More than one-third of people in the United States are living with prediabetes — and nearly 80% of them don’t know it, according to the American Diabetes Association.

But here’s the encouraging news: Prediabetes doesn’t have to be permanent. With the right mix of diet, physical activity and daily habits, many people can improve their blood sugar levels and, in some cases, bring them back to a healthy range.

Prediabetes: What It Means

Prediabetes occurs when blood sugar levels are higher than normal but not yet high enough to be classified as Type 2 diabetes. This may show up as elevated blood sugar or A1C levels.

Elevated blood sugar is a sign of insulin resistance, meaning the body has a harder time using insulin effectively to move glucose (sugar) into cells. It can also indicate that the pancreas is starting to have trouble making enough insulin to keep up with the body’s needs.

Why does this matter? Without intervention, prediabetes can progress to Type 2 diabetes. It also raises the risk of heart disease and other long-term complications, such as eye, kidney and nerve conditions.

What “Reversal” Looks Like

Reversing prediabetes does not mean a permanent cure. Clinically, it means bringing blood glucose levels back into a healthy range and improving how the body responds to insulin. Just as important, it means lowering the risk of developing Type 2 diabetes in the future.

Even modest improvements in lab values can lead to meaningful health benefits over time.

Diet Changes That Make a Difference

One of the most effective ways to improve blood sugar levels is to focus on carbohydrate quality — not just cutting carbs altogether. A lower-carbohydrate approach, when followed consistently, can help prevent or delay Type 2 diabetes.

A balanced eating pattern includes:

• Fiber-rich carbohydrates, such as vegetables, legumes and whole grains
• Lean proteins and healthy fats to slow digestion and stabilize blood glucose
• Minimizing refined carbohydrates and added sugars

Together, this approach can help reduce blood sugar spikes and support overall metabolic health.

Lean protein options include:

• Skinless chicken or turkey
• Fish (such as salmon, tuna, cod or tilapia)
• Eggs or egg whites
• Greek yogurt (plain, low-fat or nonfat)
• Cottage cheese
• Beans and lentils
• Tofu or tempeh

Healthy fats that promote fullness and heart health include:

• Avocados
• Nuts (such as almonds, walnuts and pistachios)
• Seeds (such as chia, flax, pumpkin and sunflower)
• Olive oil or avocado oil
• Fatty fish (such as salmon, mackerel and sardines)
• Nut butters with minimal added sugar

The Role of Weight and Metabolism

For many people, weight loss improves insulin sensitivity significantly. Losing just 5% to 10% of body weight can make a noticeable difference in blood sugar levels.

For example, someone weighing 200 pounds may see metabolic benefits with a loss of 10 to 20 pounds. Improved metabolism helps the body use energy more efficiently.

However, losing weight is not the only path to improvement. Increased physical activity and good nutrition can enhance insulin function — even without major changes on the scale.

Why Movement Matters

Regular physical activity helps muscles use glucose more efficiently, lowering blood glucose levels.

Ways to get moving include:

• Aerobic activity, like walking
• Strength training to build muscle mass
• Consistent daily movement

Even moderate increases in activity can reduce the risk of developing Type 2 diabetes, especially when paired with changes in your diet.

Research from the National Diabetes Prevention Program suggests that structured lifestyle changes can cut diabetes risk by more than half for some people.

Sleep, Stress and Hidden Drivers

Sleep and stress often go overlooked, but both play a major role in insulin resistance.

• Poor sleep can disrupt hormones that regulate hunger and glucose.
• Chronic stress can increase blood sugar and worsen metabolic control.

Improving sleep quality and managing stress can also help improve prediabetes, especially when changes in diet and exercise alone aren’t enough.

“Try to set consistent bedtimes and wake times to help your body adjust to a regular sleep rhythm,” says Dr. Vora. “While stress is always present in our lives, using coping strategies can help lower the blood sugar. This may mean exercise, deep breathing, meditation or consulting with a therapist.”

Tracking Meaningful Progress

Lab values like A1C and fasting blood sugar are important markers, but they don’t tell the whole story.

You might also notice everyday signs that things are heading in the right direction, such as:

• More steady energy levels throughout the day
• Fewer cravings
• Clothes fitting a little more comfortably around your waist
• Feeling better after meals

These shifts often happen gradually. Building a healthy daily routine helps many people begin to see meaningful improvements within a few months.

Risk Factors To Keep in Mind

Some people face a higher risk of developing diabetes because of factors such as:

• Family history of diabetes
• Previous gestational diabetes
• High blood pressure
• Overweight or obesity

These factors may not make Type 2 diabetes a certainty — but they do make early action even more important.

Medication as Part of the Plan

In some cases, lifestyle changes alone may not be enough. Medication can help manage blood sugar levels and reduce risk. Certain medications, such as metformin, have been shown to slow or reduce the progression of prediabetes into diabetes.

“Using medication for prediabetes is another tool to help prevent progression into diabetes, along with lifestyle changes,” says Dr. Vora.

A Realistic, Sustainable Approach

One of the most common myths is that prediabetes will always become diabetes. Another is that improving your health requires extreme or restrictive habits. Neither is true.

Sustainable, realistic changes are far more effective than short-term fixes. Small steps, such as building balanced meals or taking a daily walk, can build momentum over time and help prevent or delay Type 2 diabetes.

“With informed choices and consistent habits, many people can improve blood glucose, reduce their risk of developing Type 2 diabetes and protect their health,” says Dr. Vora. “The key is not perfection — it’s consistency.”