Pre-diabetes means your blood sugar levels are higher than normal, but not high enough to be diagnosed as type 2 diabetes. It’s a sign that your body is finding it harder to manage blood sugar, and without changes, you may go on to develop type 2 diabetes. But the good news is—it’s not too late. By empowering yourself with knowledge and lifestyle changes, you can take control and lower your risk.
What Is pre-diabetes?
Pre-diabetes (sometimes called non-diabetic hyperglycaemia or impaired glucose regulation) means:
- Your HbA1c blood test result is between 42 and 47 mmol/mol (6.0–6.4%)
- Or your fasting blood glucose is between 5.5 and 6.9 mmol/L
It doesn’t mean you’ll definitely get diabetes – but without action, about 1 in 3 people with pre-diabetes will develop type 2 diabetes within 10 years. Fortunately with the right support, up to half of all cases of type 2 diabetes can be prevented or delayed.
What causes pre-diabetes?
Pre-diabetes happens when your body starts to become insulin resistant. This means your cells don’t respond properly to insulin—a hormone made by your pancreas that helps move sugar (glucose) from your blood into your cells to be used for energy.
When your body becomes insulin resistant, it’s harder for glucose to enter your cells, so your pancreas has to produce more and more insulin to keep your blood sugar levels under control. Over time, your pancreas may struggle to keep up, and blood sugar levels start to rise.
This gradual increase in blood sugar is what leads to pre-diabetes, and if no action is taken, it can progress to type 2 diabetes.As a result, your pancreas works harder to produce more insulin to keep blood sugar levels normal. Over time, it may struggle to keep up, and blood sugar levels begin to rise. This gradual increase in blood sugar is what leads to pre-diabetes, and if not addressed, can progress to type 2 diabetes.
Risk factors for pre-diabetes
The main risk factors are similar to those for type 2 diabetes. Some risk factors are outside your control, but many can be improved through small, sustainable changes. Here’s a quick breakdown:
Risk factors you CAN’T control
Age – As you get older, especially after age 40, your risk for type 2 diabetes increases.
Sex – Men are at a slightly higher risk of developing type 2 diabetes.
Ethnicity – Some ethnic groups (people of South Asian, African-Caribbean, Black African and Middle Eastern heritage) are more likely to develop type 2 diabetes than others.
Relatives – Having immediate family members with diabetes raises your own risk.
Risk factors you CAN control
BMI and waist measurement – Carrying excess body fat and weight increases your risk of type 2 diabetes.
High blood pressure – Whilst you can’t control previously high readings or treatment history, you can take action to maintain a healthy blood pressure.
Physical activity – Staying active is a great way to balance your blood sugar levels, improve heart health, and maintain overall wellbeing.
Eat well – Focus on whole foods that are minimally processed, lean protein, plant foods like fruit and vegetables, whilst avoiding added sugar.
What you can do to reduce your risk of pre-diabetes
The great news is that small lifestyle changes can make a big difference:
- Eat a healthy, balanced diet
- Choose high-fibre, wholegrain carbs (like brown rice, oats, and wholemeal bread)
- Eat more vegetables, pulses, and lean protein
- Cut back on sugary snacks and processed foods
- Use unsaturated fats (like olive oil, nuts, and seeds)
Our article on what’s in a healthy diet can help you explore ideas to improve your nutrition and reduce your salt intake.
- Get active
- Aim for 150 minutes of moderate exercise each week
- This could be walking, swimming, dancing, or cycling – whatever you enjoy
If you’d like to explore ways to move more during the day, try our exercise tips here.
- Lose weight if you need to
- Losing even 5–10% of your body weight can significantly reduce your diabetes risk
Here’s our article on how to measure your body fat and how to reduce it.
- Sleep well and manage stress
- Aim for 7–9 hours of sleep per night
- Use relaxation techniques like deep breathing, mindfulness or gentle movement to manage stress
If you struggle with sleep, our dedicated article offers 15 tips for better quality slumber.
The NHS Diabetes Prevention Programme (NDPP)
If you’re diagnosed with pre-diabetes in England, your GP may refer you to the NHS Diabetes Prevention Programme (NDPP).
What it offers:
- Free support over 9 months
- Group sessions or digital options
- Help with eating well, being active, and losing weight
Thousands of people have used the programme to successfully reduce their risk of developing type 2 diabetes.
Ask your GP if you’re eligible. In Wales, Scotland and Northern Ireland, local programmes may vary – ask your practice for what’s available. Or, you can find a programme in your area here.
Are there any medications for pre-diabetes?
Lifestyle changes are always the first step. But in some cases, your doctor may also consider prescribing metformin – especially if you:
- Have a high HbA1c despite lifestyle efforts
- Are at very high risk (e.g. history of gestational diabetes, high BMI, or other conditions)
Metformin helps improve insulin sensitivity and lower blood sugar. It’s usually used alongside lifestyle changes, not as a replacement.
Monitoring your progress
- Your GP or nurse will usually recheck your HbA1c every 6-12 months
- Keep track of your weight, waist size, and activity levels
- Celebrate small wins – every healthy change counts
Support from the NHS and Diabetes UK
- The NDPP is free and available across most of England
- Diabetes UK offers meal ideas, activity tips, and support tools
- Your GP, nurse or pharmacist can help you build a personalised plan
How the Evergreen Life app can help
The Evergreen Life app is a useful tool for managing your health and reducing your risk of type 2 diabetes. It helps you:
- Engage with our questionnaires and content to help with weight management, nutrition, physical activity, and sleep, to reduce your risk of developing diabetes
- Access trusted health information tailored to your personal goals
- Monitor your health and stay on top of wellness goals
- Develop and manage your own personal health record with test results and health updates
- Connect with your GP practice to view records, book appointments, and request repeat prescriptions where available
Using the Evergreen Life app can help you stay motivated and organised as you work toward better health.
Key takeaways
- Pre-diabetes means your blood sugar is higher than normal, but you can take action now
- Lifestyle changes—like eating well, being active and losing weight – can prevent type 2 diabetes
- The NHS Diabetes Prevention Programme offers expert support
- Medication like metformin may be considered in some cases
- Tools like the Evergreen Life app can support you on your health journey
You have the power to change your future. Taking steps today can help you stay healthy and avoid type 2 diabetes tomorrow.
- NHS – Pre-diabetes (Non-diabetic Hyperglycaemia)
https://www.nhs.uk/conditions/type-2-diabetes/prevention/
Explains what pre-diabetes is, how it’s diagnosed, and what you can do to reduce your risk. - Diabetes UK – Understanding Pre-diabetes
https://www.diabetes.org.uk/diabetes-the-basics/pre-diabetes
Offers comprehensive information about risk factors, lifestyle changes, and monitoring. - NHS Diabetes Prevention Programme (NDPP)
https://www.england.nhs.uk/diabetes/diabetes-prevention/
Details how the NDPP supports people with pre-diabetes through lifestyle education and group support. - NICE – Type 2 Diabetes Prevention (PH38)
https://www.nice.org.uk/guidance/ph38
Provides guidance for identifying and supporting people at high risk of developing type 2 diabetes, including when to consider metformin. - NHS – Metformin and Its Role in Diabetes Prevention
https://www.nhs.uk/medicines/metformin/
Offers clear information on how metformin works, when it’s used, and possible side effects. - https://www.nice.org.uk/guidance/ph38/chapter/recommendations#risk-assessmenthttps://www.nice.org.uk/guidance/ph38/chapter/recommendations#risk-assessment
- https://www.england.nhs.uk/diabetes/diabetes-prevention/
- https://www.nice.org.uk/guidance/PH38/chapter/Recommendations#metformin
