Pre-diabetes is a metabolic condition where blood sugar levels are elevated (100–125 mg/dL) but not high enough for a diabetes diagnosis. It’s a critical warning sign, often affecting adults over 40, with a 9–14% chance of progressing to type 2 diabetes within a decade. In India, about 15.3% of adults are estimated to have pre-diabetes, yet over 80% remain unaware due to its subtle or absent symptoms. The primary cause is insulin resistance—when the body’s cells no longer respond effectively to insulin, leading to high blood sugar. Risk factors include obesity, inactivity, PCOS, cardiovascular disease, and certain hormonal or genetic conditions. The good news: pre-diabetes is reversible. A diet rich in whole grains, lean proteins, healthy fats, and fibers such as the Mediterranean diet— can improve insulin sensitivity and reduce inflammation. Exercise, especially strength training combined with aerobic activity, helps muscles absorb glucose, lowering blood sugar. Small, consistent lifestyle changes can make a significant impact and prevent disease progression.
Pre-diabetes is a warning that type 2 diabetes is setting in. Pre-diabetics have elevated blood sugar levels (about 100-125 mg/dL), but not high enough to be diagnosed as type 2 diabetics. For people in their 40s, pre-diabetes is 9-14% likely to develop into type 2 diabetes within 10 years. Pre-diabetes is quite common and affects about 15.3% of the Indian adult population. More than 80% of people with pre-diabetes aren’t even aware of it because of the lack of obvious symptoms. If symptoms do show up, they’re usually subtle – Darkened skin in the armpits, skin tags and subtle changes in vision. There is good news too though – Pre-diabetes can be reversed with a healthy lifestyle.
Pre-diabetes is basically Diabetes Lite – It’s got the same cause. Both diabetes and pre-diabetes are caused by Insulin Resistance. This is when the body’s cells do not respond to insulin normally. The insulin is supposed to facilitate glucose movement from the blood to the inside of the cells to be used for energy. However, in patients who have developed insulin resistance, the blood glucose cannot permeate the cells and just ends up staying in the blood. This causes elevated blood sugar levels, also known as hyperglycaemia. This is especially bad for your kidneys, your eyes, your nerves and your feet.
Insulin resistance could be caused by a combination of factors including obesity, physical inactivity, cardiovascular disease, metabolic dysfunction and PCOS. There could also be genetic factors at play – Research is still on-going to understand the role of genetics in insulin resistance. Hormonal disorders like Cushing’s syndrome, acromegaly and hypothyroidism can also contribute to insulin resistance.
Diabetes screening is advised for adults above the age of 40. If you have a family history of diabetes, are overweight or sedentary, your family doctor may advise you to begin screening earlier. The screening process involves a series of blood tests – Glycated haemoglobin (A1C) test, Fasting blood sugar test and the Oral glucose tolerance test. These tests measure your blood sugar levels at different points in time, and under different conditions to see how your body is processing glucose in the blood. From these test results, the doctor can figure out whether your metabolism is healthy, or if you fall within the pre-diabetic or diabetic categories.
Being diagnosed with pre-diabetes can be confusing – What exactly are you supposed to do with this information? The reason a pre-diabetes diagnosis is important is because the condition can be reversed. This is actually an opportunity to take control of your life and correct your lifestyle for the better. Learning more about how to balance your diet and implementing it is the key to stopping your pre-diabetes from progressing. There is no need to eliminate any food groups. While it may be tempting, you do not need to go on a fad diet or make drastic changes in the foods you eat. Gradual behaviour changes are more sustainable in the long term, and this is what we should strive for. Small substitutions in your diet that still satisfy your appetite are needed. A nutritionist can help you with a customized meal plan that takes your activity level, dietary preferences and blood sugar levels into account.
For pre-diabetics, the dietary end goals are clear – Decrease the speed of absorption of carbohydrates into the blood stream and build muscle to use up the blood glucose. In order to achieve these goals, we recommend taking the following steps:
Avoid refined sugar and trans fats – Limit sugary drinks, processed snacks and desserts. Substitute your sugar cravings with fruit in its whole form (not juice), and desserts sweetened with dates or non-caloric sweetener, in moderation.
Define portion sizes – A nutritionist can help you define how much carbohydrate you need to eat for various meals. This guides your consumption of rice, bread or pasta and allows you to gradually change the balance of your meals – from being more carb-heavy, to increased fiber and protein.
Replace simple carbs for complex carbs – Complex carbs have more fiber. The fiber ensures that the complex carbs are digested more slowly, releasing glucose at a slow, steady pace into the blood stream.
Avoid alcohol and tobacco consumption – Alcohol and tobacco increase inflammation in the body and have a negative effect on heart health. Your heart is already under stress from prediabetes, so it is best to remove any other stressors caused by your lifestyle.
Experts consider the Mediterranean diet the gold standard for reversing prediabetes. This diet lays emphasis on eating whole grains, lean protein and healthy fats. The Mediterranean diet is a flexible food philosophy, not a rigid diet. Whole grains like quinoa, bulgur and oats are great to include in your rotation of weekly meals. Chicken, fish and tofu are preferable to red meat, as they are low in fat, but high in protein. Beans and lentils are packed with fiber. Most importantly, the mediterranean diet advocates for variety – Eating a variety of produce ensures you get adequate amounts of all the micronutrients and enough fiber. Healthy fats, in the form of nuts, seeds and cold-pressed oils are also good for you. In terms of cooking techniques, opt for steaming, boiling and roasting over frying. Wherever possible, keep the ingredients as fresh and lightly cooked as possible. The Mediterranean diet helps keep bad cholesterol low, reduces inflammation and enhances the body’s ability to absorb blood sugar.
Exercise is a core strategy for preventing pre-diabetes from progressing into full-blown type 2 diabetes. Before you begin, check in with your family doctor about how and when to exercise. The doctor may perform some tests to check your heart. They can advise you about the intensity and frequency of exercise that you can safely do without overloading your body.
Building muscle helps reverse pre-diabetes. Muscle cells take in glucose and store it for later use. After a meal, when glucose enters the blood stream, the muscle cells are available to take it in and store it. This effectively reduces the quantity of free glucose circulating around the blood, reducing blood sugar levels to normal. Experts recommend strength training, combined with some aerobic exercises, to help beat pre-diabetes. The WHO recommends about 150 minutes of moderate intensity exercise for an average adult.
If you have lived a very sedentary life, its not a good idea to suddenly try to run a marathon because of your pre-diabetes diagnosis. Start slow – Go for a 15 minute walk after every meal. Remember – We want slow, sustainable changes. Once you become comfortable, you can start incorporating an incline or do weekly 2k runs. In parallel, you can begin strength training too. Start with strength training 2 days a week, doing full body exercises for a balanced training regimen. Try to space out the strength training days so you have time to recover in between sessions. This is a good starting point – As you get fitter, you can up the intensity and frequency, after consulting your doctor. Your doctor can also help provide feedback on whether the exercise is helping your treatment. This feedback is important because it can help you adjust your training program for optimal results.
If you’ve been diagnosed with pre-diabetes, timely guidance can help you reverse it safely and effectively. Kauvery Hospital, with branches in Chennai, Hosur, Salem, Tirunelveli, and Trichy, offers expert-led screening, nutrition counselling, and exercise guidance to support lasting lifestyle change and prevent the progression to diabetes.
Can prediabetes be reversed?
Yes. Prediabetes can often be reversed with healthy eating, regular exercise, weight management, and early lifestyle changes.
How long does it take to reverse prediabetes?
With consistent diet and physical activity changes, many people see blood sugar improvement within 3 to 6 months.
What is the best diet for prediabetes?
A diet rich in fiber, whole grains, vegetables, lean protein, and healthy fats helps control blood sugar and improve insulin sensitivity.
What type of exercise helps lower blood sugar?
Walking, strength training, and moderate aerobic exercise help muscles absorb glucose and reduce blood sugar levels.
Does prediabetes always lead to diabetes?
No. With timely lifestyle changes, many people with prediabetes never develop type 2 diabetes.
Are medicines required for prediabetes?
Most people can manage prediabetes without medication by improving diet, increasing activity, and maintaining a healthy weight.
Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai (Alwarpet, Radial Road & Vadapalani), Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and paediatric trauma care.
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