Turning prediabetes around

What the research shows about preventing type 2 diabetes, and practical steps you can take: moving more, eating well, sleep, stress, prevention programs and when medicine may help.

6 min read · last reviewed October 3, 2026

If you have prediabetes, here's some genuinely good news: type 2 diabetes is not inevitable. Research shows that healthy changes can lower your chance of getting it by more than half. You don't need to overhaul your whole life. Small, steady steps really do add up.

What the research shows

The Diabetes Prevention Program (DPP) was a large study of more than 3,000 adults in the U.S. with prediabetes and a higher body weight. People were put into one of three groups:

• a lifestyle program, with coaching to help them eat healthier, be active for at least 150 minutes a week, and lose about 7% of their body weight (about 14 pounds, or 6 kg, for someone who weighs 200 pounds, or 90 kg)
• the medicine metformin
• a placebo (dummy pill)

After about 3 years:

• The lifestyle group lowered their chance of developing type 2 diabetes by 58%. In people aged 60 and over, it was 71%.
• The metformin group lowered their chance by 31%.

Follow-up studies found that the benefits lasted for years, though they got smaller over time. Similar studies in Finland, China, India and other countries found similar results. Diabetes Canada and the American Diabetes Association both recommend structured lifestyle programs for people with prediabetes.

Step 1: Move more

Activity helps your muscles use sugar and makes your body more sensitive to insulin, starting the very first day.

• Build up to 150 minutes a week of activity that gets you breathing a bit harder, like brisk walking, cycling, swimming or dancing. That's about 30 minutes, 5 days a week, but you can break it into 10-minute chunks.
• Add strength exercises 2 or more days a week, using body weight, bands or weights.
• Sit less. Get up and move for a few minutes every 30 minutes or so.
• Walk after meals. Even 10 to 15 minutes helps blunt the rise in blood sugar.

Something you can do today: Take a 10-minute walk after your biggest meal.

Step 2: Eat in a way that works for you

There's no single "right" diet. Several eating patterns can help, including Mediterranean-style, plant-based and lower-carbohydrate eating. Some simple ideas:

• Fill half your plate with vegetables, a quarter with protein, and a quarter with whole grains or starchy foods.
• Swap sugary drinks (pop, sweet tea, energy drinks, juice) for water or other sugar-free drinks.
• Choose high-fibre foods, such as whole grains, beans, lentils, vegetables and whole fruit.
• Cut back on highly processed foods, which are often high in sugar, salt and unhealthy fats.
• Notice portions, especially of rice, bread, pasta and sweets.

Something you can do this week: Replace one sugary drink a day with water.

Step 3: If weight is a goal for you

For people who carry extra weight, losing even 5 to 7% of body weight can make a big difference. But weight is shaped by many things, including genes, sleep, stress, medicines and money, and it's not the only thing that matters. Being more active and eating well help your blood sugar and heart, whatever happens on the scale.

If you'd like support, ask your team about a dietitian, a program, or, for some people, medicines or surgery for weight management.

Step 4: Sleep, stress and smoking

• Sleep: aim for 7 or more hours a night. Short or poor sleep makes insulin work less well. If you snore loudly or feel very tired in the day, ask about sleep apnea.
• Stress: stress hormones push blood sugar up. Walking, time outdoors, talking with friends or relaxation exercises can help.
• Smoking: smoking raises the risk of type 2 diabetes and heart disease. Ask your team or pharmacist for help to quit.

Join a prevention program

You don't have to do this alone. Structured programs offer coaching, group support and practical tips. Ask your doctor or local health unit what's available.

• In the U.S., the CDC's National Diabetes Prevention Program offers recognized programs in person and online.
• In Canada, programs vary by province and community. Ask your family doctor, a local diabetes education centre or Diabetes Canada what's near you.
• In the UK, the NHS Diabetes Prevention Programme is available for people with blood sugar in the higher range.

What about medicine?

Most people start with lifestyle changes. For some people at higher risk, your doctor may suggest metformin as well. In the DPP, it seemed to help most in younger adults and in people with a higher body weight. Ask whether it's right for you.

Check in regularly

Get your blood sugar re-checked as your team suggests, often once a year. Celebrate progress in your numbers, but also in how you feel: more energy, better sleep, walking farther. If your blood sugar does rise into the diabetes range, that's not a failure. You'll already have great habits that make managing it easier.

Questions to ask your care team

• What would be a realistic goal for me?
• Is there a diabetes prevention program near me or online?
• Can I see a dietitian?
• Would metformin help me?
• When should my blood sugar be checked again?

This article is general information, not medical advice. Talk with your health care team about your own situation. In an emergency, call 9-1-1 or your local emergency number.

In an emergency, call 9-1-1 or your local emergency number.

General information, not medical advice. It does not replace your own care team. If you think you or someone else is having a medical emergency, call 9-1-1 or your local emergency number. If you are in crisis or thinking about suicide, call or text 9-8-8 (Canada and the US).

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