November 10, 2026
Many people discover during a routine medical examination that their blood sugar levels are slightly higher than normal, but not high enough to be diagnosed with diabetes. This condition is known as prediabetes.
Prediabetes is an early warning sign that the body is beginning to have difficulty regulating blood sugar levels. However, having prediabetes does not mean that developing diabetes is inevitable.
With early detection and appropriate lifestyle changes, many people can improve their blood sugar levels and even return to the normal range.
Prediabetes is a condition in which blood sugar levels are higher than normal but do not meet the criteria for a diabetes diagnosis.
It occurs when the body begins to experience difficulties controlling blood glucose, often due to reduced sensitivity to insulin, a condition known as insulin resistance.
Prediabetes is an important opportunity for early intervention, as changes in lifestyle and, in selected cases, medical treatment can help prevent or delay the development of type 2 diabetes.
Prediabetes is a common health condition affecting millions of people worldwide.
Approximately 635 million adults worldwide have impaired glucose tolerance, while another 488 million have impaired fasting glucose. These groups overlap, so the figures cannot simply be added together.
In the United Arab Emirates, estimates suggest that approximately 18% of adults have prediabetes, although the exact percentage varies depending on the diagnostic tests and definitions used.
Prediabetes is also a significant public health concern across the Gulf region, where obesity, physical inactivity, and type 2 diabetes are common.
One of the main challenges is that many people are unaware they have prediabetes because the condition usually develops without noticeable symptoms.
To understand what causes prediabetes, it is important to understand how the body regulates blood sugar.
When we eat, food is converted into glucose, which enters the bloodstream. The pancreas produces a hormone called insulin, which helps glucose move from the bloodstream into the muscles and other tissues, where it is used for energy.
However, when the body becomes less responsive to insulin, glucose regulation becomes less effective. This condition is called insulin resistance.
Prediabetes can develop through different patterns of abnormal blood sugar regulation.
Impaired fasting glucose occurs when blood sugar levels are elevated after a period of fasting, such as in the morning before breakfast.
Normally, the liver releases small amounts of glucose overnight to maintain the body’s energy supply. When the liver becomes resistant to insulin, it may release more glucose than necessary, resulting in elevated fasting blood sugar levels.
Impaired glucose tolerance occurs when blood sugar levels rise excessively after eating, even when fasting blood sugar levels are normal.
This happens partly because the muscles do not absorb glucose from the bloodstream efficiently.
Some people experience both impaired fasting glucose and impaired glucose tolerance because insulin resistance can affect both the liver and muscles.
Another way to identify abnormal blood sugar regulation is through a hemoglobin A1c (HbA1c) test.
Unlike a single blood glucose measurement, HbA1c estimates average blood sugar levels over approximately three months.
These different measurements explain why some people may have elevated fasting glucose, others may experience high blood sugar after eating, and others may have elevated HbA1c levels.
Prediabetes usually does not cause noticeable symptoms.
Many people only discover that they have prediabetes during routine blood tests or medical examinations.
Because the condition can remain undetected, screening is particularly important for people who have risk factors associated with abnormal blood sugar regulation.
Certain health conditions and lifestyle factors are associated with a higher risk of developing prediabetes.
These include:
People with these risk factors may benefit from regular blood sugar screening to identify prediabetes early.
Prediabetes can be identified through three principal blood sugar tests. Each test provides different information about how the body regulates glucose.
A fasting blood glucose test measures blood sugar levels after at least eight hours without food.
It helps identify elevated blood sugar levels during fasting, which may indicate impaired fasting glucose.
The HbA1c test estimates average blood sugar levels over approximately three months.
One of its advantages is that it does not require fasting, making it a convenient option for routine screening.
The oral glucose tolerance test evaluates how the body processes glucose.
During the test, a person drinks a glucose solution, and their blood sugar level is measured two hours later.
This test can help detect impaired glucose tolerance, particularly in people whose fasting glucose or HbA1c results may not reveal abnormalities.
For routine screening, fasting glucose or HbA1c testing is often sufficient. However, individuals at particularly high risk may benefit from an oral glucose tolerance test.
Prediabetes is associated with an increased risk of cardiovascular disease, but having prediabetes does not necessarily mean that a person already has heart disease.
People with prediabetes frequently have other health conditions that may contribute to cardiovascular risk, including:
Research has also shown that some individuals with prediabetes may develop early abnormalities affecting the blood vessels, kidneys, nerves, or retina.
However, these complications are not automatically present in everyone diagnosed with prediabetes.
For this reason, managing prediabetes involves more than monitoring blood sugar levels. It is also important to assess body weight, blood pressure, cholesterol, and other cardiovascular risk factors.
Yes, many people with prediabetes can return to normal blood sugar levels.
Excess body fat, particularly around the abdomen and within the liver and muscles, can contribute to insulin resistance.
Reducing excess weight often improves the body’s sensitivity to insulin, helping it regulate blood sugar more effectively.
Even modest weight loss can make a significant difference.
For example, a person weighing 100 kilograms may benefit from an initial weight loss target of five to seven kilograms.
Early lifestyle changes can help prevent or delay the progression from prediabetes to type 2 diabetes.
Lifestyle modifications are the foundation of prediabetes management. Improving physical activity, nutrition, and weight management can help regulate blood sugar and support long-term metabolic health.
Losing excess body weight, particularly abdominal fat, can improve insulin sensitivity.
An initial weight reduction of five to seven kilograms for someone weighing 100 kilograms can be a meaningful starting point.
Regular physical activity helps improve blood sugar regulation and insulin sensitivity.
At least 150 minutes of moderate physical activity per week is recommended.
For example, brisk walking for 30 minutes, five days a week, can help achieve this target.
Making healthier dietary choices can support better blood sugar regulation.
Important changes include:
Avoiding smoking is another important step in improving overall health and reducing health risks associated with prediabetes.
Research has demonstrated that lifestyle changes can significantly reduce the risk of developing type 2 diabetes.
The landmark American Diabetes Prevention Program found that lifestyle interventions reduced the development of diabetes by approximately 58% over three years.
Follow-up research extending beyond 20 years showed that participants originally assigned to lifestyle intervention continued to have a lower incidence of diabetes.
Similarly, the Chinese Da Qing study demonstrated long-term benefits from early lifestyle intervention, including fewer cardiovascular events and cardiovascular deaths after 30 years.
These findings highlight the lasting benefits of taking action during the prediabetes stage.
Prediabetes treatment focuses primarily on lifestyle changes. However, medications may be recommended for selected individuals, depending on their risk factors and overall health.
Healthy eating, regular physical activity, weight management, and avoiding smoking remain the foundation of prediabetes treatment.
These changes can improve insulin sensitivity and reduce the risk of progression to type 2 diabetes.
Metformin is a medication that can reduce the risk of developing type 2 diabetes, particularly in individuals at high risk.
However, medication is not necessary for everyone diagnosed with prediabetes.
Newer medications used for obesity management, including semaglutide and tirzepatide, can produce substantial weight loss and significantly improve blood sugar regulation.
For selected individuals with both obesity and prediabetes, these medications may be particularly beneficial.
The choice of treatment should always be individualized, taking into consideration:
Prediabetes often develops without noticeable symptoms, making early screening an important step in preventing or delaying type 2 diabetes.
Identifying elevated blood sugar levels provides an opportunity to make lifestyle changes before the condition progresses.
Early management also allows healthcare professionals to evaluate other factors affecting metabolic and cardiovascular health, such as weight, blood pressure, and cholesterol levels.
The goal is not only to improve blood sugar regulation but also to support long-term health and protect the heart, kidneys, and blood vessels.
Prediabetes is a common condition that often develops without symptoms, but it does not mean that type 2 diabetes is inevitable.
With early detection, healthier lifestyle choices, and appropriate medical management when needed, many people can improve their blood sugar levels and reduce their risk of developing diabetes.
Managing prediabetes is about more than controlling blood sugar. It is also an opportunity to improve overall metabolic health and reduce cardiovascular risk.
Prediabetes is an early warning, not a life sentence. Taking action today can make a lasting difference to your future health.
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