Prediabetes: symptoms, diet, treatment and whether it can be reversed

Usually there are none. Diabetes UK says there aren't usually any prediabetes symptoms, so it may not be picked up unless your GP does a routine blood test or you have an NHS Health Check, which is offered to some people in England.

If you have symptoms such as those below, the NHS says to see a GP, because they can be signs of type 2 diabetes rather than prediabetes. Diabetes UK adds that some of these, such as vaginal itching and feeling more tired than usual, can be similar to symptoms of the perimenopause, so a blood test is the only way to tell.

• Feeling very tired.

• Peeing more than usual, especially at night.

• Feeling thirsty all the time.

• Losing weight without trying to.

• Blurred vision, or cuts and wounds taking longer to heal.

• Itching around the penis or vagina, or repeated thrush.

Diabetes UK says there is no food you can't eat if you want to prevent type 2 diabetes or manage prediabetes. It is a question of choosing healthier foods more often, and portion sizes matter too. It suggests picking one or two tips to start with.

The NHS says prediabetes means your blood glucose (sugar) levels are higher than normal but not high enough for a diagnosis of diabetes, and that it puts you at higher risk of getting diabetes in the future.

Diabetes UK describes how it develops: your body is not making enough of the hormone insulin, or the insulin is not working very well (insulin resistance), so blood sugar rises. It is diagnosed by a blood test measuring HbA1c, your average blood sugar over the past few months.

Diabetes UK lists the main treatments as losing any extra weight, particularly around your middle, eating a diet higher in fruit, vegetables and wholegrains and lower in processed foods and sugary drinks, and increasing physical activity. It also says breaking up long periods of not moving matters, and that good quality sleep and stopping smoking are linked with a lower risk of type 2 diabetes.

Even small weight loss helps: Diabetes UK says 1% to 9% of your weight can lower average blood sugar levels. If you are thinking of changing your diet, losing weight or starting a new physical activity, it advises speaking to your GP first. Not everyone with prediabetes needs to lose weight, and if you are underweight, losing more weight will not help and may be unsafe.

Medicines are not usually the first step. Diabetes UK says that if lifestyle changes have not worked, your GP or another healthcare professional may recommend weight loss medication depending on your BMI, and may prescribe metformin to help your insulin work better. Your GP should offer a blood test to check HbA1c or fasting glucose at least once a year and a weight check.

Diabetes UK says it is possible to reverse prediabetes, meaning HbA1c returns to below 42 mmol/mol. It says prediabetes does not go away on its own and there is no guarantee, but even if levels do not return to normal, any reduction helps keep you healthier and helps stop HbA1c rising into the type 2 diabetes range.

On timing, Diabetes UK says a goal of reversing prediabetes within three months is unlikely to be realistic, particularly if you want to maintain healthy blood sugar levels. It suggests focusing on small, long-term goals instead. Blood sugar can also creep back up, so ongoing annual checks matter.

Diabetes UK says prediabetes is triggered by a combination of factors rather than weight alone. These include age, family history, living with overweight or obesity, having more fat stored in and around organs (sometimes indicated by a high waist measurement), ethnicity, other medical conditions, poor quality sleep and smoking. Statins and steroids can also raise the risk.

You can have prediabetes at a healthy weight. Diabetes UK also says risk is higher, and starts at a younger age and lower body weight, for people from Black African, African Caribbean and South Asian backgrounds. It stresses that you are not to blame for developing it.

In England, the NHS Healthier You Diabetes Prevention Programme refers people at risk onto a nine-month lifestyle programme, available face to face or digitally. NHS England says completing it cuts the risk of developing type 2 diabetes by more than a third. Diabetes UK says that if you have prediabetes you should be offered a type 2 prevention course or advice, depending on where you live.

An NHS Health Check, for people aged 40 to 74 without an existing condition, is another way prediabetes is found. Some people also pay for private blood tests or weight management support, but HbA1c results and follow-up should be shared with your GP so your annual checks continue.

The NHS advises seeing a GP if you think you or your child may have type 2 diabetes or you have a higher risk of developing it, because not everyone with type 2 diabetes has symptoms. Diabetes UK says that if you start noticing increased thirst, needing to pee more, tiredness, weight loss, thrush or slow-healing cuts you may have developed type 2 diabetes and should contact your GP.