Prediabetes Is Not Almost Nothing

Prediabetes gets dismissed more than almost any other result. The prefix does the damage: pre sounds like not yet, and not yet sounds like not a problem.

So it is worth saying both halves of the truth, because most people only hear one.

The first half: this is real. Prediabetes means the process leading to Type 2 diabetes is already under way. A meaningful proportion of people with it go on to develop diabetes, and the risk to your heart and blood vessels begins rising at this stage rather than waiting for a formal diagnosis.

The second half: this is the most reversible stage there is. Around 40% of people in the intensive lifestyle arm of the landmark Diabetes Prevention Program returned to normal glucose, against about 20% on metformin or placebo. In an Indian lifestyle programme, 47.1% achieved remission within a year while only 1.2% progressed to diabetes.

And reaching normal glucose even once matters years later — people who did so had a 56% lower risk of developing diabetes than those who stayed in the prediabetes range.

So the useful attitude is neither alarm nor dismissal. It is a result worth acting on, at the point where acting works best.