Prediabetes: A Personal Wake-Up Call About Nutrition, Lifestyle, and Prevention

Why family history, healthy habits, and early detection matter more than we sometimes realize.

November is National Diabetes Month, making it an important time to bring awareness to diabetes, prediabetes, prevention, and the role lifestyle choices play in long-term health.

Working in an endocrinology clinic, I have the opportunity to see how diabetes affects individuals and families. This November, I wanted to take a closer look at prediabetes, not only from a healthcare perspective but also through my own personal experience.

At 48 years old, I have always considered myself relatively health-conscious. I eat a balanced diet approximately 75% of the time and stay physically active four to five days a week. My exercise routine consists primarily of strength training, which I have consistently maintained for almost three years.

However, despite these habits, I recently received my first elevated A1C result. This was something I had never experienced before.

I also have a significant family history of diabetes on both sides of my family, which makes this finding especially important to me. Genetics and family history are risk factors that cannot simply be changed through diet or exercise.

The good news is that I have identified this potential concern early, and I have additional laboratory testing scheduled for December as part of my annual health evaluation.

I consider myself fortunate to have the opportunity to recognize this early and take a proactive approach to understanding my health.

What Is Prediabetes?

Prediabetes occurs when blood glucose levels are higher than normal but not high enough to meet the diagnostic criteria for type 2 diabetes.

The condition is often associated with insulin resistance. Insulin is a hormone produced by the pancreas that helps glucose move from the bloodstream into the body's cells for energy.

When the body becomes resistant to insulin, glucose can begin accumulating in the bloodstream.

Prediabetes is particularly concerning because it often develops without noticeable symptoms. Many individuals may have elevated blood sugar for years without realizing it.

An A1C test is one of the most common ways to identify prediabetes. It measures average blood glucose levels over approximately three months.

A1C reference ranges:

• Normal: Below 5.7%

• Prediabetes: 5.7%–6.4%

• Diabetes: 6.5% or higher

An elevated result deserves follow-up and interpretation by a healthcare professional.

Genetics and Family History Matter

One of the biggest takeaways from my own experience is the importance of family history.

Having diabetes on both sides of my family has always been something I have been aware of. However, because I have maintained an active lifestyle and generally balanced nutrition, I never expected to see an elevated A1C.

Family history can increase an individual's risk of developing type 2 diabetes, even when other healthy habits are present. This is an important reminder that diabetes prevention is not simply about how someone eats or how often they exercise. Age, genetics, family history, sleep, stress, medications, and other metabolic factors can all contribute to an individual's overall risk.

Knowing your family history and communicating it to your healthcare provider can help determine when screening is appropriate.

Nutrition: Small Choices Can Make a Difference

Nutrition plays an important role in blood glucose regulation.

The goal is not to eliminate carbohydrates or follow an extreme diet. Instead, it is about developing sustainable eating patterns that support overall metabolic health.

Some nutritional habits worth considering include:

Prioritizing fiber: Vegetables, beans, lentils, whole fruits, and whole grains provide fiber, which helps slow digestion and supports blood glucose management.

Including protein: Fish, chicken, eggs, Greek yogurt, tofu, and legumes can help create balanced meals.

Choosing healthy fats: Avocados, nuts, seeds, and olive oil provide beneficial fats.

Being mindful of added sugars: Reducing sugar-sweetened beverages and frequently consumed highly processed sweets can support better overall nutrition.

Building balanced meals: Combining protein, fiber-rich carbohydrates, vegetables, and healthy fats can help support a more gradual rise in blood glucose after eating.

Consistency matters much more than perfection.

Strength Training and Cardiovascular Exercise

Physical activity is another important component of diabetes prevention.

One area I have personally prioritized over the past three years is strength training. I currently exercise four to five times per week, primarily focusing on resistance training.

Strength training has benefits beyond building muscle. Active muscle tissue uses glucose for energy, and regular resistance exercise can improve insulin sensitivity.

But I have decided to add another healthy habit to my routine: more consistent cardiovascular exercise.

My new goal is to incorporate walking or running first thing in the morning, three to four times per week. I want to be more intentional about combining resistance training with cardiovascular activity to support my overall metabolic health.

Other beneficial activities include:

• Walking.

• Swimming.

• Cycling.

• Dancing.

• Recreational sports.

For adults, the general recommendation is at least 150 minutes of moderate-intensity physical activity per week, along with muscle-strengthening activities at least two days per week.

The important takeaway is that physical activity should be a consistent part of an overall healthy lifestyle.

Can Prediabetes Be Reversed?

One of the most encouraging aspects of identifying prediabetes is that progression to type 2 diabetes is not inevitable.

Research has demonstrated that lifestyle interventions can significantly reduce the risk of developing type 2 diabetes. For adults with prediabetes who have overweight or obesity, evidence-based diabetes prevention programs commonly recommend a modest 5–7% reduction in starting body weight.

This level of weight reduction can help improve blood glucose levels and significantly reduce the risk of developing type 2 diabetes. Some individuals may even return to normal blood glucose levels.

Weight reduction is not necessary or appropriate for everyone. Individual recommendations should be based on a person's health status and discussed with their healthcare professional.

Other important interventions include:

• Consistent physical activity.

• Balanced nutritional habits.

• Adequate sleep.

• Stress management.

• Routine blood glucose monitoring when recommended.

• Regular healthcare follow-up.

The goal is to reduce metabolic risk and support long-term health, not pursue a one-size-fits-all approach.

Why Early Detection Is So Important

Prediabetes often develops without noticeable symptoms, meaning many people may not realize their blood sugar levels are elevated.

According to the CDC, approximately 115.2 million American adults have prediabetes, and about 8 in 10 do not know they have it. These statistics emphasize the importance of routine screening, especially for individuals with known risk factors.

My own experience has reinforced this message. Despite exercising consistently, prioritizing strength training, and maintaining balanced eating habits most of the time, my first elevated A1C has made me look more closely at my family history and long-term metabolic health.

I am scheduled for additional laboratory testing in December as part of my annual evaluation. Until then, I am taking the opportunity to learn more, ask questions, and work with my healthcare professionals to better understand my results.

Being proactive is one of the most valuable things we can do for our health.

Who's With Me?

This November, I am making a renewed commitment to my metabolic health. For me, that means continuing my strength training routine, being more consistent with morning cardiovascular exercise, prioritizing balanced nutrition, and staying informed about my laboratory results.

I know that healthy habits don't have to be perfect to make a difference. Small, consistent changes can add up over time.

I'd love to hear from you:

Who's with me in taking proactive steps to reduce our risk of prediabetes and type 2 diabetes?

Whether it's adding a morning walk, incorporating strength training, making more balanced food choices, or scheduling that overdue annual checkup, let's make our health a priority.

Let's use Diabetes Awareness Month as a reminder that prevention starts with awareness, and positive change can start with one small step.

Know your numbers. Know your family history. Move your body. Nourish yourself. Take charge of your health.

I'm not striving for perfection. I'm choosing consistency, being proactive, and investing in my health. Who's with me?