar. 

• Mediterranean diet: This is an eating plan where you eat mostly fruits, vegetables, fish, and grains. And you eat smaller amounts of red meat, sugar, and fats. There’s some evidence that eating a Mediterranean diet can prevent diabetes, even if you don’t restrict calories. 

• Plant-based diet: This means eating fewer animal products, like meat, dairy, and eggs. In some studies, vegetarians and vegans have a lower risk of developing Type 2 diabetes. 

Are you feeling overwhelmed? Remember, when it comes to food, even small changes can help. It’s about figuring out what works for you, your culture, and your lifestyle. If you need support, think about meeting with a dietitian (a nutrition expert). They can help you figure out which type of eating plan is best for you. 

Be physically active

Getting regular physical activity is great for your mental and physical health — and it can also help prevent diabetes. When you exercise, your cells get better at using sugar for energy. This can help keep your blood sugar level under control.  

According to the American Diabetes Association, 150 minutes (2.5 hours) of moderate-intensity exercise every week is a good target if you have prediabetes or diabetes. But how you approach it is up to you. You can spread it out over the whole week or concentrate your workouts on 2 or 3 days. 

It’s also important to find activities you enjoy. Examples of moderate-intensity exercise include:

• Brisk walking

• Dancing

• Tennis

• Pickleball

• Biking

• House cleaning

• Basketball

• Gardening

Consider weight loss

If you have prediabetes, and your weight is higher than what is considered normal for your height, losing weight can help get your blood sugar back on track. It’s about how your body functions, not your shape and size. People with a BMI of 25 or higher have more insulin resistance, which means it’s hard for their bodies to manage sugar. 

There’s good evidence that losing weight — sometimes even a small amount — can help you keep your blood sugar under control. In research studies, losing just 7% of body weight was enough to make a difference. 

When it comes to weight loss, it can be hard to know where to begin. A realistic goal is to lose 1 to 2 pounds a week. If you’ve changed your eating and exercise habits, you’re probably already off to a great start. 

Are you looking for more tips? Again, think about meeting with a dietitian. You can also check out our articles on weight loss and diabetes and how to lose weight safely — and for good.  

Consider metformin

Metformin is an oral medication for diabetes. Research shows that taking metformin may reverse prediabetes, but it doesn’t work as well as lifestyle changes. Though metform isn’t FDA approved for prediabetes, it’s sometimes used off-label to help your blood sugar level come down to normal — especially if lifestyle changes haven’t worked. 

Explore other medications and treatments

There aren’t any medications that are FDA approved for prediabetes. Though many research studies have looked at whether medications for Type 2 diabetes are helpful for prediabetes, it isn’t clear whether these medications work. Overall, these medications seem to have more side effects than proven benefits in people with prediabetes. 

It’s also not clear whether bariatric surgery (weight-loss surgery) is helpful for prediabetes. Though there’s some evidence that it might prevent diabetes, it’s not clear whether the benefit is from the surgery itself or from the associated weight loss and change in diet. More research is needed before we can say for sure.

If your BMI is over 25, your healthcare provider might also recommend a GLP-1 agonist (glucagon-like-peptide-1). GLP-1 agonists are medications that can help you lower your weight. Though they’re not FDA approved for prediabetes, they are sometimes used to help people at risk for Type 2 diabetes lose weight. 

Are you looking for more information? Read more about metformin and GLP-1 agonists in our GoodRx guide to prediabetes treatments and medications.  

How long does it usually take to reverse prediabetes?

It’s hard to say. The amount of time it takes to reverse prediabetes can vary from person to person. It depends on:

• How close your starting blood sugar is to the normal range

• Your starting weight and physical health

• Whether or not you already exercise 

• Your other health problems

• Your genetics (family history)

Some people might start to see improvements in just a few weeks. For other people, it can take months or even years. 

Why trust our experts?

Written by:

Sarah Gupta, MD

Sarah Gupta, MD, is a licensed physician with a special interest in mental health, sex and gender, eating disorders, and the human microbiome. She is currently board certified by the American Board of Psychiatry and Neurology.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

Our editorial standards

Meet our experts