Prediabetes is reversible. Losing 5% or more of your body weight, moving more, and changing what you eat can bring your blood sugar back to normal range and significantly reduce your risk of developing type 2 diabetes. The changes aren’t extreme, but they do need to be consistent.
Prediabetes means your A1C falls between 5.7% and 6.4%, a range where your body is starting to struggle with processing sugar but hasn’t crossed into diabetes territory (6.5% and above). The good news is that this window gives you real leverage. Here’s how to use it.
Lose a Moderate Amount of Weight
You don’t need to hit an ideal weight to make a difference. Losing just over 5% of your body weight, roughly 10 to 15 pounds for many people, increases the likelihood of reverting from prediabetes to normal blood sugar by about 60%. That finding comes from a long-term study tracking older adults over time, and the effect held even without dramatic lifestyle overhauls.
The reason weight matters so much is that excess fat, particularly around your midsection, makes your cells less responsive to insulin. When insulin can’t do its job efficiently, sugar builds up in your blood. Reducing that fat restores sensitivity, and your body starts processing glucose the way it should. A slow, steady pace of one to two pounds per week is more sustainable than aggressive dieting and more likely to stick long term.
Move for 150 Minutes a Week
The target recommended by the American Diabetes Association is 150 minutes of moderate-intensity activity per week. That’s about 30 minutes a day, five days a week. Moderate intensity means you can carry on a conversation while exercising but couldn’t sing a song. Brisk walking, cycling on flat ground, and swimming all qualify.
Spreading those minutes across five or six days matters more than cramming them into a weekend. Your muscles act like sponges for blood sugar during and after exercise, pulling glucose out of your bloodstream without needing as much insulin. That effect lasts roughly 24 to 48 hours, so regular sessions keep your blood sugar more stable throughout the week.
Adding strength training two or three times a week helps further. Building muscle mass gives your body more tissue that actively absorbs glucose, improving insulin sensitivity even at rest. You don’t need a gym membership. Bodyweight exercises like squats, push-ups, and lunges work.
Restructure Your Plate Around Fiber
Fiber is the single most underrated tool for blood sugar control. Adults need 22 to 34 grams per day depending on age and sex, but most people get barely half that. Fiber slows the speed at which sugar enters your bloodstream after a meal, preventing the sharp spikes that strain your insulin system.
There are two types, and both help in different ways. Soluble fiber (found in oats, black beans, apples, bananas, avocados, and Brussels sprouts) forms a gel-like substance in your gut that slows digestion. Insoluble fiber (found in whole wheat, bran, nuts, seeds, and the skins of fruits and vegetables) improves insulin sensitivity directly. You don’t need to track which type you’re eating. A diet built around whole grains, legumes, vegetables, and fruit with the skin on will naturally cover both.
A practical starting point: swap refined carbs for their whole-grain counterparts. Brown rice instead of white, whole wheat bread instead of white, steel-cut oats instead of instant. These changes add fiber while reducing the foods most likely to spike your blood sugar.
Pay Attention to Glycemic Load
You may have heard of the glycemic index, which ranks foods by how fast they raise blood sugar on a scale of 0 to 100. It’s useful but incomplete, because it doesn’t account for how much carbohydrate a typical serving actually contains. Glycemic load is the more practical measure because it factors in both speed and quantity.
Watermelon is a good example. It has a high glycemic index of 80, which sounds alarming. But a normal serving contains so little carbohydrate that its glycemic load is only 5, which is low. Meanwhile, a bowl of white rice has a moderate glycemic index but delivers a large dose of carbohydrate per serving, giving it a much higher glycemic load.
The takeaway: don’t avoid a food just because someone told you it has a high glycemic index. Focus on reducing foods with both a high glycemic index and a large carb load per serving, like white bread, sugary cereals, pastries, and sweetened drinks. Pair carbohydrates with protein, fat, or fiber to slow their absorption. An apple with peanut butter will hit your blood sugar very differently than apple juice.
Prioritize Sleep
Sleep deprivation directly impairs your body’s ability to use insulin. In a controlled study, healthy men who slept only five hours per night for one week showed significantly reduced insulin sensitivity compared to when they slept a full night. Their stress hormone levels also rose, with cortisol increasing by about 51%. Both effects push blood sugar higher, even if your diet and exercise are on track.
Seven to eight hours per night is the range most strongly associated with healthy glucose metabolism. If you’re doing everything else right but sleeping six hours or less, you’re working against yourself. Consistent sleep and wake times, a cool bedroom, and limiting screens before bed are the basics that tend to make the biggest difference.
Manage Chronic Stress
Stress triggers the release of cortisol and adrenaline, hormones that tell your liver to dump stored sugar into your bloodstream. That’s useful if you’re running from danger. It’s counterproductive if you’re sitting at a desk with a high-pressure deadline. Chronic stress keeps these hormones elevated, which gradually erodes insulin sensitivity in the same way sleep deprivation does.
The most effective stress-reduction strategies are the ones you’ll actually do consistently. Walking, deep breathing exercises, spending time outdoors, and maintaining social connections all lower cortisol. Even 10 to 15 minutes of deliberate relaxation per day can blunt the hormonal cascade that raises blood sugar.
Check Your Vitamin D Levels
People with low vitamin D levels are roughly three times more likely to have elevated blood sugar and nearly two and a half times more likely to have increased insulin resistance compared to those with adequate levels. Interestingly, this effect is tied to your blood levels of vitamin D, not how much you get from food alone. Supplementing through diet without actually raising your blood levels doesn’t appear to help.
If you live in a northern climate, have darker skin, or spend most of your time indoors, ask for a vitamin D blood test at your next checkup. Getting your levels into the sufficient range (typically above 30 ng/mL) may improve how well your body handles glucose.
Know When Medication Enters the Picture
Lifestyle changes are the first-line treatment for prediabetes, but some people benefit from medication alongside those changes. Current guidelines suggest considering metformin for adults between 25 and 59 with a BMI over 35, a fasting blood sugar above 110 mg/dL, or an A1C above 6%. Women who had gestational diabetes are also candidates. Metformin works by reducing the amount of sugar your liver releases and improving how your cells respond to insulin.
Medication isn’t a replacement for the habits described above. It’s an additional tool for people whose risk factors make lifestyle changes alone less likely to be sufficient.
Track Your Progress Annually
Once you’ve been diagnosed with prediabetes, the standard recommendation is to have your A1C retested once a year. This gives you a reliable snapshot of your average blood sugar over the previous two to three months and tells you whether your changes are working. If your A1C drops below 5.7%, you’ve returned to the normal range. If it’s holding steady or rising, it’s a signal to adjust your approach or discuss additional options with your doctor.
Some people also find continuous glucose monitors or regular finger-stick testing helpful for understanding how specific meals and activities affect their blood sugar in real time. Seeing the immediate impact of a post-dinner walk or a high-fiber breakfast can reinforce the habits that are making a difference.