Prediabetes is a state of elevated blood glucose that is below the threshold for Type 2 diabetes. It is common, often silent, and — importantly — modifiable.
How prediabetes is defined
- HbA1c 5.7%–6.4%
- Fasting glucose 100–125 mg/dL
- 2-hour OGTT glucose 140–199 mg/dL
What the data shows about progression
Without intervention, a substantial proportion of people with prediabetes progress to Type 2 diabetes within a few years. Progression risk depends on baseline A1c, weight trajectory, family history, age, and other factors.
What can lower the risk
Structured lifestyle programs (such as the CDC's National Diabetes Prevention Program), weight loss, increased physical activity, and — for selected patients — pharmacotherapy can meaningfully reduce progression risk.
When metabolic surgery is considered
Metabolic surgery is generally not a first-line treatment for prediabetes alone. For patients with obesity and additional metabolic comorbidities, current guidelines may discuss it after other options have been considered. Individual evaluation by qualified healthcare professionals is required.