Prediabetes

Prediabetes means blood sugars are higher than normal but not yet in the diabetes range: fasting glucose 100-125 mg/dL, or 2-hour post-glucose 140-199 mg/dL, or HbA1c 5.7-6.4%. Without intervention, roughly a third of Indian adults with prediabetes progress to type 2 diabetes within 5 years. It's the single best window to change course — the body still makes enough insulin; the metabolism can still recover.

Most people have no symptoms at all — which is why prediabetes is missed for years unless someone runs a fasting sugar or HbA1c. A few people notice mild fatigue, increased thirst, or slow wound healing. If you have any risk factor (age over 35, overweight around the waist, family history of diabetes, past gestational diabetes, PCOS, high BP, sedentary work), ask for the test — don't wait for symptoms.

Yes — the strongest evidence in medicine for reversing a metabolic condition. Losing 5-7% of body weight, walking or exercising 150 minutes per week, reducing refined carbs (white rice, maida, sugar), increasing vegetables and pulses, and cutting sugary drinks reduces diabetes risk by 40-58% over 3 years (US and Indian trials both confirm). This works better than metformin in patients with mild prediabetes — though metformin is added for higher-risk cases.

Diet matters more than exercise for weight loss; exercise matters more for insulin sensitivity. Both are needed. Practical shifts for an Indian household: replace half your rice with vegetables and dal, choose multigrain roti over maida, swap fried snacks for roasted or steamed alternatives, add a 30-minute walk after dinner, and do 2 sessions of strength training a week. Small consistent changes beat dramatic short-lived overhauls.

If lifestyle changes for 3-6 months aren't moving the numbers — or if HbA1c stays close to 6.4%, or if you have significant risk factors (obesity with family history, past gestational diabetes) — endocrinologists often add metformin. It's the same first-line diabetes drug, used earlier here to prevent progression. It doesn't replace diet and exercise; it complements them.