Written by Diana Licalzi, MS, RD, CDE
Currently, 96 million Americans (more than 1 in 3) have prediabetes but only 80% know they have it.  Prediabetes is a silent disease, meaning it doesn't have many signs or symptoms so it can easily go undetected for months or even years. However, if left untreated, about 70% of people with prediabetes will go on to develop type 2 diabetes.  In this article, we’ll discuss the best ways to treat prediabetes and how to prevent prediabetes from developing into type 2 diabetes.
What is Prediabetes?
The amount of sugar (or glucose) someone has in their blood determines whether they have prediabetes or type 2 diabetes. A person without diabetes has a fasting blood sugar level below 100 mg/dl or an HbA1c test below 5.7%. HbA1c, or A1c for short, reveals an average blood glucose level over the past 3 months.
Over time, if a person’s blood sugar level rises above this normal criteria, they enter the prediabetes range. The diagnostic criteria for having prediabetes is when blood sugar levels reach 100-125 mg/dL or an A1c between 5.7-6.4%. As blood sugar levels rise above this level, then type 2 follows, which is a diagnostic criteria of a fasting blood sugar of 126 mg/dL (and greater) or an A1c of 6.5% (and greater).
How Does Prediabetes Develop?
Type 2 diabetes, also referred to as “insulin-resistant diabetes,” usually takes years to develop, so to understand the process of how this condition progresses from prediabetes to type 2 diabetes, it’s important to understand how glucose and insulin normally work in our body.
Our body converts carbohydrates into glucose (our body and brain’s preferred energy source). When glucose enters the bloodstream, our pancreas receives a signal to release a hormone called insulin. Insulin acts like a key, opening “channels” on the surface of our cells. Once the channels open, glucose can funnel out of the bloodstream and into our cells. Our cells can then utilize this glucose for energy or store it for later use.
Having excess body fat, especially around the abdominal area, is one of the strongest risk factors for pre- and type 2 diabetes. This excess fat often leads to the development of insulin resistance—when the cells of our body are not able to respond adequately to insulin. If insulin can’t do its job, then glucose can’t get into our cells and lingers in our blood. As insulin resistance worsens over time, blood glucose levels continue to rise. Persistent blood levels above normal lead to prediabetes.
To read more about how insulin resistance develops, check out this blog.
How Do You Prevent Prediabetes From Turning Into Type 2 Diabetes?
One of the best ways to reverse prediabetes is through weight loss and physical activity. The landmark 2002 Diabetes Prevention Program trial showed that when people achieved a 7% reduction in body weight and engaged in at least 150 minutes of physical activity per week, they reduced their incidence of type 2 diabetes by 58%.
There is also a well-established link between dietary patterns and pre- and type 2 diabetes. The Standard American Diet, which is high in refined carbohydrates, saturated fat, and processed foods, can lead to insulin resistance and prediabetes. When it comes to eating patterns, focusing on one that emphasizes whole grains, legumes, fruits, vegetables, nuts, and seeds has been shown to reverse insulin resistance and reduce one's risk for pre- and type 2 diabetes. 
Prediabetes Treatment: Actionable Ways to Reverse Prediabetes
Here are three other healthy ways to adjust your lifestyle to reverse prediabetes:
(1) Swap animal-based proteins (e.g. red and processed meats) for more plant-based ones (e.g. beans, lentils, tofu). This helps reduce the saturated fat in the diet while also increasing fiber intake, resulting in a lower risk for insulin resistance, pre-diabetes, and type 2 diabetes. 
(2) Swap refined/processed carbs for their whole grain or complex carb counterparts. For example, if your diet consists of white bread, sugary breakfast cereals, and chips, swap these foods for whole wheat bread, oatmeal, and popcorn instead. The reduction in refined grains and increase in whole grains will have a more favorable effect on glucose levels and reduce the risk of developing type 2 diabetes. 
(3) Get moving! Engaging in more physical activity is crucial for reversing prediabetes. Physical exercise helps lower blood glucose levels, improve glycemic control and increase insulin sensitivity due to its effects on stimulating pathways relating to glucose uptake. For more information on how exercise impacts diabetes, read our blog on the topic.
Let's Recap: Prediabetes & The Best Ways to Treat It
- Sadly, more than 1 in 3 people in the United States have prediabetes but only 80% know they have it.
- Prediabetes is categorized as having a blood sugar levels between 100-125 mg/dL or an A1c between 5.7-6.4%
- Excess fat, especially around the abdominal area, is one of the strongest risk factors for pre- and type 2 diabetes.
- One of the best ways to reverse prediabetes is through weight loss and physical activity.
- Adopting more of a plant-based diet can help with weight loss and provide important nutrients to treat prediabetes.