Pre-diabetes: Why you need to take control

A diagnosis of pre-diabetes often comes as a surprise, picked up during a routine blood test even when you're feeling OK.

Pre-diabetes is not something to ignore.

It’s a clear sign that your body is no longer managing blood glucose (sugar) as effectively as it should, and while you may still feel fine, important changes are happening under the surface.

Research from a large-scale study in the Netherlands published in 2020 found that people diagnosed with pre-diabetes have a lifetime risk of up to 80% of developing type 2 diabetes [1].

Another study looking at over 10 million people found that having pre-diabetes raises your chances of heart disease, stroke and even early death compared to people with normal blood sugar [2].

So, while pre-diabetes might not feel like much now, it’s a gentle nudge to make some changes to your diet and lifestyle. Read on.

What is pre-diabetes?

Pre-diabetes (known as non-diabetic hyperglycaemia within the healthcare field) means your blood glucose levels are higher than normal, but not high enough for a diagnosis of type 2 diabetes.

It is estimated that 6.3 million people in the UK have pre-diabetes, and this number is rising [2,3]

It reflects increasing insulin resistance – the reduced ability of your cells to respond to the hormone insulin properly.

Pre-diabetes is commonly diagnosed using an HbA1c test, which measures your average blood sugar level over the last 3 months. A measure of 42–47 mmol/mol (6.0–6.4%) is pre-diabetic.

Another test that is sometimes used is the fasting blood glucose test, and a result of 5.5–6.9 mmol/L gives a pre-diabetes diagnosis.

Why does it happen?

Pre-diabetes develops gradually, often with no obvious symptoms.

It’s linked to several factors, including:

• A diet high in refined carbohydrates, added sugars and ultra-processed foods

• Increased abdominal fat and body weight

• Sedentary lifestyle

• A family history of diabetes

• Ageing (it is particularly common after 45)

• Hormonal changes (e.g. menopause can affect insulin sensitivity).

It’s important to note that you don’t need to be overweight or inactive to develop pre-diabetes; genetics and age-related changes in insulin function can still play a role [3].

It is thought that insulin resistance (a defining feature of pre-diabetes) often begins 10–15 years before a formal diagnosis of type 2 diabetes, showing how early the underlying processes start [4].

Are there symptoms?

A lot of people with pre-diabetes feel completely normal. But you may notice:

• Fatigue or brain fog

• Feeling unusually sleepy or lethargic in the afternoon (due to blood sugar ‘crashes’)

• Increased thirst

• Frequent urination

• Slow-healing skin issues

Can it be reversed?

In many cases, yes - early action can genuinely reverse the trajectory.

Clinical trials in the US show that improving your diet, moving more and losing a bit of weight can cut your risk of developing type 2 diabetes by around 37% [5].

UK real-world data backs this up, with similar reductions seen in people who make lasting lifestyle changes [6].

What to take away

Pre-diabetes doesn’t mean you’ll definitely develop type 2 diabetes, but it does mean your risk is significantly increased.

It’s a chance to make small, meaningful changes before things progress.

Here’s what the research supports:

• Early action matters: even small improvements in weight, fitness or food quality can make a measurable difference

• Simplicity works: you don’t need supplements, fasting plans or cutting out entire food groups

• Support helps: people are more likely to succeed when they have guidance and realistic goals.

If you’ve recently been told you have pre-diabetes, try to see it as useful information - not something to fear, but a nudge to act.

Please get in touch if you've been diagnosed with pre-diabetes, or if you're concerned about your blood sugars, and need some support.

Contact me

Disclaimer

The information and advice I provided here is of a general nature and should never replace individual health or medical advice provided by your doctor or other healthcare professional involved in your care.

References

1. van Herpt TTW, Ligthart S, Leening MJG, et al. Lifetime risk to progress from pre-diabetes to type 2 diabetes among women and men: comparison between American Diabetes Association and World Health Organization diagnostic criteria. BMJ Open Diabetes Res Care. 2020;8(2):e001529. https://drc.bmj.com/content/8/2/e001529

2. The Lancet Diabetes Endocrinology. Prediabetes: much more than just a risk factor. Lancet Diabetes Endocrinol. 2025;13(3):165. https://www.thelancet.com/journals/landia/article/PIIS2213-8587(25)00034-8/fulltext

3. Diabetes UK, 2025. Prediabetes symptoms and risk reduction. https://www.diabetes.org.uk/about-diabetes/type-2-diabetes/prediabetes

4. Freeman AM, Acevedo LA, Pennings N. Insulin Resistance. [Updated 2023 Aug 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. https://www.ncbi.nlm.nih.gov/books/NBK507839/

5. Crandall JP, Dabelea D, Knowler WC, Nathan DM, Temprosa M; DPP Research Group. The Diabetes Prevention Program and Its Outcomes Study: NIDDK's Journey Into the Prevention of Type 2 Diabetes and Its Public Health Impact. Diabetes Care. 2025;48(7):1101-1111. https://diabetesjournals.org/care/article/48/7/1101/158195/The-Diabetes-Prevention-Program-and-Its-Outcomes

6. Valabhji J, Barron E, Bradley D, et al. Early Outcomes From the English National Health Service Diabetes Prevention Programme. Diabetes Care. 2020;43(1):152-160. https://diabetesjournals.org/care/article/43/1/152/35810/Early-Outcomes-From-the-English-National-Health