Prediabetes lifestyle in adults

Overview

Prediabetes means your blood sugar levels are higher than normal, but not high enough to be called diabetes. It is a warning sign that you are at risk of developing type 2 diabetes, but it can often be reversed with healthy lifestyle changes.

Yes, prediabetes is very common. Around 1 in 3 adults in the UK have prediabetes, but most have no symptoms and are unaware.

Prediabetes can affect any adult, but it is more common in people who are overweight, inactive, or have a family history of type 2 diabetes. It also occurs more often in people over 40 and those from South Asian, African-Caribbean, or Middle Eastern backgrounds.

Symptoms

Common symptoms

• Most people with prediabetes have no symptoms at all.
• Some people may notice darkened skin in the armpits or neck (a condition called acanthosis nigricans).
• Occasionally, mild increased thirst or needing to urinate more often.

Symptoms in children

• Prediabetes in children is less common but possible, especially if the child is overweight.
• Symptoms in children are usually absent, but may include increased thirst, frequent urination, or fatigue.

Symptoms in older adults

• Older adults often have no symptoms, or may feel tired or have blurred vision.
• They may also have other health conditions that can mask prediabetes.

Causes

Main causes

• Your body’s cells become less responsive to insulin (insulin resistance), so blood sugar builds up.
• Your pancreas cannot produce enough insulin to keep blood sugar in a normal range.

Risk factors

• Being overweight, especially having extra belly fat
• Not getting enough physical activity
• Unhealthy diet high in sugar, refined carbs, and unhealthy fats
• Family history of type 2 diabetes
• Age over 40 (or over 25 for South Asian people)
• History of gestational diabetes (diabetes during pregnancy)
• High blood pressure or abnormal cholesterol levels

When to see a doctor

See a doctor urgently if:

• If you have any emergency symptoms listed above (call your local emergency number).

Book a routine appointment if:

• If you have risk factors for prediabetes (such as being overweight, family history, or being over 40) you should see your doctor for a simple blood test.
• If you are concerned about your blood sugar for any reason.

Diagnosis

Your doctor diagnoses prediabetes with a blood test. You may need to fast (not eat or drink anything except water) for 8 hours before the test.

Tests that may be done

• Fasting plasma glucose test: measures your blood sugar after fasting.
• HbA1c test: shows your average blood sugar over the past 2-3 months.
• Oral glucose tolerance test: your blood sugar is tested before and after drinking a sugary drink.

What to expect at your appointment

The tests are simple and quick. Your doctor will explain the results and what they mean. If you have prediabetes, they will work with you on a plan to lower your blood sugar.

Treatment

The main treatment for prediabetes is lifestyle change. The goal is to lower your blood sugar and prevent type 2 diabetes. For some people, medication may be considered, but lifestyle is always the first step.

Self-care at home

• Lose 5-7% of your body weight if you are overweight (for example, 5-10 kg if you weigh 90 kg).
• Be physically active for at least 150 minutes a week (like brisk walking, cycling, or swimming).
• Eat a balanced diet with plenty of vegetables, whole grains, lean protein, and healthy fats. Limit sugary drinks and processed foods.
• Manage stress and get enough sleep – both affect blood sugar.
• Quit smoking and limit alcohol.

Medical treatments

If lifestyle changes are not enough, your doctor may recommend a medication to help lower blood sugar. These medicines are only available with a prescription and are not a substitute for healthy habits. Your doctor will discuss the benefits and risks with you.

When is surgery considered?

Surgery is not a treatment for prediabetes. In rare cases, weight loss surgery (bariatric surgery) may be considered for severe obesity, but it is not a direct treatment for prediabetes.

Living with this condition

Living with prediabetes means being aware of your blood sugar and making healthy choices every day. Many people find it helpful to check their blood sugar at home, but your doctor will tell you if that is needed. It is a condition you can manage and often reverse.

Lifestyle tips

• Plan your meals to include more vegetables, whole grains, and lean proteins.
• Aim for at least 30 minutes of moderate activity most days.
• Find ways to reduce stress – try walking, meditation, or hobbies.
• Get support from family, friends, or a support group.
• Keep regular medical appointments to track your progress.

Diet and exercise

A balanced diet and regular exercise are the cornerstones of managing prediabetes. Focus on portion control, eating at regular times, and choosing foods with a low glycaemic index (like oats, lentils, and non-starchy vegetables). Exercise helps your body use insulin better. Even small changes, like taking the stairs or walking after meals, can make a difference.

Mental health and emotional wellbeing

Being diagnosed with prediabetes can feel worrying, but it is also a chance to make positive changes. Some people feel stressed or anxious about their health. If you feel overwhelmed, talk to your doctor or a counsellor. Remember, you have the power to improve your health.

Prevention

Yes, prediabetes can often be prevented by maintaining a healthy weight, staying active, eating well, and avoiding smoking. If you have risk factors, talk to your doctor about screening and prevention strategies.

Vaccines

There are no vaccines for prediabetes. However, staying up to date with recommended vaccines (like flu and pneumonia) is important for overall health, especially if you have high blood sugar.

Screening programmes

Screening for prediabetes is recommended if you are overweight and over 40 (or over 25 for South Asian people) or have other risk factors. Your doctor can do a simple blood test. Early detection gives you the best chance to prevent type 2 diabetes.

Complications

If left untreated

• Prediabetes often progresses to type 2 diabetes within 5-10 years if no changes are made.
• High blood sugar can damage blood vessels, increasing the risk of heart disease, stroke, kidney disease, and vision problems.

Long-term outlook

The outlook for prediabetes is very positive if you take action. Many people can return their blood sugar to normal with lifestyle changes. Even if you don't fully reverse it, you can delay or prevent type 2 diabetes and its complications. Your efforts truly make a difference.

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