Prediabetes: How To Identify It & The Most Effective Way To Reverse It

woman with prediabetes checking her blood sugar

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Approximately 37 million Americans have diabetes, the vast majority of which is type 2 diabetes. If you think that number is high, listen to this. Prediabetes affects more than 2.5 times that number of people! It’s estimated that a whopping 96 million US adults are walking around with prediabetes… that’s 38% of the adult population! What’s even scarier is that 80% of people with prediabetes are unaware that they have it. 

When it comes to your health, knowledge is power. So in this article we’re going to cover how to identify prediabetes and the most effective way to reverse this condition.

What Is Prediabetes?

Prediabetes is a condition that precedes type 2 diabetes. In prediabetes, blood sugar levels are higher than normal, but not yet high enough to be considered type 2 diabetes. In my article on Type 2 Diabetes we discussed how diabetes is a result of insulin resistance and dysfunctional insulin signaling, the underlying issue being high glucose levels in the body and in the cells. This same scenario plays out in prediabetes, with insulin resistance being a precursor to this condition.

Prediabetes serves as a critical warning sign, offering those that become aware of it an opportunity to make lifestyle changes that reverse prediabetes, and prevent the development of full-blown diabetes. It’s a critical point in which taking proactive steps can make all the difference in living out a healthier future.

woman with prediabetes testing her blood glucose with a glucose meter

What Tests Identify Prediabetes?

Certain blood tests can be performed to identify whether you have prediabetes or diabetes, and can be ordered by your healthcare provider.

Hemoglobin A1C

Hemoglobin A1C (HbA1C) is a blood test that measures what your average blood sugar levels have been over the previous 3 months. A HbA1C between 5.7% and 6.4% indicates you have prediabetes.

Fasting Blood Glucose

Another blood test commonly done to identify prediabetes or diabetes is a simple fasting blood glucose test. Levels between 100 to 125 mg/dL indicate you have prediabetes.

Serum Insulin

Insulin resistance precedes prediabetes and diabetes, so getting insulin tested can help identify the issue before these conditions develop. An optimal insulin level is less than 6 uIU/mL.

Risk Test

While only blood tests can indicate an official diagnosis, the CDC has an online risk test that you can take to find out if you’re at increased risk. 

The test takes into consideration the following factors which increase your risk for prediabetes or diabetes:

  • Your age – people over the age of 35 have a higher risk
  • Your gender – men are more likely than women to develop diabetes
  • Having a family history of diabetes
  • Women with a history of gestational diabetes (diabetes during pregnancy) are at higher risk
  • Having high blood pressure 
  • Being overweight
  • A sedentary lifestyle

You can take the test here.

woman with early diabetes symptoms like a headache

Prediabetes symptoms

People with prediabetes sometimes have no symptoms at all, potentially explaining why such a high percentage of people don’t know they have this condition. Another possibility is that prediabetes develops slowly, and people often grow accustomed to the symptoms which would otherwise be considered a warning sign, downplaying the symptoms as ‘normal’ for them. 

To identify prediabetes it’s helpful to know what symptoms commonly appear prior to diabetes developing, as well as what signs, symptoms and risk factors are associated with insulin resistance (which precedes prediabetes and diabetes). 

Common symptoms that present prior to diabetes are a result of poor blood glucose regulation, with blood sugar levels swinging between too high (hyperglycemia) and too low (hypoglycemia), and include:

  • Fatigue
  • Brain fog
  • Headaches
  • Intense food cravings, especially for sweets
  • Irritability, especially when going for longer periods of time without food… aka feeling ‘hangry’ 😉
  • Feeling shaky or light-headed when going for longer periods of time without food
  • Difficulty sleeping

In addition to the risk factors noted in the section above, such as living a sedentary lifestyle and having high blood pressure, other physical signs and factors that are associated with insulin resistance include:

  • Skin tags
  • Patches of dark skin around the armpits, neck, and groin regions
  • Obesity, especially in the abdominal region
  • Smoking
  • Eating a diet high in carbohydrates
  • Taking medications such as corticosteroids, antipsychotics, and HIV meds
  • Having certain medical conditions such as polycystic ovarian syndrome (PCOS), Cushing’s syndrome, nonalcoholic fatty liver disease, and sleep apnea

You can also find a list of symptoms associated with Type 2 Diabetes in this article.

too much sugar

What Causes Prediabetes?

The underlying root cause of prediabetes is the same as what we discussed for type 2 diabetes. As was mentioned in that article, the single most important determinant is diet. A diet excessively high in carbohydrates, in combination with a sedentary lifestyle is a recipe for insulin resistance, blood sugar dysregulation, weight gain, prediabetes, and ultimately diabetes. 

There are other environmental, genetic, and lifestyle factors that can increase the risk for developing insulin resistance, prediabetes, and diabetes, which are expanded upon in the above mentioned article on type 2 diabetes.

If you have prediabetes or several of the risk factors associated with diabetes, that doesn’t necessarily mean you’ll develop diabetes. Prediabetes is reversible with lifestyle changes!

Prediabetes IS reversible! 🤸 BUT you can’t reverse it with the same lifestyle that caused it. 🤯 Lifestyle change is necessary.

example keto meal for people with prediabetes

What Is The Most Effective Way To Reverse Prediabetes?

If we know the most important determinant for developing prediabetes and diabetes is diet, it only makes sense to start there.


The underlying dietary issue in the development of prediabetes and diabetes is a carb-heavy diet. The Standard American Dietary pattern includes sugar at every turn → 

  • Sugar sweetened coffee
  • Breakfast of sugary cereal, sugar-laced instant oats, carb-heavy bagels or pastries, sugar-sweetened yogurts, and fruit juices
  • Carb-based snacks like candy, chips, crackers, pretzels, granola bars or other sugary snack bars, and sugar sweetened beverages
  • Lunch of sandwich with chips or fries and a soda or sweetened iced tea
  • Dinner of pizza or pasta with a sugary beverage and cookies or ice cream to top it off


I’m certainly not pointing this out to make anyone feel bad… I enjoy cookies as much as the next person! My intention is to show just how easy it could be to develop a condition like prediabetes or diabetes when there’s a constant influx of sugar and carbs, as there is in the Standard American Diet. And of course my intention is to share strategies that can turn this prediabetes bus around! So, let’s talk about that.

The American Diabetes Association (ADA) released a consensus report in 2019 on nutritional therapy for adults with diabetes or prediabetes, indicating that the nutritional intervention with the most evidence to improve blood glucose regulation is to reduce overall carbohydrate intake. Let’s discuss two strategies with strong evidence for improving insulin function and blood glucose levels.

Low-Carb or Ketogenic Diet

A low-carbohydrate or ketogenic diet is a great strategy to reduce the amount of sugar and carbs in the diet. A ketogenic style of eating significantly reduces carbs while increasing healthy fats. This encourages a shift in metabolism and the body enters a state of nutritional ketosis where it becomes more efficient at burning fat as a fuel source instead of sugar. 

This style of eating results in significant improvements in blood glucose and insulin levels, making it a great solution for those with prediabetes and diabetes. This study shows that 93% of patients with prediabetes that followed a low-carbohydrate diet were able to reverse their condition! If you’re looking for a low-carb meal plan, I created a 3 Day Diabetes-Friendly Meal Plan Resource to help get you started. 

If you aren’t ready for major lifestyle change, but you want to implement a few simple nutrition strategies that make a big difference, the Diabetes Nutrition Workshop is the perfect place to start.

image signifying intermittent fasting with a plate that looks like an alarm clock

Intermittent Fasting

Another way to reduce carbohydrates is to incorporate a strategy like intermittent fasting, also called time-restricted feeding. Intermittent fasting is shown to effectively lower fasting glucose and insulin, reverse insulin resistance, and encourage weight loss in people with diabetes.

There are various strategies for intermittent fasting, but my personal favorite is fasting for a certain period of time every day. This allows you to remain consistent with your daily meal timing, which is important for maintaining a healthy circadian rhythm, which is another important factor in regulating blood glucose levels.

A regimen that can be really easy for beginners is a simple 12 hour fast. For example, if you finish dinner by 7pm, wait until 7am to have breakfast. If that feels good, then work up from there.

Physical Activity

Given that a sedentary lifestyle is another major risk factor for developing diabetes, increasing physical activity is another valuable priority on the quest to reverse prediabetes. We all know inherently that exercise supports overall health, but evidence also shows that physical activity can actually reduce type 2 diabetes development by 30-50%!

If exercise isn’t part of your lifestyle currently, don’t feel overwhelmed. There’s a very simple, yet powerful way to get the benefits of physical activity on blood sugar control without doing long, intense, sweaty workouts. 

Studies show that light intensity walking for just 10 minutes after meals leads to improvements in post-meal blood glucose levels. If you don’t have 10 minutes to spare, evidence shows even 2 minute bouts of light intensity walking can improve blood glucose levels after meals!

woman with type 2 diabetes walking for exercise


Prediabetes is a condition that precedes type 2 diabetes and affects more than 1 in 3 people, 80% of which are unaware that they have it. Being aware of the signs, symptoms and risk factors are vital to recognizing the early stages of prediabetes and insulin resistance. 

Awareness at this stage provides a great opportunity to reverse this condition with lifestyle practices and prevent it from progressing to type 2 diabetes! Lifestyle practices like a low-carbohydrate style of eating, intermittent fasting, and physical activity are shown to improve insulin function and blood glucose control and reverse prediabetes.

PreDiabetes & Diabetes Nutrition Workshop

There are 5 incredibly simple nutrition changes that can make a dramatic difference in blood sugar regulation without drastically changing your overall lifestyle. These changes form an amazing foundation to begin the process of improving blood sugar regulation and reversing insulin resistance, prediabetes and type 2 diabetes. Further change may be necessary, but these simple changes are the best starting point. Discover these simple changes in the Diabetes Nutrition Workshop.

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