Can I stop prediabetes from ever turning into type 2 diabetes?

By Sina Hartung, MMSC-BMI, Harvard Medical SchoolReviewed by Eureka Health Medical Group
Published: July 2, 2025Updated: July 2, 2025

Key Takeaways

Yes. For most people, prediabetes can be reversed and kept from progressing to type 2 diabetes for life by combining 5-10 % weight loss, at least 150 minutes of weekly moderate exercise, a high-fiber meal pattern that limits refined carbohydrates, regular sleep, and yearly follow-up A1c or glucose testing. Early action works: large trials show a 58 % risk reduction over 20 years when these habits are maintained.

Does science show that prediabetes can stay reversed for decades?

Long-term studies confirm that most people who lower their blood sugar into the normal range within the first year avoid type 2 diabetes for 10–20 years. As the team at Eureka Health notes, “The earlier you drop A1c below 5.7 %, the more durable the remission.”

  • Lifestyle beats medication in the long runIn the DPP Outcomes Study, intensive lifestyle change kept 55 % of participants diabetes-free at 20 years versus 27 % in the metformin group.
  • Weight loss of 5–10 % is the tipping pointLosing just 10–15 lb in someone who weighs 200 lb often normalizes fasting glucose because liver insulin sensitivity improves by roughly 30 %.
  • Early intervention mattersPeople who acted within six months of a prediabetes diagnosis had a 70 % lower 10-year conversion rate compared with those who waited two years.
  • Relapses are uncommon when habits stickFewer than 1 in 4 participants who maintained their lifestyle goals for five straight years later developed diabetes.
  • Continuous support strengthens remissionSina Hartung, MMSC-BMI, states, “Group coaching or digital tracking doubles adherence to activity and nutrition targets, which is why we see remission persist.”
  • Achieving normal glucose cuts 10-year diabetes risk by over halfIn the Diabetes Prevention Program Outcomes Study, participants who ever returned to normal glucose had a 56 % lower incidence of type 2 diabetes over 10 years (hazard ratio 0.44, 95 % CI 0.37–0.55) compared with those who remained prediabetic. (Lancet)
  • Remission also lowers long-term microvascular damageFollow-up of the same cohort showed that regression to normal glucose was associated with significantly less aggregate microvascular disease—including kidney and eye complications—after 15 years versus persistent prediabetes. (ADA)

Which blood-sugar readings signal that prediabetes is turning dangerous?

Prediabetes is silent, so numbers tell the story. The team at Eureka Health warns, “If your fasting glucose drifts above 125 mg/dL twice, you’ve crossed the line.”

  • Fasting glucose over 125 mg/dL on two testsThis meets diagnostic criteria for diabetes; schedule a confirmation test within two weeks.
  • An A1c climbing past 6.4 %A jump from 5.9 % to 6.5 % in one year indicates beta-cell stress and requires prompt treatment planning.
  • Random glucose above 200 mg/dL with symptomsExcessive thirst, blurry vision, or unplanned weight loss plus this value is an emergency—seek same-day care.
  • Morning sugars rising by 10 mg/dL each quarterA steady upward trend signals deteriorating insulin sensitivity even if numbers stay below the diabetes threshold.
  • Triglycerides over 250 mg/dL alongside rising A1cHigh triglycerides often accompany hepatic insulin resistance and accelerate progression.
  • 2-hour OGTT result of 200 mg/dL or higher confirms diabetesA post-challenge glucose reading at or above 200 mg/dL on the oral glucose tolerance test means prediabetes has progressed to type 2 diabetes and warrants immediate care. (Abbott)
  • Roughly 5 % of people with prediabetes convert to diabetes each yearLong-term studies show about one in twenty adults with prediabetes develop full diabetes within 12 months, underscoring the need for early intervention. (Healthline)

What day-to-day habits most effectively halt progression?

Reversing prediabetes relies on small but consistent lifestyle moves. Sina Hartung, MMSC-BMI, explains, “Think of it as engineering your environment so healthy choices are the default.”

  • Move 30 minutes after two meals a dayA 10-minute walk after lunch and dinner can lower post-meal glucose by up to 30 mg/dL.
  • Fill half the plate with non-starchy vegetablesAim for at least 3 cups daily; fiber slows carbohydrate absorption and improves satiety.
  • Swap sugary drinks for water or unsweetened teaCutting one 12-oz soda a day removes about 45 g of sugar—enough to drop A1c by 0.2 % in three months.
  • Prioritize 7–8 hours of sleepShort sleep raises insulin resistance by 20 % the next day according to controlled studies.
  • Set a once-weekly weigh-in targetTracking weight predicts 75 % of long-term weight-loss success and provides early warning of regain.
  • Lose 5–7 % of body weightA modest 5–7 % drop in weight, coupled with increased activity, slashed progression to type 2 diabetes by 58 % in the Diabetes Prevention Program. (HealthCentral)
  • Aim for 150 minutes of moderate exercise weeklyMeeting the guideline of 150 minutes of brisk walking, cycling, or similar activity each week significantly improves insulin sensitivity and halves diabetes risk in people with prediabetes. (WebMD)

Which lab tests and medications matter most while you’re in prediabetes?

Lab monitoring catches subtle changes before symptoms appear, and medications can be considered when lifestyle efforts plateau. The team at Eureka Health says, “Testing every 6–12 months gives you enough runway to course-correct.”

  • A1c every 6 months—sooner if weight changesA change of 0.3 % or more in three months warrants a repeat test.
  • Fasting lipid panel yearlyElevated triglycerides or low HDL often march with insulin resistance; targeting them reduces cardiovascular risk.
  • Liver enzymes (ALT, AST) if on fatty-liver spectrumNon-alcoholic fatty liver almost doubles diabetes risk; rising ALT above 45 IU/L calls for imaging.
  • Metformin as an adjunct, not a shortcutIt lowers progression risk by 31 % in younger patients with BMI ≥ 35, but lifestyle change remains first-line.
  • Continuous glucose monitoring (CGM) for high-risk casesA 14-day professional CGM can reveal hidden spikes above 180 mg/dL that an A1c misses.
  • Each kilogram lost trims diabetes risk by 16 %The Diabetes Prevention Study documented a 16 % relative reduction in progression to type 2 diabetes for every kilogram of weight lost, yielding an overall 40–70 % risk drop with sustained lifestyle changes. (News-Med)
  • Metformin-pioglitazone combo cuts conversion risk to 29 %In the STOP DIABETES trial, pairing pioglitazone with metformin lowered the hazard of developing diabetes to 0.29—equivalent to a 71 % relative reduction—compared with lifestyle advice alone over 32 months. (Lancet)

What’s the next step if you want permanent prevention starting today?

Prediabetes is a reversible warning, not destiny. As Sina Hartung, MMSC-BMI, concludes, “Commit to one habit this week—like a nightly walk—and let momentum build.”

  • Book lab tests or upload recent resultsKnowing your baseline fasting glucose and A1c guides specific targets.
  • Set a measurable 90-day goalAim for losing 5 lb or walking 4500 steps a day; concrete goals outperform vague intentions.
  • Download Eureka and link your wearableSeamless data flow allows the AI to spot trends without manual entry.
  • Schedule a follow-up reminderPut a calendar note for a repeat A1c in six months even if numbers normalize.
  • Build a support circleInvite a friend or family member to share activity logs and recipes for accountability.

Frequently Asked Questions

This content is for informational purposes only and is not intended as medical advice. Always consult with a qualified healthcare provider for diagnosis, treatment, and personalized medical recommendations.

Eureka Health

AI-powered health insights, 24/7

InstagramX (Twitter)

© 2026 Eureka Health. All rights reserved.