Prediabetes means that someone’s blood sugar is higher than normal ranges. The condition can increase a person’s risk of developing type 2 diabetes. However, there may be ways to reverse prediabetes naturally.

Losing excess weight and exercising regularly are steps that individuals can take to normalize their blood sugar and reverse prediabetes. Other approaches, such as reducing stress and improving sleep, may also help.

According to the Centers for Disease Control and Prevention (CDC), about 1 in 3 American adults have prediabetes, amounting to about 88 million people.

This article describes prediabetes and how it compares to the different types of diabetes. It discusses strategies for reversing prediabetes and offers advice on when someone should see a doctor.

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Diabetes means that someone’s blood sugar levels are consistently too high. Another name for blood sugar is blood glucose.

Someone with prediabetes has higher blood sugar levels than normal, but the levels are not as high as in diabetes.

Typically, a person’s digestive system breaks down food to produce glucose, which goes into the bloodstream. A hormone called insulin helps cells take up the glucose and use it for energy.

Types of diabetes have different causes:

  • Type 1 diabetes: The body’s immune system attacks cells in the pancreas that make insulin. Without insulin, glucose stays in the blood, leading to high blood sugar.
  • Type 2 diabetes: Cells stop responding to insulin, which affects their ability to take up glucose from the blood. This is known as insulin resistance.
  • Prediabetes: Cells may become insulin resistant, or the body may start producing less insulin. Blood sugar levels increase, but not as much as in type 2 diabetes.

Diabetes can lead to health problems, including:

Prediabetes increases the risk for heart disease and stroke, as well as the risk of developing type 2 diabetes.

If an individual has type 1 diabetes, they need daily insulin shots to manage the disease. Scientists have not yet found a way to cure or reverse type 1 diabetes.

Someone with type 2 diabetes may reverse the condition by losing weight. A person is in remission if their blood sugar levels are normal for six months or longer.

However, remission is not a cure for type 2 diabetes because the disease may return.

For someone with prediabetes, steps such as losing weight and exercising regularly can help reverse insulin resistance. These steps may prevent or slow the progression to type 2 diabetes.

Losing excess weight and exercising regularly are the keys to controlling blood sugar levels. Other measures may help a person manage or reverse prediabetes.

Changing diet

Changing eating habits is a step that may help reverse prediabetes.

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) recommends a low-fat, reduced-calorie eating plan for people who want to lose weight and prevent or delay type 2 diabetes.

A person should choose foods that are low in added sugars, saturated fat, and trans fat. They should eat smaller portions of foods high in calories, fat, and sugar.

The American Diabetes Association (ADA) says there is no universal eating plan for people with diabetes or prediabetes.

The Mediterranean diet works well for some people. A person on this plan eats plenty of fruits, vegetables, and whole grains. They eat moderate amounts of poultry, eggs, fish, and dairy. Olive oil is the primary source of fat.

Eating fewer carbs

Other people with prediabetes may choose a low-carbohydrate eating plan.

Research suggests that low-carb and very low-carb plans help reduce blood sugar levels in people with type 2 diabetes. In these studies, people on a low-carb diet received 40–45% of their daily calories from carbohydrates.

Getting adequate sleep and treating sleep apnea

A study in Diabetes Care found a link between sleeping less than 5 hours a night or over 8 hours a night and higher blood sugar levels. The study included people with prediabetes or untreated type 2 diabetes who also had overweight or obesity.

Other research suggests a link between sleep apnea and blood sugar control in people with prediabetes.

A study in the American Journal of Respiratory and Critical Care Medicine found that blood sugar levels improved in people with prediabetes after receiving 2 weeks of continuous positive airway pressure (CPAP) treatment for their sleep apnea.

Exercising

Regular exercise, such as walking, can help prevent or reverse prediabetes and insulin resistance.

If someone is typically inactive, they can start by taking a 5–10 minute walk on most days of the week, gradually working up to 30 minutes.

Getting up and moving around at least once an hour rather than sitting for long periods may also help.

Losing excess weight

A person with prediabetes and excess weight can reduce their risk of developing type 2 diabetes by losing about 5–7% of their weight. For someone who weighs 200 pounds, that works out as 10–14 pounds.

A study published in the Journal of General Internal Medicine looked at weight loss in the 6 months following a prediabetes diagnosis. People who lost about 10% of their body weight decreased their risk of developing type 2 diabetes during the next 3 years by 85%.

For those who lost 5% to 7% of their body weight, the risk of developing type 2 diabetes within three years dropped by 54%.

Stop smoking

Active smokers have a 30–40% higher risk of developing diabetes. The risk increases with the number of cigarettes a person smokes.

Research suggests that insulin is less effective if people with type 2 diabetes are exposed to nicotine.

Maintaining hydration

Drinking plenty of water may help control blood sugar levels, research suggests. A study in Diabetes Care followed 3,615 middle-aged men and women with normal blood sugar levels. After 9 years, 565 participants had high blood sugar levels, and 202 developed diabetes.

Participants who drank more than a half-liter of water a day had a 28% lower chance of developing high blood sugar than those who drank less water, the study found.

Avoiding alcohol

Some research suggests that consuming a moderate amount of alcohol may reduce a person’s risk of developing type 2 diabetes, while drinking more heavily may increase the risk.

The ADA recommends that people with diabetes or prediabetes drink in moderation if they choose to drink alcohol. Moderate drinking is a maximum of one drink per day for women and two drinks per day for men. One drink is 5 ounces of wine, 12 ounces of beer, or 1.5 ounces of spirits.

Reducing stress

Stress causes the body to release hormones such as adrenaline and cortisol, which may contribute to insulin resistance, according to Diabetes UK. Ongoing stress may lead to high blood sugar levels.

Making time for rest and relaxation can help a person better manage their stress levels. Someone who is anxious about their prediabetes may feel more relaxed if they learn more about the condition through educational materials or a support group.

Working with a nutritionist

The ADA recommends that people with prediabetes work with a registered dietitian nutritionist or enroll in a lifestyle program.

Medical nutrition therapy can help someone lower their blood sugar levels and meet other goals such as losing weight or reducing blood pressure by making changes to what they eat. The dietician considers someone’s food preferences and culture in making eating recommendations.

CDC-approved lifestyle-change programs can help people with prediabetes. The programs assist individuals who are:

  • 18 or older
  • overweight based on body-mass index (BMI)
  • not pregnant
  • not diagnosed with type 1 or type 2 diabetes

In addition, a person must meet one of the following to qualify for the program:

  • have a recent blood test with results in the prediabetes range
  • be at high risk for type 2 diabetes based on a risk assessment
  • have had gestational diabetes

People 65 or older may enroll in a Medicare diabetes prevention program. For someone to qualify, they need recent blood test results showing they are in the prediabetes range.

Taking a drug called metformin is another strategy for controlling prediabetes.

Data from the Diabetes Prevention Program suggests taking metformin could delay type 2 diabetes in people at high risk of diabetes. According to the NIDDK, the drug was most effective in women who had diabetes during pregnancy, people with obesity, and younger adults.

The drug may have side effects, including:

  • diarrhea
  • nausea
  • vomiting
  • flatulence

Bariatric surgery, such as gastric bypass, may lead to remission of type 2 diabetes.

Research suggests that the surgery may also benefit people with prediabetes. A study in The Lancet Diabetes and Endocrinology looked at a type of diabetes complication, called microvascular complications, in obese individuals. Fewer of these complications occurred in those who received bariatric surgery compared to a non-surgical group.

A person with prediabetes who is considering metformin treatment or bariatric surgery should discuss the pros and cons of the treatment with their doctor.

A person can take a simple screening test from the CDC to see if they are at increased risk of prediabetes. If the test shows an elevated risk, an individual should ask their doctor about taking a blood sugar test to see whether they have diabetes or prediabetes.

Someone who is having symptoms of diabetes should see a doctor. The symptoms may include:

  • frequent urination
  • extreme thirst
  • blurry vision
  • feeling hungry all the time
  • fatigue
  • slow healing of cuts or bruises
  • tingling, numbness, or pain in the feet or hands

Prediabetes is a condition to take seriously, as it can potentially lead to type 2 diabetes.

Lifestyle changes, such as healthy eating and staying active, may help someone manage or even reverse prediabetes.

People with prediabetes can ask their healthcare team for tips and resources for reaching their health goals.