Can You Reverse Prediabetes? What the Research Says

Prediabetes means blood glucose (blood sugar) levels are higher than normal, but not high enough to be diagnosed as type 2 diabetes (NIDDK). In 2021, about 97.6 million adults in the United States had prediabetes (NIDDK).

This guide looks at how public health sources use the word "reverse" and what one of the largest prevention studies found.

What prediabetes is

Insulin is a hormone made by the pancreas. Insulin resistance is a condition in which the body doesn't respond to insulin the way it should (NIDDK). The CDC explains that when cells don't respond normally to insulin, the pancreas makes more insulin to try to get them to respond. Eventually the pancreas can't keep up, and blood sugar rises (CDC).

People with insulin resistance and prediabetes usually have no symptoms (NIDDK).

How sources use the word "reverse"

Public health sources use careful language here:

• NIDDK says healthy living "may help prevent or reverse insulin resistance and prediabetes" (NIDDK).
• MedlinePlus says lifestyle changes may help delay or prevent type 2 diabetes in people with prediabetes (MedlinePlus).
• NIDDK also notes that not everyone with prediabetes develops type 2 diabetes (NIDDK).

The word "may" matters. These sources describe what is possible for many people, not a guaranteed result for any one person.

What the Diabetes Prevention Program found

The Diabetes Prevention Program (DPP) is a major NIH-funded study of people at high risk for type 2 diabetes. It compared a lifestyle change program, built around dietary changes and more physical activity, with a placebo and with a medicine (NIDDK).

According to NIDDK, after about 3 years (NIDDK):

• Participants in the lifestyle change program lowered their chances of developing type 2 diabetes by 58 percent compared with participants who took a placebo.
• For participants ages 60 and older, the reduction was 71 percent.
• About 5 percent of lifestyle program participants developed diabetes each year, compared with 11 percent in the placebo group.
• Participants who took metformin, a generic diabetes medicine, lowered their chances by 31 percent compared with placebo.

These are group results from one large study. Individual results vary.

What follow-up research shows

The DPP Outcomes Study has followed most DPP participants since 2002. NIDDK reports that participants from the lifestyle program or taking metformin have continued to prevent or delay type 2 diabetes for at least 15 years. Researchers are also following other health problems in participants, including heart and blood vessel disease, kidney disease and eye disease (NIDDK).

When to see a clinician

Questions about prediabetes, or about any change in health, are best discussed with a licensed clinician who knows a person's history. In a medical emergency, call 911 or go to the nearest emergency room.

Frequently asked questions

What is prediabetes? Prediabetes means blood glucose levels are higher than normal but not high enough to be diagnosed as type 2 diabetes (NIDDK).

How common is prediabetes? NIDDK reports that about 97.6 million U.S. adults had prediabetes in 2021 (NIDDK). The CDC puts it at more than 2 in 5 American adults (CDC).

Does everyone with prediabetes develop type 2 diabetes? No. According to NIDDK, not everyone with prediabetes develops type 2 diabetes (NIDDK).

What was the Diabetes Prevention Program? An NIH-funded study of people at high risk for type 2 diabetes. It found that a lifestyle change program lowered participants' chances of developing type 2 diabetes by 58 percent compared with placebo over about 3 years (NIDDK).