Prediabetes

Prediabetes means your blood sugar is above normal but not yet in the diabetes range. It is not "almost diabetes" — it is the single best window for preventing diabetes entirely. In India, where millions are in this zone, acting on prediabetes is one of the highest-value health interventions available.

Definitions

• Fasting glucose 100–125 mg/dL, OR
• 2-hour post 75 g OGTT 140–199 mg/dL, OR
• HbA1c 5.7–6.4%.
• Confirm on two occasions unless very clear.

Why it matters

• Without intervention, about 5–10% of people with prediabetes progress to type 2 diabetes each year.
• Lifestyle change can cut that risk by ~60% — more effective than any medicine in clinical trials.
• Prediabetes itself already raises the risk of heart attack and stroke — it's not "harmless".

What works — proven

• 7% weight loss if overweight — for an 80 kg person that's about 5–6 kg, realistic over 6 months.
• 150 minutes a week of brisk walking or equivalent, plus strength training twice a week.
• Diet shift: Indian plate model; millets and whole grains over refined rice/wheat; pulses and vegetables at every meal; cut sugar-sweetened drinks, sweets, fried snacks.
• Sleep 7–8 hours; stop tobacco; limit alcohol.
• A biguanide-class diabetes tablet may be added by the doctor — especially for higher-risk people (BMI ≥ 27, past gestational diabetes, HbA1c closer to 6.4%).

Follow-up

• Repeat HbA1c / fasting glucose every 6–12 months.
• Annual eye, BP, lipid, waist, kidney check — because prediabetes already affects vessels.
• If a woman had gestational diabetes, she is in the highest-risk prediabetes group — lifelong annual screening is standard.

Avoid

• "Sugar control" teas and powders marketed to prediabetics — no evidence, some contain hidden diabetes drugs or steroids.
• Ignoring it as "border" — the border is the opportunity.
• Extreme crash diets that aren't sustainable — losing 5 kg in a month and regaining 7 in the next doesn't help.