Could your body be sending you warning signs that you are at risk of type 2 diabetes? Prediabetes affects an estimated 6.3 million people in the UK, yet many have no idea they have it. Understanding prediabetes symptoms and recognising the early warning signs can be the difference between preventing diabetes altogether and developing a lifelong condition. The encouraging news is that with the right dietary changes and lifestyle adjustments, up to 50% of type 2 diabetes cases can be prevented or delayed. At Abbey Wood Hospital’s Dietitian Services, our registered dietitians help patients take control of their metabolic health before it becomes a serious problem.
In This Article
This guide explains what prediabetes is, the subtle signs to watch for, how it is diagnosed, and most importantly, how nutritional changes can help you avoid progressing to type 2 diabetes.
What Is Prediabetes?
Prediabetes is a condition where your blood sugar levels are higher than normal but not yet high enough to be classified as type 2 diabetes. It is sometimes called borderline diabetes, non-diabetic hyperglycaemia, or impaired glucose regulation. Think of it as a warning signal from your body that something needs to change.
When you eat carbohydrates, your body breaks them down into glucose. Insulin, a hormone produced by your pancreas, helps move this glucose from your blood into your cells where it is used for energy. In prediabetes, your body either does not produce enough insulin or your cells have become resistant to it, meaning glucose builds up in your bloodstream.
According to Diabetes UK, an estimated 6.3 million people in the UK are at increased risk of type 2 diabetes based on their blood sugar levels. Additionally, around 1.3 million people are living with type 2 diabetes but have not yet been diagnosed. If left untreated, prediabetes typically progresses to type 2 diabetes within 5 to 10 years, though this timeline varies between individuals.
The critical point to understand is that prediabetes is reversible. With appropriate dietary changes and lifestyle modifications, many people successfully return their blood sugar levels to normal and significantly reduce their risk of developing diabetes.
Early Warning Signs of Prediabetes
One of the challenges with identifying prediabetes symptoms is that the condition often produces no obvious signs. Most people feel completely normal, which is why prediabetes frequently goes undetected for years. However, there are subtle indicators that may suggest your blood sugar is creeping into the danger zone.
Physical Signs to Watch For
While prediabetes itself rarely causes symptoms, some people notice changes as their blood sugar levels rise. These may include increased thirst and more frequent urination (particularly at night), unexplained fatigue or feeling more tired than usual, blurred vision that comes and goes, cuts or wounds that take longer to heal than expected, and recurring infections such as thrush or urinary tract infections.
If you experience any of the classic diabetes symptoms listed above, it may indicate that your blood sugar has already progressed beyond prediabetes into type 2 diabetes territory. This is why regular health checks are so important, particularly if you have risk factors.
Physical Markers Your Doctor May Identify
During a health check, your GP or nurse may identify physical markers associated with insulin resistance and prediabetes. These include a waist circumference above 80cm for women or 94cm for men, dark patches of skin (acanthosis nigricans) typically found on the neck, armpits, or groin, elevated blood pressure, and abnormal cholesterol levels (high triglycerides or low HDL cholesterol).
These markers, combined with blood tests, help healthcare professionals assess your overall metabolic health and risk of developing type 2 diabetes.
Who Is at Risk of Prediabetes?
Certain factors increase your likelihood of developing prediabetes. Understanding your personal risk helps you know when to seek testing and take preventive action.
Age and Ethnicity
Your risk increases with age. If you are white, risk rises significantly after age 40. However, if you are of South Asian, African-Caribbean, or Black African descent, your risk becomes elevated from age 25. People from these ethnic backgrounds are two to four times more likely to develop type 2 diabetes than white Europeans.
The National Institute for Health and Care Excellence (NICE) recommends that prevention efforts should begin at a lower BMI threshold for certain ethnic groups. While the standard intervention point is a BMI of 30, NICE advises action at a BMI of 27.5 for people of Black African, African-Caribbean, South Asian, and Chinese descent. Research suggests intervention should start even earlier for South Asian populations (BMI of 24) and Bangladeshi populations (BMI of 21).
Family History and Genetics
If you have a parent, sibling, or child with type 2 diabetes, you are two to six times more likely to develop the condition yourself. This genetic predisposition means you should be particularly vigilant about monitoring your blood sugar and maintaining a healthy lifestyle.
Lifestyle Factors
Being overweight or living with obesity significantly increases your risk, particularly if you carry excess weight around your middle. A sedentary lifestyle, poor diet high in processed foods and refined carbohydrates, and inadequate sleep all contribute to insulin resistance.
Research shows that for young adults aged 17 to 22, a 10% increase in ultra-processed food consumption is linked to a 64% higher risk of developing prediabetes. This highlights the importance of dietary quality, not just quantity.
Medical History
Other conditions that increase your risk include a history of gestational diabetes during pregnancy, polycystic ovary syndrome (PCOS), high blood pressure, and abnormal cholesterol levels. If any of these apply to you, discuss prediabetes symptoms and testing with your GP.
How Prediabetes Is Diagnosed
Prediabetes is diagnosed through blood tests that measure how well your body processes glucose. The most common test is the HbA1c test, which measures your average blood sugar levels over the past two to three months.
Understanding Your HbA1c Results
HbA1c is measured in millimoles per mole (mmol/mol). The results are interpreted as follows: below 42 mmol/mol is considered normal, between 42 and 47 mmol/mol indicates prediabetes, and 48 mmol/mol or above indicates type 2 diabetes (this should be confirmed with a second test).
Your GP may also use other tests such as fasting plasma glucose (measuring blood sugar after an overnight fast) or an oral glucose tolerance test (measuring blood sugar before and two hours after drinking a glucose solution).
When to Get Tested
If you have any of the risk factors mentioned above, speak to your GP about getting tested. In England, you may be eligible for a free NHS Health Check if you are aged 40 to 74 and have not already been diagnosed with certain conditions. You can also use the Diabetes UK Know Your Risk tool to assess your risk online in just a few minutes.
How Diet Can Help Reverse Prediabetes
The food you eat has a direct impact on your blood sugar levels. Making strategic dietary changes is one of the most effective ways to reverse prediabetes and prevent progression to type 2 diabetes. Our registered dietitian Heather Daniels works with patients to create personalised nutrition plans that fit their lifestyle and preferences.
Foods That Help Lower Blood Sugar
Research has shown that certain dietary patterns are associated with a decreased risk of type 2 diabetes. The Mediterranean diet, which emphasises olive oil, fish, vegetables, legumes, and whole grains, is particularly effective. Other beneficial approaches include the DASH diet (Dietary Approaches to Stop Hypertension), vegetarian and vegan diets, the Nordic diet, and moderately reducing carbohydrate intake.
Foods specifically linked with reduced diabetes risk include total fruit and vegetable intake (especially green leafy vegetables, blueberries, grapes, and apples), whole grains rather than refined carbohydrates, yoghurt and cheese, nuts and seeds, oily fish rich in omega-3 fatty acids, and unsweetened tea and coffee.
Foods to Reduce or Avoid
Equally important is reducing foods associated with increased diabetes risk. These include sugar-sweetened drinks (including fruit juices and fizzy drinks), red and processed meats such as beef, lamb, pork, ham, and sausages, refined carbohydrates including sugary snacks, white bread, and sugary cereals, and fried foods, particularly chips and crisps.
The World Health Organization advises limiting added sugars to less than 10% of total energy intake, with additional health benefits observed at 5% or less.
The Importance of Fibre
Fibre plays a crucial role in blood sugar control. It slows the absorption of glucose into your bloodstream, helping to prevent spikes after meals. Aim for at least 30 grams of fibre daily from sources such as vegetables, beans and pulses, whole grains, nuts, and seeds.
Lifestyle Changes That Make a Difference
While diet is fundamental, other lifestyle factors also significantly impact your blood sugar and overall metabolic health.
Physical Activity
Regular movement helps your body use insulin more effectively. Aim for at least 150 minutes of moderate-intensity exercise per week, such as brisk walking, swimming, or cycling. Even small increases in daily activity make a difference, whether that means taking the stairs instead of the lift, walking during phone calls, or doing chair-based exercises.
Research indicates that performing resistance training (strength exercises) approximately one hour before eating can increase insulin sensitivity and slow the rate at which glucose enters your bloodstream. Maintaining muscle mass is also important because muscle tissue helps absorb glucose from your blood.
Weight Management
If you are living with overweight or obesity, even modest weight loss can dramatically reduce your diabetes risk. Losing just 5% of your body weight can significantly improve your blood sugar levels. For someone weighing 90kg, that is just 4.5kg. Studies show that participants who lost over 15% of their body weight achieved a 94% remission rate from prediabetes.
Sleep and Stress
Poor sleep quality and chronic stress both affect blood sugar levels. Aim for 7 to 9 hours of quality sleep per night and explore stress management techniques such as mindfulness, meditation, or simply taking time for activities you enjoy. For more information on how stress and food are connected, read our guide on anxiety caused by food.
What the Research Shows
The evidence for reversing prediabetes through lifestyle intervention is compelling. The UK-based DiRECT trial, a landmark study often cited alongside Diabetes UK, achieved a 46% remission rate at one year using a supervised lifestyle and diet intervention. At two years, the remission rate was 36%, highlighting the importance of ongoing support to maintain changes.
More recent research shows even better outcomes with intensive support. In a randomised trial comparing supervised high-protein, low-calorie lifestyle intervention with standard medical care, 87% of participants in the intervention group achieved remission at one year compared to just 16.7% receiving standard care. Among those starting with prediabetes specifically, 73% returned to normal blood sugar levels.
A 2022 global review of 47 studies found that 33% to 59% of adults with prediabetes returned to normal blood sugar levels within 1 to 5 years when weight loss and activity goals were met. These figures demonstrate that prediabetes is not an inevitable path to diabetes but rather a reversible condition for many people.
It is worth noting that the scientific community prefers the term “remission” rather than “reversal” because diabetes can return if weight is regained or healthy habits are not maintained. For comprehensive information on managing diabetes if it does develop, see our guides on type 2 diabetes treatment and type 1 diabetes treatment.
Frequently Asked Questions
Can prediabetes be reversed?
Yes, prediabetes can often be reversed through dietary changes, increased physical activity, and weight management. Research shows that up to 50% of type 2 diabetes cases can be prevented or delayed with the right lifestyle modifications. Working with a registered dietitian can help you develop a sustainable plan tailored to your needs.
How long does it take to reverse prediabetes?
Many people see improvements in their blood sugar levels within 3 to 6 months of making dietary and lifestyle changes. However, the timeline varies depending on individual factors such as starting weight, the extent of insulin resistance, and how consistently changes are maintained. Regular monitoring through HbA1c tests helps track your progress.
What are the first signs of prediabetes?
Prediabetes symptoms are often subtle or absent entirely. Some people notice increased thirst, frequent urination, fatigue, or blurred vision, but many have no symptoms at all. This is why screening is so important, particularly if you have risk factors such as family history, being overweight, or belonging to a higher-risk ethnic group.
Should I see a dietitian if I have prediabetes?
A registered dietitian can be invaluable in helping you make effective, sustainable dietary changes. They can create a personalised nutrition plan based on your food preferences, lifestyle, and health goals, and provide ongoing support and accountability. At Abbey Wood Hospital, our dietitians work alongside our endocrinology team to provide comprehensive metabolic health support.
What HbA1c level indicates prediabetes?
An HbA1c level between 42 and 47 mmol/mol indicates prediabetes. Below 42 mmol/mol is considered normal, while 48 mmol/mol or above indicates type 2 diabetes. If your result falls in the prediabetes range, this is the ideal time to make changes before your blood sugar rises further.
Is prediabetes serious?
Prediabetes should be taken seriously as a warning sign. Without intervention, 5% to 10% of people with prediabetes progress to type 2 diabetes each year. Prediabetes also increases your risk of heart disease and stroke. However, the condition is reversible, making early detection and action extremely valuable.
How a Dietitian Can Help You Take Control
Receiving a prediabetes diagnosis can feel overwhelming, but it is actually an opportunity. You have been given advance warning and the chance to make changes before developing a more serious condition. Working with a registered dietitian provides the expert guidance and accountability many people need to succeed.
At Abbey Wood Hospital, our Dietitian Services offer personalised nutrition assessments and evidence-based advice for managing prediabetes. Our dietitian, Heather Daniels, is a member of the British Dietetic Association and Health Professions Council with extensive experience in helping patients improve their metabolic health.
During your consultation, you will receive a thorough assessment of your current diet and lifestyle. Doing so a personalised nutrition plan designed around foods you enjoy, practical strategies for reducing blood sugar through diet. Guidance on portion sizes and meal timing, and ongoing support to help you maintain your progress.
We also work closely with our Endocrinology and GP Services teams to provide coordinated care for patients with metabolic health concerns. Our Imaging and Diagnostics Centre offers convenient on-site blood testing to monitor your HbA1c levels and track your progress.
If you are concerned about prediabetes symptoms or have been told your blood sugar is elevated, book a consultation with our dietitian team today. Contact Abbey Wood Hospital on 020 8358 7100 or book online.
Please note: This article provides general information about prediabetes and is not a substitute for professional medical advice. Individual circumstances vary, and a consultation with a healthcare professional is essential to determine the most appropriate approach for your situation.