What Is Prediabetes? (and what it isn’t)
If you’re here because someone said, “Your labs show prediabetes,” I just want to say: I get it. It can feel like you got handed a problem you didn’t ask for—especially if you feel fine. I felt fine too.
And then suddenly you’re googling numbers, trying to figure out if you’re “basically diabetic,” wondering if you have to stop eating bread forever, and getting hit with a wave of guilt or fear. Let’s take all of that down a notch and make this simple and doable.
Prediabetes in plain English
Prediabetes means your blood sugar is higher than normal, but not high enough to meet the criteria for type 2 diabetes.
Think of it like this: your body is already having a harder time handling glucose (sugar) efficiently, but you’re not at the “diagnosis line” yet.
That “yet” matters. Because for a lot of us, this is the moment where small, realistic changes can actually move the numbers in a better direction.
And also: you didn’t “fail.” This isn’t a moral score. It’s a health signal—one you can respond to.
What prediabetes is (and what it isn’t)
This helped me stop spiraling: prediabetes is a range and a warning sign, not a destiny.
Prediabetes is:
- A sign that your body is trending toward insulin resistance (more on that below)
- A risk marker for type 2 diabetes, heart disease, and often fatty liver
- Often asymptomatic (meaning you can feel normal)
Prediabetes isn’t:
- A guarantee you’ll develop type 2 diabetes
- Proof you “ate wrong” or “did this to yourself”
- Something that requires extreme diets to improve
- A situation where you have to be perfect to get results
If there’s one mental shift that helped me, it’s this: prediabetes is not a life sentence. It’s a warning light. And warning lights are useful—annoying, yes—but useful.
The numbers: A1C, fasting glucose, and OGTT
When people say “prediabetes,” they’re usually talking about one (or more) of these tests:
A1C
A1C is an estimate of your average blood sugar over roughly the past 2–3 months.
- Normal: below 5.7%
- Prediabetes: 5.7%–6.4%
- Diabetes: 6.5%+
A1C is convenient—no fasting, one number—but it’s not perfect. Some conditions can make it less accurate. If your A1C is borderline and doesn’t match your other labs, ask your clinician how they interpret it in your specific case.
Fasting blood glucose
This is your blood sugar after not eating for at least 8 hours.
- Normal: below 100 mg/dL
- Prediabetes: 100–125 mg/dL
- Diabetes: 126 mg/dL+ (usually confirmed with repeat testing)
Fasting glucose is a snapshot. It can be influenced by sleep, stress, illness, alcohol, and even what you ate the day before.
Oral Glucose Tolerance Test (OGTT)
You drink a sugary drink and they test your blood sugar after 2 hours.
- Normal (2-hour): below 140 mg/dL
- Prediabetes (2-hour): 140–199 mg/dL
- Diabetes: 200 mg/dL+
This is like a “stress test” for your metabolism. It can catch early issues for some people.
Why it happens (insulin resistance, simplified)
Here’s the simplest explanation that helped me:
- Insulin is the hormone that helps move glucose from your bloodstream into your cells.
- With insulin resistance, your cells stop responding as well to insulin.
- Your pancreas makes more insulin to get the same job done.
- Over time, it becomes harder to keep blood sugar in the normal range.
Can you “reverse” prediabetes?
People use “reverse” in different ways. If your labs move back into the normal range, many clinicians will say prediabetes is in remission or resolved. That doesn’t mean “cured forever.” It means your current habits + physiology are producing better numbers.
What I’m focusing on right now (a simple plan)
If you’re overwhelmed, here’s the approach I’m using because it feels sane:
- Consistency over perfection
- Meals built around protein + fiber (not “no carbs”)
- Walking after meals when I can
- Strength training (even light)
- Sleep like it’s part of the plan
What to ask your doctor
- “Which test put me in the prediabetes range—A1C, fasting glucose, or OGTT?”
- “What’s my exact number and what’s a realistic target for 3–6 months?”
- “How often should I re-check A1C?”
- “Do I need other labs (lipids, liver enzymes)?”
- “Should we discuss metformin for my risk profile?”
- “Should I be screened for sleep apnea?”
Quick FAQ
Do I need to cut out all sugar?
No. But I would be strategic: sugary drinks are often the first change worth making.
Should I do keto?
You don’t need keto to improve prediabetes. You need something you can live with.
What should I do this week?
If you do only one thing: walk 10 minutes after your biggest meal 4–5 days this week. Then build from there.
Related: Prediabetes Basics • A1C vs Fasting Glucose vs OGTT • Insulin Resistance Explained