If you have been diagnosed with prediabetes, you will play a key role in your treatment and have an opportunity to reverse the condition or delay the progression to type 2 diabetes. Losing weight, eating a healthy diet, and getting regular exercise are very effective in preventing or delaying the onset of diabetes as well as lowering your risks for other complications, such as coronary artery disease or stroke. These measures may sound simple, but they are very important for your overall health and for preventing diabetes.

In some cases, your health professional may prescribe medicine in addition to diet and exercise. But recent research has shown promising results in preventing diabetes through diet and exercise alone. One large study done in the U.S. (Diabetes Prevention Program) showed that making these lifestyle changes was more effective at lowering the risk of getting type 2 diabetes than taking medicine:⁷

• Those who lost a modest amount of weight (5% to 10% of total body weight) and exercised lowered their risk by 58%.
• Those who took medicine lowered their risk by 31%.

Monitor your weight

Most people with prediabetes are overweight-body mass index, BMI, of 25 or greater. If you have a BMI of 25 or higher, losing just 5% to 10% of your body weight may help you prevent or delay type 2 diabetes.¹³ A healthy weight helps your body use insulin properly. One recent study showed that losing weight improves insulin resistance in people with prediabetes. The degree of improvement is related to the amount of weight lost.¹⁴ For more information on determining your BMI, see:

• Body mass index (BMI) chart for adults .
• Body mass index (BMI) for adults (metric) .

Eat a balanced diet

If you have prediabetes, you may be able to prevent or delay the disease by doing all of the following:

• Limit the amount of fat you eat. Eat foods low in saturated fat and high in soluble fiber
• Eat less calories.
• Spread carbohydrate throughout the day and limit sweets to avoid sudden peaks in blood sugar. Of the three major nutrients (carbohydrate, protein, and fat), carbohydrate has the greatest effect on blood sugar.

Talk to your health professional about developing a plan for healthy eating.

One large study found that men who ate a diet high in vegetables, fish, poultry, and whole grains had a lower risk for getting type 2 diabetes compared with men who ate a diet high in red meat, processed meat, high-fat dairy foods, refined grains, and sweets.¹⁵

Planning meals to manage prediabetes often means looking at food in a new way. There are several easy ways to adapt your diet. A registered dietitian can help you build a meal plan that fits your lifestyle. For more information on one type of meal planning, see:

Using a plate format.

Exercise regularly

Experts advise doing either of these things for exercise:¹⁶

• Do moderate activity for at least 30 minutes a day, 5 days a week or more. Moderate activity is equal to a brisk walk, cycling about 10 to 12 miles per hour (mph), sailing, or shooting hoops. You notice your heart beating faster with this kind of activity.
• Do vigorous activity for at least 20 minutes a day, 3 days a week or more. Vigorous activity is equal to jogging, cycling at least 12 mph, cross-country skiing, or playing a basketball game. You breathe rapidly and your heart beats much faster with this kind of activity.

Being active in several chunks of 10 minutes or more throughout the day can count towards the above recommendations. You can choose to do one or both types of activity. Talk to your doctor before you start a fitness program.

Exercise helps control your blood sugar by using glucose for energy during and after activity. Exercise helps your body respond better to insulin and lowers your risk of getting diabetes. It also helps you maintain a healthy weight; lower high cholesterol; raise high-density lipoprotein (HDL), or "good," cholesterol; and lower high blood pressure. These benefits also help prevent heart and blood vessel (cardiovascular) disease. You may lower your risk of getting diabetes even more by exercising for longer periods of time during each exercise session.

Exercise can consist of moderate walking or more vigorous activities such as jogging, running, bicycling, or playing tennis. Research has also shown that other activities, such as gardening or snow shoveling may be beneficial.¹⁷ Work with your health professional to plan a safe exercise program.

Take medicine if needed

In some cases a health professional may prescribe an oral medicine-most commonly metformin-to help improve metabolism in insulin-resistant patients. This may be appropriate in people with polycystic ovary syndrome. If your doctor has prescribed medicine for prediabetes, be sure to take it as directed.

Stop smoking

If you smoke cigarettes, talk with a health professional about ways to quit. Smoking may play a role in the development of type 2 diabetes, and it contributes to early development of diabetes complications.¹⁸ For more information on how to quit, see the topic Quitting Tobacco Use.

Monitor blood pressure and cholesterol levels

If you have prediabetes you are more likely to get cardiovascular disease than someone with normal blood glucose levels.² Your health professional may take your blood pressure and test your blood periodically to check your cholesterol levels. By lowering your cholesterol to the recommended levels and keeping your blood pressure under 140/90 millimeters of mercury (mm Hg), you may reduce your risk of heart and large blood vessel disease.

By eating a healthy diet and getting regular exercise, you may be able to keep your blood pressure and cholesterol levels within the recommended ranges. People who have high-density lipoprotein (HDL) cholesterol levels of 35 milligrams per deciliter (mg/dL) or less or triglyceride levels of 250 mg/dL or more are at higher risk for getting type 2 diabetes.⁵