Prediabetes (or borderline diabetes) is a health condition where blood sugar levels are higher than normal but not yet high enough to be considered diabetes. It frequently develops silently, with no visible symptoms, as the body struggles to use insulin, a hormone that helps regulate the levels of sugar (glucose) in your bloodstream.
Many people are unaware they have prediabetes, yet it affects millions worldwide and significantly increases the risk of developing type 2 diabetes, heart disease, and other serious health problems. In simple terms, prediabetes serves as an early warning sign that the body’s blood sugar-regulating system is under stress.
To understand the importance of recognizing prediabetes early, it helps to know a bit about diabetes itself. Diabetes occurs when the body does not produce enough insulin or cannot effectively use the insulin it makes, causing sugar to build up in the bloodstream. Over time, this can lead to complications affecting the eyes, kidneys, nerves, and cardiovascular system.
Prediabetes represents a crucial stage where appropriate lifestyle adjustments can support better metabolic health and significantly reduce the likelihood of progression to type 2 diabetes.
What are the Symptoms of Prediabetes?
Most individuals with prediabetes do not exhibit any symptoms. For this reason, it is crucial to visit your doctor regularly so they may perform screenings to assess your blood sugar levels, such as a basic metabolic panel (BMP).
The few individuals who do exhibit prediabetes symptoms could have the following:
- Feeling more tired than usual
- Increased thirst or urination
- Blurred vision
- Skin tags
- Darkened skin in your armpit or the back and sides of your neck
What are the Causes of Prediabetes?
Prediabetes occurs due to insulin resistance. That is when your body produces insulin (a hormone that helps regulate blood sugar levels), but does not use it properly. This raises your blood sugar levels above normal.
Various factors may contribute to insulin resistance, including:
- Genetics
- Excess body fat
- Long-term stress
- Sleep loss
- Physical inactivity
- A diet heavy in processed foods
- Some hormonal health conditions, such as Cushing’s syndrome and hypothyroidism
- Some medications, such as steroid drugs, used for an extended period
What are the Risk Factors of Prediabetes?
The following are the risk factors of prediabetes:
Modifiable Risk Factors
Modifiable risk factors are lifestyle or health-related behaviors and conditions that a person can change or improve to reduce their risk of disease.
The following are the modifiable risk factors of prediabetes:
- Overweight or obesity – particularly excess middle belly fat
- Physical inactivity – being physically active fewer than three times a week.
- Unhealthy eating habits – especially diets high in processed foods, refined carbs, and sugary drinks
- Smoking – worsens insulin resistance
- Poor sleep and stress – can negatively affect blood sugar regulation
Unmodifiable Risk Factors
Unmodifiable risk factors are inherent characteristics, such as age, genetics, or family history, that cannot be altered but may increase a person’s likelihood of developing a disease.
For prediabetes, these include:
- Family history of type 2 diabetes (parent or sibling affected)
- Increasing age, especially after 45
- Ethnicity, higher risk in South Asian (Pakistani, Indian, Bangladeshi), Black Africans, African Caribbean, Hispanic/Latino, African American, and Pacific Islander communities
- Genetic predisposition
- History of gestational diabetes (diabetes during pregnancy)
- Polycystic ovary syndrome (PCOS) in women
Health-Related Conditions that Increase the Risk
These conditions include:
- High blood pressure
- Abnormal cholesterol levels
- Low HDL (“good” cholesterol)
- High triglycerides
- Cardiovascular disease or metabolic syndrome
- Sleep apnea and other sleep disorders
- History of insulin resistance (sometimes seen with obesity or PCOS)
What are the Possible Complications of Prediabetes?
The primary prediabetes complication is that it progresses to Type 2 diabetes. Undiagnosed or untreated Type 2 diabetes raises the risk for various complications, such as:
- Heart attack and stroke
- High blood pressure
- Eye issues (diabetes-related retinopathy)
- Kidney issues (diabetes-related nephropathy)
- Nerve damage (diabetes-related neuropathy)
- Loss of a limb (amputation)
Untreated prediabetes can harm your heart, kidneys, and blood vessels over time, even before it develops into diabetes. It has been associated with silent heart attacks, which are so minor that you might not even be aware of them.
Although prediabetes can be reversed, complications from diabetes are usually irreversible. That’s why prevention and effective management are essential.
How is Prediabetes Diagnosed?
Healthcare providers rely on routine blood test screenings to check for prediabetes. If you have risk factors for prediabetes, your provider may recommend these screenings more often.
This blood test measures your average blood sugar levels over the previous 2-3 months. Doctors provide it to diabetes patients to determine whether their blood sugar levels are under control. They can also prescribe this test to diagnose diabetes or prediabetes.
Fasting Plasma Glucose Test (FPG)
This blood test is performed after you have fasted for at least eight hours without eating or drinking anything other than water. Both basic and comprehensive metabolic panels include a glucose test. Doctors frequently order these tests to get a comprehensive picture of your health.
Oral Glucose Tolerance Test (OGTT)
The Oral Glucose Tolerance Test (OGTT) checks how well the body processes sugar over a set period. After fasting overnight, a blood sample is taken, and then you drink a sweet drink. Your blood sugar is checked again two hours later to see how well your body has processed the sugar.
Prediabetes Diagnostic Criteria (American Diabetes Association)
Identifying prediabetes early is essential, and the American Diabetes Association (ADA) provides clear guidelines to help determine when blood sugar levels fall into the prediabetes range. These tests are typically recommended for individuals with risk factors or those who want to assess their metabolic health. According to the ADA, the diagnostic criteria for prediabetes are as follows [1,2]:
- Hemoglobin A1C: 5.7% – 6.4%
- Fasting Plasma Glucose (FPG): 100 – 125 mg/dL
- 2-Hour Plasma Glucose (OGTT, 75 g): 140 – 199 mg/dL
These criteria help identify individuals at higher risk of developing type 2 diabetes, allowing them to take preventive action through lifestyle changes and regular monitoring.
Is Prediabetes Reversible?
Making healthy lifestyle changes is the best approach to treat prediabetes and possibly reverse it. You can prevent or delay Type 2 diabetes and get your blood sugar back to normal by eating a healthy diet and exercising frequently.
The most crucial strategies include the following:
Healthy Eating Habits
Making wise eating choices helps to reverse prediabetes. A diet rich in vegetables, whole grains, fruits, lean proteins, and healthy fats helps maintain steady blood sugar levels. Reducing sugary drinks, sweets, refined carbohydrates, and highly processed foods can prevent blood sugar spikes and support better metabolic health. A consistent, balanced diet helps the body use insulin more effectively.
Regular Physical Activity
Increasing daily activity helps lower excess blood sugar levels and improves the body’s ability to use insulin effectively. Activities like brisk walking, swimming, cycling, or even home workouts can make a meaningful difference when done most days of the week. Adding strength training helps build muscle, which allows the body to manage blood sugar more efficiently. Aim for 150 minutes each week, or 30 minutes per day, five days a week [3].
Weight Management
For individuals who are overweight, losing even a modest amount of weight can significantly reduce the risk of progressing to type 2 diabetes. A gradual, sustainable weight loss of about 5–7% of current body weight can improve insulin sensitivity and overall metabolic health [4]. The goal is to develop long-term, healthy habits that maintain a stable weight.
Quality Sleep and Stress Management
Chronic stress and poor sleep can disrupt hormone balance, increase cravings, and negatively affect blood sugar control. Developing a consistent sleep routine, reducing screen time before bed, and engaging in relaxation techniques such as deep breathing, meditation, or stretching can enhance sleep quality and lower stress levels. Taking care of emotional well-being is an essential part of managing prediabetes.
Avoiding Smoking
Smoking contributes to insulin resistance and raises the risk of cardiovascular disease (heart disease), which is a major concern for people with prediabetes. Quitting smoking can improve overall health, blood circulation, and the body’s ability to use insulin and process blood sugar effectively.
Medical Guidance and Monitoring
Collaborating with a healthcare professional allows for consistent monitoring of blood sugar levels and timely adjustments to the care plan. Routine medical evaluations help track progress, identify areas requiring further attention, and reinforce preventive strategies. When lifestyle modifications alone are insufficient, a clinician may consider prescribing medications such as metformin to enhance blood sugar control and reduce the risk of progression to type 2 diabetes.
How can you Prevent Prediabetes?
The approaches for preventing prediabetes are the same as those for reversing it and preventing Type 2 diabetes:
- Exercising regularly.
- Maintaining a weight that’s healthy for you.
- Eating nutritious food.
- Not smoking
What is the Significance of Early Screening?
Early screening for prediabetes is essential because the condition often develops silently without noticeable symptoms. Identifying elevated blood sugar levels at an early stage allows individuals to take preventive action before serious complications arise.
Routine screening, especially for those with risk factors such as excess weight, physical inactivity, or a family tendency toward diabetes, supports timely lifestyle changes and medical guidance. Detecting prediabetes early not only reduces the likelihood of progressing to type 2 diabetes but also helps protect heart, kidney, and nerve health in the long term.
Key Takeaways
Prediabetes occurs when blood sugar levels are higher than normal but not yet in the diabetes range. Many people exhibit no symptoms, although fatigue, increased thirst, or frequent urination may sometimes appear. Risk increases with excess body weight, inactivity, unhealthy eating habits, age, and a family tendency toward diabetes. If not addressed, prediabetes can progress to type 2 diabetes and cause heart, nerve, or kidney problems. The positive aspect is that prediabetes can often be reversed by making healthy lifestyle changes, such as improving your diet, staying active, managing your weight, reducing stress, and ensuring sufficient sleep, in addition to seeking medical guidance when necessary.
How Chughtai Lab Helps in Prediabetes Prevention
Chughtai Lab is committed to supporting the early detection and ongoing monitoring of prediabetes, enabling you to take proactive steps toward improving your health. Through accurate and timely testing, we help you understand your blood sugar status and identify potential risks before they progress further.
We provide essential diagnostic tests for prediabetes screening, including HbA1c and Fasting Blood Sugar. Regular screening, especially for individuals with risk factors, empowers you to make informed lifestyle choices and follow the right preventive measures.
By choosing our laboratory for your routine check-ups and follow-up screenings, you receive dependable results and professional guidance that support informed decisions for your long-term metabolic health.
References
- ElSayed, N.A., McCoy, R.G., Aleppo, G., Balapattabi, K., Beverly, E.A., Briggs Early, K., Bruemmer, D., Ebekozien, O., Echouffo-Tcheugui, J.B., Ekhlaspour, L. and Gaglia, J.L., 2025. 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes—2025. Diabetes Care, 48(Supplement_1):S27–S49.
- Diabetes Diagnosis. American Diabetes Association. https://diabetes.org/about-diabetes/diagnosis. Accessed: 17th November, 2025.
- Diabetes Prevention Program (DPP) Research Group, 2002. The Diabetes Prevention Program (DPP) description of lifestyle intervention. Diabetes care, 25(12), pp.2165-2171.
- Kucera, M., Marchewka, T. and Craib, A., 2021. Does Losing 5-7% of Prediabetic Body Weight from a Diabetes Prevention Program decrease Cardiovascular Risks?. Spartan Medical Research Journal, 6(2), p.27627.
- Ethnicity and Type 2 Diabetes. Diabetes UK. https://www.diabetes.org.uk/about-diabetes/type-2-diabetes/diabetes-ethnicity. Accessed: 7th November, 2025.
- Prediabetes. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/21498-prediabetes. Last Reviewed: 8th November, 2023. Accessed: 7th November, 2025.
- Prediabetes: Causes, Symptoms, and Treatment. WebMD. https://www.webmd.com/diabetes/what-is-prediabetes. Published Online: 5th February, 2024. Accessed: 7th November, 2025.
