Lowering it

Can prediabetes be reversed?

By GyroscopeUpdated November 14, 20266 sources

Often, yes. Each year 5 to 10% of people with prediabetes move on to diabetes, and about the same share go back to normal. In the biggest prevention trial, people who got back to normal blood sugar even once had 56% lower diabetes risk years later, whichever group they’d been in. Prediabetes is the stage where the numbers still move both ways.

Why people think it’s a one-way street

The name sounds like a waiting room for diabetes, and plenty of people hear “prediabetes” as “diabetes, eventually”. Nothing feels different, so it’s easy to assume nothing can be done, and the yearly numbers from the big studies show the opposite.

What’s going on in your body

Prediabetes comes from two problems that start before your blood sugar changes. Your muscles and liver stop responding as well to insulin, and the cells in your pancreas that make insulin start to struggle to keep up, and both can improve.

The clearest look at how fast this can turn around came from a small, extreme study in people who’d already crossed into type 2. In 2011, researchers put 11 people with type 2 diabetes on 600 calories a day. Within a week their fasting blood sugar was normal, from 9.2 to 5.9 mmol/L (166 to 106 mg/dL). Their liver came to respond to insulin about as well as a healthy group’s, their liver fat fell from 12.8% to 2.9% by week 8, and their pancreas was making insulin almost like people without diabetes. That diet is far beyond anything the prevention plan asks for, but it shows the machinery can recover, even a stage later than prediabetes.

Prediabetes is like a fork in the road. Each year, about as many people turn back as keep going.

What the trial found

The Diabetes Prevention Program put 3,234 adults with raised blood sugar on a placebo, metformin, or a lifestyle program aiming for 7% weight loss and 150 minutes of activity a week. After about 3 years, the lifestyle group had 58% fewer new cases than placebo.

Researchers later followed 1,990 of them. Those who’d returned to normal blood sugar at least once during the trial had 56% lower diabetes risk in the years after, whichever group they’d been in.

The fight

“Reversed” doesn’t mean cured. Over 15 years, 55% of the lifestyle group got diabetes anyway, against 62% on placebo, and the gap between the groups narrowed from 58% to 27%. Part of that is because the placebo group was offered the lifestyle program after the first phase. People who got back to normal still had a lower risk than those who stayed in prediabetes, which is why you keep testing every year after you get there.

Medicines and pregnancy

GLP-1 drugs for weight loss are on the ADA’s 2026 list for people at risk with overweight or obesity, and bodyfat.guide explains how they work. Metformin cut new diabetes 31% in the same trial and is your doctor’s call. In pregnancy the numbers are tighter, so take any number to your midwife or doctor.

The plan, week by week, is on how do I reverse prediabetes?, and the prediabetes plan gives you your own target and retest date.