What’s the difference between pre-diabetes and type 2 diabetes?
I deal with a lot of clients who are prediabetic and they are often confused about the difference between all the different diabetic categories. I am here to help you understand prediabetes a bit better and how it differs from other forms of diabetes.
Diabetes means that your blood glucose is too high. Most people understand blood glucose as blood sugar. Blood glucose is the scientific term. Here are the differences between the different diabetes categories.
Type 1 Diabetes: Your pancreas does not produce any insulin, and therefore, you need to inject insulin into your body.
Type 2 Diabetes: Your pancreas produces too little or ineffective insulin. Your blood glucose levels are above 48 mmol/mol. Your blood glucose levels are based on a test marker called HbA1c, which measures your blood glucose levels over three months.
Gestational Diabetes: Developed during pregnancy.
Prediabetes: Your blood glucose levels measure between 42 – 47.99 mmol/mol, and if you carry on with your lifestyle as it is, you are more at risk of developing Type 2 Diabetes.
When it comes to Prediabetes and Type 2 Diabetes, unfortunately, certain lifestyle factors are not in our control and lead to an increased risk of Type 2 Diabetes.
These are:
- Family history of diabetes.
- Age, the older we get, the more at risk we become.
- Ethnicity. People with darker skin are more at risk of developing diabetes e.g. ethnicities such as African and South-East Asian.
The good news is that if you become prediabetic, there are lifestyle factors you can work on to reduce your diabetes risk and bring your blood glucose levels to normal. These are2:
- Weight loss. A 5-10% weight loss reduction can make a significant impact on reducing blood glucose levels1. However, even super skinny people can become prediabetic, so it’s not only weight loss that one must look at.
- Nutrition3. Nutrition plays a vital role in reducing blood glucose levels. You are probably not doing yourself any favours by losing weight and living on lettuce and cucumber. Nourishment is key. A Mediterranean-style diet has been shown to have remarkable results in reducing blood glucose levels. Here are some foods to increase and foods to reduce in your diet. Please note I say “reduce” and not cut out. I know you’re human, not a robot. Life is also about living and sometimes you should enjoy that Birthday cake, pudding, pizza or ice cream etc.
| Food to improve in diet | Food to reduce in diet |
| Fruit and vegetables. Eat the rainbow throughout the week. | Ultra-processed foods that are high in sugar, salt and saturated fat e.g. biscuits, sweets, sugary cereals, processed meats. |
| Lean proteins such as fish, chicken, turkey, eggs, tofu, beans and pulses such as lentils, chickpeas, red kidney beans. | Red meat – limit to twice a week if possible4 |
| Wholegrains such as oats, brown rice, barley, brown pasta, wholemeal bread, wholemeal pita, wholemeal tortilla high-fibre cereals such as All-Bran and Weetabix. | Refined carbohydrates like white bread, white pasta, white pita, white rice etc. |
| While not a food, drinking water and increasing hydration is very important. | Alcohol |
| Unsaturated fat i.e. the healthier fats such as olive oil, rapeseed oil, nuts, seeds, avocado and oily fish. | Saturated fat like the fat on meats, skin of chicken, Fat in dair |
- Physical Activity: A combination of cardio and resistance training is another way to reduce diabetes risk5. Find the exercise you love, such as walking, running, resistance training, Pilates, yoga, walking rugby, football, or swimming. Aim for more than 20 minutes at a time.
- Stress Management6: This lifestyle factor often gets overlooked. It is also a very hard one to manage as you cannot just switch stress off. It needs to work overtime. So, it is essential to find hobbies, activities, and pastimes that take your focus away from stressful triggers, even for five minutes. E.g. reading, walking, exercising without your phone, sudoku, puzzles, crosswords, meditation.
- Sleep quality: This is also a contributing lifestyle factor that gets overlooked. Lack of sleep can affect hunger hormones that signal when we are full and/or hungry, leading to poor food choices.
- Smoking: This is the only habit you should strive to eliminate.
What is the fastest way to reverse prediabetes?
You will need to be patient as you reduce your blood glucose levels to normal. Blood glucose measures HbA1c, which indicates your average blood glucose level over the past three months. To make sustainable changes to your lifestyle and create long-term habits, start with small changes and build on them from there. This may take longer than three months.
Can drinking water help with pre-diabetes?
Drinking at least 8 glasses of water per day and staying hydrated is a great habit to form to reduce your risk of diabetes.
What is the best medication for prediabetes?
Unless advised by your GP, there is no medication for prediabetes. Always consult your GP before taking any medication. When I first meet with clients, there appears to be a common belief that Continuous Glucose Monitors can help people with prediabetes. This is untrue as the research around continuous glucose monitors is specific to people with Type 1 Diabetes, not even Type 2 diabetes.
What are 10 warning signs of prediabetes?
There are not really warning signs for prediabetes. If you have any symptoms, it may be that you have type 2 diabetes. Examples of symptoms that related to Type 2 Diabetes are7:
- Frequent urination.
- Increased thirst.
- Wounds are taking longer than usual to heal.
- Fatigue.
- Blurred vision.
How quickly does prediabetes turn into diabetes?
It is hard to know precisely how long it will take for prediabetes to turn into Type 2 Diabetes. However, prediabetes will turn into Type 2 diabetes if you are prediabetic and continue to carry on with your lifestyle and not make any changes to the above lifestyle factors (weight loss, nutrition, exercise, stress, sleep, etc).
What happens if I get type 2 diabetes?
Diabetes is associated with unfavourable health conditions like cardiovascular disease, kidney disease, cancers and obesity. It is, therefore, an investment in your health to avoid it.
Can type 2 diabetes be reversed?
Type 2 diabetes can be put into remission, primarily through weight loss and changes to the above-mentioned lifestyle factors. It can always come back if you resort to previous habits.
References
- Jayedi, Ahmad, et al. “Efficacy of Lifestyle Weight Loss Interventions on Regression to Normoglycemia and Progression to Type 2 Diabetes in Individuals with Prediabetes: A Systematic Review and Pairwise and Dose-Response Meta-Analyses.” The American Journal of Clinical Nutrition, vol. 120, no. 2, 2024, doi:10.1016/j.ajcnut.2024.08.031.
- Diabetes UK. Prediabetes. Diabetes UK, https://www.diabetes.org.uk/about-diabetes/type-2-diabetes/prediabetes. Accessed 13 June 2025.
- Reynolds, Andrew, and Joanna Mitri. “Dietary Advice For Individuals with Diabetes.” Endotext, edited by Kenneth R. Feingold et al., MDText.com, Inc., 28 Apr. 2024, https://www.endotext.org/wp-content/uploads/pdfs/dietary-advice-for-individuals-with-diabetes.pdf.
- 2. Gu, Xiao, et al. “Red Meat Intake and Risk of Type 2 Diabetes in a Prospective Cohort Study of United States Females and Males.” The American Journal of Clinical Nutrition, vol. 118, no. 6, 2023, pp. 1153–1163. doi:10.1016/j.ajcnut.2023.08.017.
- Church, Timothy S., et al. “Effects of Aerobic and Resistance Training on Hemoglobin A1c Levels in Patients with Type 2 Diabetes: A Randomized Controlled Trial.” JAMA, vol. 304, no. 20, 2010, pp. 2253–2262.
- Stress and Diabetes | The Impact on Your Wellbeing.” Diabetes UK, 13 June 2025, https://www.diabetes.org.uk/living-with-diabetes/emotional-wellbeing/stress.
- NHS. “Symptoms of Type 2 Diabetes and How It’s Diagnosed.” NHS, 10 Feb. 2025, https://www.nhs.uk/conditions/type-2-diabetes/symptoms/. Accessed 13 June 2025.