Here's some good news to start with: for many people, prediabetes can be reversed. If you've been told your blood sugar is a little high, the right prediabetes diet and a few steady habits can often bring those numbers back down before they ever become type 2 diabetes. The tricky part is that prediabetes usually gives you almost no warning, which is exactly why it's worth understanding.

More than 2 in 5 American adults, about 115 million people, have prediabetes, and 8 in 10 of them don't know it. It often turns up on a routine blood test in someone who feels completely fine. That's not a reason to panic. It's an opportunity.

The big picture on your prediabetes journey:

• Prediabetes is common and quiet. More than 2 in 5 American adults have prediabetes, and 8 in 10 of them don't know it.
• It's defined by a number. An A1C of 5.7% to 6.4% means prediabetes, and it shows up on a simple blood test.
• What you eat is one of your biggest levers. In a major trial, modest weight loss through healthier eating and more activity cut the risk of type 2 diabetes by more than half.
• Prediabetes can often be reversed. For many people, blood sugar returns to a normal range, and steady lifestyle changes improve the odds.
• Screening matters. If you're 35 to 70 and carry extra weight, or simply 35 or older per the ADA, ask your doctor about a blood sugar check.

What is prediabetes, exactly?

Prediabetes means your blood sugar is higher than normal but not yet high enough to be called type 2 diabetes. Think of it as an early warning light on your dashboard. The engine still runs fine, but something needs attention before it turns into a bigger problem.

Doctors diagnose it with a blood test, most often the A1C, which reflects your average blood sugar over the past two to three months. The prediabetes A1C range is 5.7% to 6.4%, according to ADA and CDC guidelines; an A1C below 5.7% is considered normal, while 6.5% or higher indicates diabetes. Two other tests can also show it: a fasting blood sugar of 100 to 125 mg/dL, or a result of 140 to 199 mg/dL two hours into an oral glucose tolerance test. These tests don't always agree, which is one reason a second test is often used to confirm. Some things can also throw off an A1C. Iron deficiency can make it read falsely high, while pregnancy, recent blood loss or a transfusion, and chronic kidney disease can make it read falsely low. Some inherited hemoglobin traits, such as sickle cell trait, can interfere too. So your provider may repeat the test or confirm it another way before settling on a diagnosis.

Why does it matter so much to catch it early? Because prediabetes doesn't always stay put, and for some people it moves toward diabetes. Each year, roughly 5 to 10% of people with prediabetes go on to develop type 2 diabetes. That risk isn't the same for everyone in the range, though. In one study of older adults, those with an A1C between 5.7% and 5.9% progressed at about 2.8% a year, while those between 6.0% and 6.4% progressed at about 8.2% a year. Where you fall in that range is worth asking your provider about. Age matters too. In a different study of adults averaging 75, more people with prediabetes returned to normal or died of other causes than developed diabetes. For many older adults, protecting your heart matters at least as much. The flip side is the hopeful part: changes to food and movement can delay or prevent that progression for many people.

Prediabetes isn't a diagnosis of failure. It's a heads-up you still have time to act on.

What are the warning signs of prediabetes?

Prediabetes usually has no symptoms at all, according to the CDC. That's what makes it so easy to miss and so important to screen for.

Some people notice darker, velvety patches of skin on the neck, armpits, or groin, which can signal insulin resistance. The signs below are worth knowing too, but they are signs of high blood sugar, and they can mean blood sugar has already reached the diabetes range:

• Feeling more thirsty than usual
• Needing to urinate more often
• Feeling unusually tired
• Blurred vision

If you have any of these, don't wait for routine screening. Get your blood sugar checked soon. And if you don't have them, that isn't a reason to skip screening, because most people with prediabetes feel perfectly normal.

Knowing your risk factors helps you decide whether to get checked. Your risk is higher if you're 45 or older, carry extra weight, have a parent or sibling with type 2 diabetes, had diabetes during pregnancy, or are active fewer than three days a week. Black, Hispanic or Latino, American Indian, and Alaska Native people are also at higher risk, as are some Pacific Islander and Asian American people. And because genetics play a role, people at a normal weight can develop prediabetes too if they have other risk factors.

Who should get screened, and when?

Because you often can't feel prediabetes, a simple blood test is the only reliable way to catch it. Two major groups give screening advice, and they differ slightly. The USPSTF recommends screening for prediabetes and type 2 diabetes in adults aged 35 to 70 years who have overweight or obesity. This is a change from older advice, and it happened for a real reason: the incidence of diabetes increases at age 35 compared with younger ages, so the USPSTF lowered the age at which to begin screening to 35 years.

If your result is normal, rechecking every 3 years is generally enough, according to the USPSTF. If the test does show prediabetes, the USPSTF recommends being offered or referred to a proven prevention program, such as a CDC-recognized lifestyle change program. Many of these programs are available online, and Medicare covers its version for people who qualify. The American Diabetes Association casts a wider net. It recommends testing everyone starting at age 35, whatever their weight, and testing earlier for adults who have overweight or obesity plus at least one other risk factor. If you already have prediabetes, the ADA recommends rechecking at least once a year.

A blood sugar check is a quick preventive blood test. If you have Medicare, your provider can order it during your Annual Wellness Visit, and it's covered under its own screening benefit if you qualify. Understanding your numbers is easier with a little guidance. If you want a plain-English walkthrough, our guide on how to read your blood test results breaks down what those figures mean.

If you're between 35 and 70 and carrying extra weight, a single blood test can tell you where you stand. That's worth the five minutes.

Building a prediabetes diet that actually works

Weight loss is the biggest single factor in lowering your risk, and what you eat drives most of it. A prediabetes diet isn't a rigid, joyless plan you follow for a few weeks. It's a set of steady, realistic swaps you can live with, the kind that quietly bring your blood sugar down and keep it there.

The goal is simple to describe: eat in a way that keeps your blood sugar steadier throughout the day. That generally means filling most of your plate with vegetables, lean proteins, whole grains, and healthy fats, while cutting back on the foods that spike blood sugar fastest. The American Diabetes Association notes that several eating patterns can work, including Mediterranean-style, lower-carbohydrate, plant-based, and DASH. What they share is a base of whole grains, legumes, nuts, fruits, and vegetables, with few refined and processed foods.

You don't have to overhaul everything overnight. The changes that tend to stick are the small ones you repeat every day.

A simple prediabetes meal plan framework

Instead of counting every gram, try a plate-based approach. It's easy to remember and easy to eyeball at any meal, whether you're at home or grabbing lunch around Meridian.

A few swaps go a long way with a prediabetes meal plan. Trade sugary drinks for water or unsweetened tea. Choose whole fruit over fruit juice. Pick whole grains over white bread and white rice. And watch portion sizes on the foods that raise blood sugar quickly, like sweets, chips, and refined carbs.

One caution: everyone's body and health history are different, and some conditions or medications change what's ideal for you. Use this as a starting framework, not a prescription, and talk with your provider or a dietitian about what fits your situation.

Can you reverse prediabetes?

Often, yes, and this is the most important takeaway. In a pooled analysis of 19 long-term studies, about 36% of people with prediabetes returned to normal blood sugar within 10 years, while about 12.5% went on to develop type 2 diabetes. These were people followed over time, not people in a special program, and getting back to normal was less likely for those with higher blood sugar or more extra weight. That's where lifestyle changes come in: they are the best-proven way to tip the odds in your favor.

The landmark research on this is the Diabetes Prevention Program, a large national study. Participants aimed to lose 7% of their body weight by eating fewer calories and getting at least 150 minutes of activity a week. Over about three years, their risk of type 2 diabetes dropped by 58%. And the benefit was even greater for older adults: the program showed a 71% reduced incidence of type 2 diabetes for people 60 and older.

Here's the encouraging math on that weight loss target. Today the CDC uses 5% to 7% of body weight as the goal, just 10 to 14 pounds for a 200-pound person. That's not a dramatic transformation. It's a realistic, achievable goal for most people, and it pays off in a big way.

Movement is the other half of the equation. Regular physical activity means getting at least 150 minutes a week of brisk walking or similar activity, which is just 30 minutes a day, five days a week. And if the scale is your sticking point, this is worth knowing: in that same research, people who hit the 150-minute goal lowered their risk by 44% even when they didn't reach the weight-loss target. Movement counts on its own. Best of all, the effect lasts. A 10-year follow-up study showed that participants were still one-third less likely to develop type 2 diabetes a decade later.

A quick note on medication: you may wonder whether you need a prescription. Most people manage prediabetes with lifestyle changes, and in the research those changes outperformed medication. That said, the American Diabetes Association says metformin can be worth considering for some people at especially high risk, such as women who have had diabetes during pregnancy or younger adults with higher blood sugar or a higher BMI. Metformin isn't FDA-approved specifically for preventing diabetes, and long-term use calls for occasional vitamin B12 checks. Whether medication makes sense for you is a conversation to have with your own provider, based on your numbers and your health history.

In the Diabetes Prevention Program, modest weight loss and about 30 minutes of activity most days cut the risk of type 2 diabetes by 58%.

How we help patients with prediabetes at Ridgeview

We built this practice around knowing our patients by name and taking the time to explain things without rushing you out the door. Prediabetes is a great example of where that matters, because the plan isn't a one-size-fits-all handout. It's tailored to your labs, your schedule, your food preferences, and your life.

At a wellness visit or checkup, we review risk factors like weight, blood pressure, and cholesterol, and order a blood sugar test if you're due. If your numbers point to prediabetes, we'll set up a separate visit to build a realistic plan together. Because prediabetes so often travels with those other conditions, it fits naturally into how we approach chronic disease management, including diabetes, blood pressure, and cholesterol, right here in Meridian.

Our team includes providers who take a whole-person, practical approach to nutrition and lifestyle, and two of our providers speak Spanish, so language is never a barrier to understanding your health. If you want to see what a first visit looks like, our guide on what to expect at your annual wellness visit lays it out step by step. We're an independent practice, not corporate medicine, and we're currently accepting new patients who want to establish care with a team that will actually get to know them.

Frequently Asked Questions

What is a normal A1C level, and when is it prediabetes?

An A1C below 5.7% is considered normal. An A1C of 5.7% to 6.4% falls in the prediabetes range, and 6.5% or higher indicates diabetes. A single number isn't the whole story, so your provider will look at it alongside your other risk factors and may repeat the test to confirm it.

Can prediabetes go away on its own?

Sometimes it does, but you can't count on it. In large long-term studies, about a third of people with prediabetes were back in the normal range within 10 years. You can improve your odds a lot: in the Diabetes Prevention Program, modest weight loss through healthier eating and more activity cut the risk of type 2 diabetes by 58%.

How much weight do I need to lose to lower my risk?

Less than you might think. Modest weight loss of 5% to 7% of body weight, just 10 to 14 pounds for a 200-pound person, is the target used in the research. Small, sustainable changes tend to work better than crash diets.

What foods should I avoid with prediabetes?

Focus on cutting back the foods that spike blood sugar fastest. It helps to limit added sugar and highly processed foods, especially sweets, chips, and refined grains. Swapping sugary drinks for water and refined grains for whole grains is a great place to start.

Should I get screened for prediabetes in Meridian if I feel fine?

Yes, especially if you have risk factors, because prediabetes often has no symptoms. The USPSTF recommends screening adults aged 35 to 70 who have overweight or obesity, and the American Diabetes Association recommends testing everyone 35 and older. We can easily include a blood sugar check at a visit at our Meridian office, so ask us at your next appointment.

The bottom line

Prediabetes is common, quiet, and, most importantly, reversible for many people. A realistic prediabetes diet, modest weight loss, and regular movement are proven to lower your risk of type 2 diabetes. The first step is simply knowing your numbers.

If you're wondering where you stand, we'd be glad to check and talk it through with you. Reach out to establish care, or ask for a blood sugar screening at your next visit. If your numbers come back high, we'll build a plan that fits your life.

Sources

1. Prediabetes Statistics | CDC
2. Preventing Type 2 Diabetes | CDC
3. Diabetes Risk Factors | CDC
4. Diagnosis and Management of Prediabetes: A Review | JAMA (2023)
5. Diagnosis and Classification of Diabetes: ADA Standards of Care in Diabetes 2026 | Diabetes Care
6. Prevention or Delay of Diabetes and Associated Comorbidities: ADA Standards of Care in Diabetes 2026 | Diabetes Care
7. Recommendation: Prediabetes and Type 2 Diabetes: Screening | USPSTF
8. Prevent Type 2 Diabetes: Talking to Your Patients About Lifestyle Change | CDC
9. The Surprising Truth About Prediabetes | CDC
10. What Is the National DPP? | CDC
11. Risk of Progression to Diabetes Among Older Adults With Prediabetes | JAMA Internal Medicine (2021)
12. Progression to Diabetes Among Older Adults With Hemoglobin A1c-Defined Prediabetes in the US | JAMA Network Open (2022)
13. Effect of Weight Loss With Lifestyle Intervention on Risk of Diabetes | Diabetes Care (2006)
14. Prediabetes transitions to normoglycaemia or type 2 diabetes: pooled analysis of 19 prospective cohort studies | The Lancet Global Health (2025)
15. Medicare Diabetes Prevention Program | Medicare.gov