Making Sense of Prediabetes
Prediabetes: what it is, why it matters, and what published guidance actually asks of you.
It carries a substantially raised risk of progressing, and it is the point at which intervention is most effective.
Key takeaways
- HbA1c range: 42-47 mmol/mol
- Normal: below 42 mmol/mol
- Most useful single change: Ask for referral to the NHS Diabetes Prevention Programme.
- Commonest mistake: Treating it as a milder diagnosis that needs no action.
- See a doctor if any of the signs under "When to speak to a doctor" below apply to you.
The short answer
Blood glucose above normal but below the diabetes threshold, also called non-diabetic hyperglycaemia.
Where it fits
This is part of Diabetes. The published position is set out below, along with what it means day to day.
The numbers, in one place
| Measure | Figure |
|---|---|
| HbA1c range | 42-47 mmol/mol |
| Normal | below 42 mmol/mol |
| Diabetes | 48 mmol/mol or above |
| NHS Diabetes Prevention Programme | available on referral in England |
| Weight loss target commonly used | 5-10 per cent of body weight |
What that means in practice
In everyday terms:
- Ask for referral to the NHS Diabetes Prevention Programme
- Aim for a 5 to 10 per cent weight loss if you carry excess weight
- Meet the 150-minute activity target and add strengthening
- Have HbA1c rechecked as advised, usually annually
What gets people into trouble
The mistakes that come up again and again:
- Treating it as a milder diagnosis that needs no action
- Very restrictive diets you cannot sustain
- Skipping the annual recheck
Where to go next
- What People Get Wrong About Prediabetes
- The First Steps With Prediabetes
- Prediabetes — the reference entry
- What the Guidance Really Says About HbA1c
- The Evidence on Diabetic Foot Care, Without the Hype
When to speak to a doctor
See a GP if you develop excessive thirst, passing much more urine than normal, unexplained weight loss, blurred vision or recurrent infections, which suggest progression to diabetes. Anyone with a family history, a high BMI, or a history of gestational diabetes should ask for regular HbA1c testing.
Where this comes from
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarised or generalised beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to a GP, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 999.
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