I Have Prediabetes. What Now?

Reviewed by the JForH team · 2026-10-30

Prediabetes means an A1C of 5.7–6.4% or a fasting blood sugar of 100–125 mg/dL. In the US Diabetes Prevention Program trial, losing about 7% of body weight and walking 150 minutes a week cut the chance of type 2 diabetes by 58%, and by 71% in people 60 and older. A CDC-recognized lifestyle program helps you do this. Recheck your A1C at least once a year.

I have prediabetes. What should I do first?

Take a breath. Prediabetes means your blood sugar is higher than normal but not in the diabetes range. It does not mean you will get type 2 diabetes. Many people bring their numbers back down.

These three steps have the strongest evidence behind them:

1. Aim to lose 5–7% of your body weight if you're carrying extra weight. For someone who weighs 200 pounds, that's 10 to 14 pounds.
2. Build up to 150 minutes a week of brisk walking or similar activity. That's 30 minutes on 5 days.
3. Join a CDC-recognized lifestyle change program, which helps you do both with a coach and a group.

You don't have to do it all this week. Small changes that you keep up beat big ones you drop after a month.

What A1C and blood sugar numbers count as prediabetes?

The American Diabetes Association (ADA) and CDC use the same lab ranges:

So an A1C of 6.1% or a fasting sugar of 108 mg/dL both fall in the prediabetes range. Numbers near the top of the range, such as an A1C of 6.0% or higher or a fasting sugar of 110 or more, carry more risk. The ADA uses those cutoffs when it talks about who might also benefit from metformin.

Can prediabetes be reversed?

It can be. The strongest evidence is that lifestyle change can prevent or delay type 2 diabetes for years.

The strongest proof comes from the Diabetes Prevention Program (DPP), a US trial of 3,234 adults with high blood sugar who didn't yet have diabetes. Over about 3 years, the group in the lifestyle program cut their chance of getting type 2 diabetes by 58% compared with a dummy pill. For people 60 and older, the drop was 71%, according to the CDC.

The lifestyle goals in the trial were simple: lose at least 7% of body weight and get at least 150 minutes of activity a week. The ADA says weight loss was the biggest single factor.

The benefit lasted. In follow-up studies, the risk was still 27% lower at 15 years and 24% lower at 21 years.

What is the CDC Diabetes Prevention Program?

It's a year-long lifestyle change program built on the DPP trial. A trained lifestyle coach leads a small group. You learn how to eat healthier, move more and handle stress, and you check in on your weight.

• First 6 months: you meet about once a week.
• Second 6 months: you meet once or twice a month.
• Formats: in person, fully online, by video or phone with a live coach, or a mix.

The ADA's 2026 Standards of Care say doctors should offer these programs to adults at high risk, and that online and app-based programs recognized by the CDC can work too.

Am I eligible for the National Diabetes Prevention Program?

You need all of these:

• Age 18 or older
• A BMI of 25 or higher, or 23 or higher if you're Asian American
• No diagnosis of type 1 or type 2 diabetes
• Not pregnant

And one of these: a prediabetes-range blood test in the past year, a past diagnosis of gestational diabetes, or a score of 5 or higher on the CDC Prediabetes Risk Test.

How do I find a CDC-recognized program near me?

Use the CDC's Find a Program tool. Type in your city, state or ZIP code and you'll see a list of in-person sites, plus online options. The CDC also keeps a national registry of every recognized organization at dprp.cdc.gov/Registry.

Look for the words "CDC-recognized." That means the program follows the CDC's curriculum and reports its results.

How much does a diabetes prevention program cost?

It depends on where you go. The CDC says some programs are free, and many employers and insurers cover them. Call your plan and ask about the "National Diabetes Prevention Program."

If you have Medicare Part B, the Medicare Diabetes Prevention Program is free if you qualify. You need a BMI of 25 or higher (23 if you're Asian) and a recent test showing an A1C of 5.7–6.4%, a fasting sugar of 110–125 mg/dL or a 2-hour glucose tolerance result of 140–199 mg/dL.

What should I eat with prediabetes?

An eating pattern you can stick with that helps you lose some weight. The ADA names Mediterranean-style and low-carbohydrate eating as two evidence-based options.

A good place to start is the CDC's plate method. Use a 9-inch plate. Fill half with nonstarchy vegetables, a quarter with lean protein such as fish, chicken or eggs, and a quarter with carb foods such as whole grains, potatoes, beans or fruit. Drink water or a zero-calorie drink.

A walk after meals helps too. In our glucose report, a typical sugar rise after eating peaked about an hour after it started, so a 10-minute walk soon after you eat lands at the right time.

Do I need metformin for prediabetes?

Not usually as a first step. In the DPP trial, metformin cut the risk of diabetes by 31%, less than the 58% from lifestyle change.

The ADA says doctors should consider metformin for some adults at high risk. It points especially to people aged 25–59 with a BMI of 35 or higher, a higher fasting sugar (such as 110 mg/dL or more) and a higher A1C (such as 6.0% or more), and to women who had gestational diabetes. Ask your doctor whether it makes sense for you.

How often should I get my A1C checked with prediabetes?

At least once a year, the ADA says. Your doctor may test more often if your numbers are near the top of the range or you have other risk factors.

If you've made big changes, such as losing weight, a retest after about 3 months will show you the effect. A1C reflects your average over roughly the past 3 months, so testing sooner won't tell you much.

Call your doctor sooner if you notice strong thirst, passing a lot of urine, blurred vision or weight loss you can't explain. Those can be signs of diabetes.

This guide is for education and does not replace advice from your own doctor.

See where your numbers stand (free check)

Last updated: 2026-10-30. Educational information, not medical advice. Talk to your doctor before changing your treatment.