Last reviewed June 12, 2026 · AI-assisted, human-reviewed
Overview
Prediabetes is a condition where blood sugar levels are higher than normal but not yet high enough to be diagnosed as type 2 diabetes.
Prediabetes is a serious health condition where blood glucose levels are elevated, but not to the threshold for a type 2 diabetes diagnosis. It indicates that the body is having difficulty processing glucose effectively, often due to insulin resistance, where cells don't respond well to insulin, or insufficient insulin production by the pancreas. This state significantly increases the risk of developing type 2 diabetes, heart disease, and stroke.
The condition often has no clear symptoms, making regular screening important, especially for individuals with risk factors such as a family history of type 2 diabetes, overweight or obesity, physical inactivity, or certain ethnic backgrounds. Early detection and intervention are crucial, as lifestyle changes can often reverse prediabetes and prevent or delay the onset of type 2 diabetes and its associated complications.
Management typically involves adopting healthier eating patterns, increasing physical activity, and achieving a healthy weight. In some cases, healthcare providers may consider medication, though lifestyle modifications are usually the first line of defense. Regular monitoring of blood glucose levels is also a key component of managing prediabetes.
Why it may help Prediabetes: Low vitamin D is associated with higher progression risk to T2D.
Individuals with prediabetes who are on other medications should consult a healthcare provider regarding potential interactions. Monitoring vitamin D levels and calcium status is advisable, especially with higher intake, to avoid hypercalcemia.
Why it may help Prediabetes: Vitamin D may improve insulin sensitivity and pancreatic beta-cell function, which are crucial for glucose regulation and can help prevent the progression of prediabetes.
Why it may help Prediabetes: Polyphenols support insulin sensitivity and may aid weight loss.
Individuals taking medications for blood sugar control, such as sulfonylureas or insulin, should use caution and consult a healthcare provider due to potential additive effects. High doses of green tea extract may affect liver function, especially in susceptible individuals. Individuals with iron deficiency should be aware that green tea may inhibit iron absorption.
Why it may help Prediabetes: Strong glucose-lowering effects can help reverse prediabetes when paired with lifestyle changes.
Typical dose
500 mg 2-3 times daily
Mechanism
May improve insulin sensitivity, reduce glucose production in the liver, and enhance glucose uptake by cells.
Notes
Can cause gastrointestinal upset. Avoid during pregnancy. Consult a healthcare provider, especially if on diabetes medication.
Evidence
moderate
Individuals with prediabetes should be aware of berberine's potential to lower blood sugar, which may require monitoring. It interacts with numerous medications, including those metabolized by CYP3A4, which is important for individuals potentially on other therapies.
Why it may help Prediabetes: Helps reduce sugar cravings — a major behavioral driver in prediabetes.
Individuals with prediabetes who are also taking medications to lower blood sugar should use Gymnema sylvestre with caution due to the potential for additive hypoglycemic effects. Monitoring blood glucose levels is important. It is generally advised to avoid during pregnancy given insufficient safety data.
Why it may help Prediabetes: Bitter Melon may help manage prediabetes by activating AMPK and inhibiting glucose production in the liver, thereby improving insulin sensitivity and reducing blood glucose levels.
Why it may help Prediabetes: Myo-Inositol may improve insulin sensitivity and glucose metabolism by acting as a secondary messenger in insulin signaling pathways, which helps regulate blood sugar levels in prediabetes.
Typical dose
2-4 grams daily
Mechanism
May improve insulin signaling and sensitivity, particularly in individuals with PCOS.
Why it may help Prediabetes: Exercise improves insulin sensitivity by increasing glucose uptake by muscle cells and reducing insulin resistance, which is a primary driver of prediabetes progression.
Why it may help Prediabetes: Blunts post-meal glucose spikes — protects beta-cell function.
Individuals with prediabetes who are on medication for blood sugar control should consult a healthcare provider before using apple cider vinegar, as it may interact with these medications. It should be diluted to prevent damage to teeth and the esophagus, especially with regular use.
Why it may help Prediabetes: Reduces post-meal glucose excursions.
Individuals with prediabetes who are already taking blood sugar-lowering medications should exercise caution, as fenugreek may potentially enhance these effects, leading to hypoglycemia. Monitoring blood glucose levels closely is advisable. As with any herb, discuss with a healthcare provider before use, especially if managing a chronic condition.
Why it may help Prediabetes: May modestly reduce fasting glucose in prediabetic ranges.
Typical dose
1-6 grams daily
Mechanism
May improve insulin sensitivity and lower blood glucose levels.
Notes
Ceylon cinnamon is preferred over Cassia due to lower coumarin content. Can be added to food or taken as a supplement.
Evidence
limited
Individuals with prediabetes who are taking blood-sugar-lowering medications should exercise caution, as Ceylon cinnamon may potentiate their effects, potentially leading to hypoglycemia. Although Ceylon cinnamon has lower coumarin than Cassia, excessive intake could still be a concern. Monitoring blood glucose levels is advisable when using this remedy for prediabetes.
Why it may help Prediabetes: Omega-3 fatty acids may improve insulin sensitivity and reduce inflammation, which can help regulate glucose metabolism and mitigate the risk factors associated with prediabetes.
Why it may help Prediabetes: Magnesium may improve insulin sensitivity and glucose utilization by acting as a cofactor for enzymes involved in carbohydrate metabolism, which is beneficial for managing prediabetes.
Why it may help Prediabetes: Magnesium repletion improves insulin sensitivity and may reduce progression to T2D.
Individuals with prediabetes, especially those with co-existing conditions like kidney impairment, should consult a healthcare provider before initiating magnesium supplementation. High doses of magnesium can lead to gastrointestinal upset. Magnesium may interact with certain medications commonly used by individuals with prediabetes, such as diuretics or some antibiotics.
Why it may help Prediabetes: May improve insulin action.
Typical dose
200-1000 mcg daily
Mechanism
May enhance insulin sensitivity and glucose metabolism.
Notes
Best taken with meals. Consult a healthcare provider, especially if on diabetes medication.
Evidence
moderate
Individuals with prediabetes should consult a healthcare provider before taking chromium picolinate, especially if also on medications that affect blood sugar. High doses in susceptible individuals may be associated with kidney or liver concerns. It may interact with certain medications, including antacids and corticosteroids.
Why it may help Prediabetes: Sulforaphane has shown reductions in fasting glucose.
Individuals with prediabetes who are also managing thyroid conditions should exercise caution, as large raw amounts of broccoli sprouts may be goitrogenic. Discuss supplement use with a healthcare provider, especially if on medications for glucose regulation.
Major health organizations like the American Diabetes Association (ADA) and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) strongly emphasize lifestyle interventions, including diet and exercise, as the primary approach for prediabetes management. While some natural remedies are studied, they are generally not recommended as standalone treatments by these bodies. The NCCIH acknowledges research into certain supplements like chromium and alpha-lipoic acid for blood sugar control but cautions that evidence is often limited or inconsistent, and they should not replace conventional medical care. The WHO and NHS also prioritize lifestyle changes and medical supervision.
Evidence ecosystem
Indexed studies for Prediabetes, grouped by source type and quality.
Tobias DK, Pradhan AD, Duran EK, Li C, Song Y, Buring JE · Nature communications · 2025 · n=220
Observational and experimental evidence suggests that vitamin D plays a role in type 2 diabetes (T2D). However, prior randomized supplementation trials are limited to high-risk patients with prediabetes. Here we aim to evaluate whether vitamin D supplementation reduces risk of T2D in a general population of older US adults. The study design is an ancillary analysis (VITAL-T2D) of The Vitamin D and Omega-3 Trial (VITAL), a completed randomized, double-blind, placebo-controlled 2 × 2 trial of daily vitamin D3 (cholecalciferol; 2000 IU/day) and omega-3 fatty acids (1 g/day) for the primary prevention of cancer and cardiovascular disease. We also conducted a systematic review and meta-analysis of vitamin D trial (≥1000 IU/d cholecalciferol) vs. placebo and T2D risk. We analyzed 22,220 adults with mean age 67.2 years (SD = 7.1) without T2D at enrollment (2011 to 2014), randomized to vitamin D3 or placebo. Mean body mass index (BMI) was 27.5
Wang Y, Chai X, Wang Y, Yin X, Huang X, Gong Q · Journal of medical Internet research · 2025
Lifestyle interventions have been acknowledged as effective strategies for preventing type 2 diabetes mellitus (T2DM). However, the accessibility of conventional face-to-face interventions is often limited. Digital health intervention has been suggested as a potential solution to overcome the limitation. Despite this, there remains a significant gap in understanding the effectiveness of digital health for individuals with prediabetes, particularly in reducing T2DM incidence and reverting to normoglycemia.
This study aimed to assess the effectiveness of different intervention modes of digital health, face-to-face, and blended interventions, particularly the benefits of digital health intervention, in reducing T2DM incidence and facilitating the reversion to normoglycemia in adults with prediabetes compared to the usual care.
We conducted a comprehensive search in 9 electronic databases, namely MEDLINE, Embase, ACP Journal Club, Cochrane Central Register of Controlled Trials, Cochrane
Obesity affects 1 in 5 children and adolescents, increasing the risk of type 2 diabetes (T2D). Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are among the few pharmacotherapy options available for this population, necessitating a comprehensive evaluation of efficacy and safety.
To assess the efficacy and safety of GLP-1 RAs in children and adolescents (<18 years) with obesity, prediabetes, or T2D.
A systematic search was conducted in PubMed, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) for randomized clinical trials (RCTs) published from inception until February 28, 2025. Data analysis was completed from January 2025 to April 2025.
RCTs comparing GLP-1 RAs to placebo in children and adolescents with obesity, overweight, prediabetes, or T2D with reported safety and efficacy data were included.
Two reviewers independently extracted data on sample size, population, interventions, follow-up, and outcomes. Risk of bias was assessed using version 2
Meta-AnalysisPubMedVery High Quality
Systematic Reviews(3)
Structured reviews of the full body of evidence (incl. Cochrane).
Derosa G, D'Angelo A, Angelini F, Belli L, Cicero AFG, Da Ros R · Nutrients · 2024
Dysglycemia is a condition preceding diabetes mellitus. The two situations inherent in this condition are called impaired fasting glucose (IFG) and impaired glucose tolerance (IGT). If one of these situations is found in the patient, after the advice of an appropriate diet and physical activity, the addition of nutraceuticals or supplements can be considered, which can stop or delay the progression to diabetes mellitus over time. The purpose was to compile a systematic review about the use of nutraceuticals for treating diabetes and prediabetes and to offer a valuable resource for colleagues working on this crucial subject, thereby improving patient health. The added value of the paper compared to other reviews is that it was written by experts appointed by five different scientific societies dealing with diabetes, nutrition, and complications.
Wagner J, Spille JH, Wiltfang J, Naujokat H · International journal of implant dentistry · 2022
Dental implant surgery was developed to be the most suitable and comfortable instrument for dental and oral rehabilitation in the past decades, but with increasing numbers of inserted implants, complications are becoming more common. Diabetes mellitus as well as prediabetic conditions represent a common and increasing health problem (International Diabetes Federation in IDF Diabetes Atlas, International Diabetes Federation, Brussels, 2019) with extensive harmful effects on the entire organism [(Abiko and Selimovic in Bosnian J Basic Med Sci 10:186-191, 2010), (Khader et al., in J Diabetes Complicat 20:59-68, 2006, https://doi.org/10.1016/j.jdiacomp.2005.05.006 )]. Hence, this study aimed to give an update on current literature on effects of prediabetes and diabetes mellitus on dental implant success.
A systematic literature research based on the PRISMA statement was conducted to answer the PICO question "Do diabetic patients with dental implants have a higher complication rate in comp
Zilliox LA, Russell JW · Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2019
Diabetic neuropathy is a common and disabling disorder, and there are currently no proven effective disease-modifying treatments. Physical activity and dietary interventions in patients with diabetes and diabetic neuropathy have multiple beneficial effects and are generally low risk, which makes lifestyle interventions an attractive treatment option. We reviewed the literature on the effects of physical activity and dietary interventions on length-dependent peripheral neuropathy and cardiac autonomic neuropathy in diabetes.
The electronic database PubMed was systematically searched for original human and mouse model studies examining the effect of either dietary or physical activity interventions in subjects with diabetes, prediabetes, or metabolic syndrome.
Twenty studies are included in this review. Fourteen studies were human studies and six were in mice. Studies were generally small with few controlled trials, and there are no widely agreed upon outcome measures.
Recent research
Systematic ReviewPubMedVery High Quality
Clinical Guidelines(21)
Recommendations from medical societies (NICE, AHA, ADA, ACG, Endocrine Society…).
Samson SL, Vellanki P, Blonde L, Hirsch IB, Hoang TD, Isaacs SD · Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2026
This consensus statement provides evidence-based visual guidance in graphic algorithms and a summary of evidence and considerations to assist health care professionals with the diagnosis and management of adults with prediabetes and diabetes mellitus in shared decision making to improve care.
The American Association of Clinical Endocrinology (AACE) selected a task force of medical experts to update the 2023 AACE Comprehensive Type 2 Diabetes Management Algorithm and align this algorithm update with related AACE clinical guidance.
This algorithm for management of adults with type 2 diabetes (T2D) includes 11 sections: (1) Principles for the Management of Adults With T2D; (2) Prediabetes Algorithm (3) Diabetes Classification Algorithm (new); (4) Atherosclerotic Cardiovascular Disease Risk Reduction Algorithm: Dyslipidemia; (5) Atherosclerotic Cardiovascular Disease Risk Reduction Algorithm: Hypertension; (6) Comorbidities- and Complications-Centric Glycemic Control Algorithm; (7) Gluc
Clinical GuidelinePubMed (Practice Guideline)Very High Quality
A total of 37.3 million Americans have diabetes, and 96 million more have prediabetes. Hyperglycemia, the hallmark of diabetes, increases the risk for diabetes-related complications, including skin breakdown and cardiovascular disease. Many clinical practice guidelines exist, but there are gaps regarding the best approaches to assess physical fitness and mobility in adults with diabetes; incorporate exercise into the care plan; and reload the diabetic foot after ulcer closure has occurred to avoid ulcer reoccurrence. The purpose of this clinical practice guideline was to review and assess previously published guidelines and address gaps within the guidelines specific to the following: best screening tools/tests and interventions to prevent a future reulceration, best screening tools and interventions to assess and address mobility impairments, best tools to measure and interventions to address reduced physical fitness and activity, best approach to reloading the foot after ulceration c
Clinical GuidelinePubMed (Practice Guideline)Very High Quality
Díez JJ, Anda E, Bretón I, González-Blanco C, Miguélez M, Zugasti A · Endocrinologia, diabetes y nutricion · 2025
Quality healthcare should be grounded on clinical practice with the highest benefit-risk ratio and cost-effectiveness according to the available scientific evidence. The overuse of unproven diagnostic or therapeutic procedures is common in our setting and leads to increased healthcare spending and even iatrogenic harm. Previous cost-effectiveness initiatives have proposed identifying diagnostic and therapeutic measures that are better 'not done' in certain clinical contexts under the lens of the available scientific evidence. In this regard, the Spanish Society of Endocrinology and Nutrition (SEEN) has compiled a series of 'not-to-do' recommendations from its various working groups. These recommendations cover common clinical situations classified into the following thematic areas: diabetes, nutrition, pituitary gland, neuroendocrine tumors, thyroid, and hormone replacement therapy in postmenopausal women.
Clinical GuidelinePubMed (Practice Guideline)Very High Quality
Fridén M, Rosqvist F, Kullberg J, Berglund L, Vessby J, Martinell M · Nature communications · 2025 · n=150
Polyunsaturated fatty acids (PUFA) have been shown to reduce liver fat compared to saturated fat, but effects of a novel "anti-lipogenic" diet replacing carbohydrates with PUFA (LCPUFA) or a low-fat healthy Nordic diet (HND) rich in whole-grains are unknown. The objective of this study was to investigate the effects of these diets, as compared with usual care (UC), on liver fat (primary outcome) and related glycemic and lipid disorders after 12 months of intervention, in individuals with prediabetes or type 2 diabetes (T2D). A three-arm parallel ad libitum randomized trial was completed in December 2022 (NCT04527965). Outcome assessors and care providers were blinded to participants' diets. Men and women (n=150) with prediabetes or T2D (55%) were randomized in a 1:1:1 allocation ratio, stratified by sex and T2D status, and were assessed at the Uppsala Academic hospital. General linear models were employed to estimate intention-to-treat effects. Liver fat was reduced after the LCPUFA di
Patient education is a crucial strategy for promoting prevention and diabetes self-management since glycemic control achievement involves taking medications, medical nutrition therapy, physical exercise, and behavior changes. However, patient education programs are still barely implemented in low- and middle-income countries. This trial aims to investigate whether a lifestyle education intervention added to physical exercising is superior to sole physical exercising regarding functional capacity, disease-related knowledge, health behaviors, cardiometabolic health parameters, quality of life, depression, and diet quality in individuals with prediabetes or diabetes.
Multicenter double-blinded randomized controlled trial with two parallel arms involving 12-week intervention and 6-month follow-up. The eligible individuals (≥ 18 years, living with prediabetes or diabetes, literate, no clinical decompensation and/or physical and/or mental limitations that contraindicate p
Kawahara T, Suzuki G, Mizuno S, Tominaga N, Toda M, Toyama N · The lancet. Healthy longevity · 2024 · n=1094
Observational studies show inverse associations between serum 25-hydroxyvitamin D concentrations and sarcopenia incidence; however, it remains unclear whether treatment with vitamin D prevents its development. We aimed to assess whether treatment with active vitamin D (eldecalcitol [0·75 μg per day]) can reduce the development of sarcopenia among adults with prediabetes.
This randomised, double-blind, placebo-controlled, multicenter trial as an ancillary study was conducted at 32 clinics and hospital sites in Japan. Participants were assigned (1:1) by using a central randomisation method in which a randomisation list was made for each hospital separately using a stratified permuted block procedure. The primary endpoint was sarcopenia incidence during 3 years in the intention-to-treat population defined as weak handgrip strength (<28 kg for men and <18 kg for women) and low appendicular skeletal muscle index (<7·0 kg/m2 for men and <5·7 kg/m2 for women
Randomized TrialPubMedHigh Quality
Observational Studies(12)
Cohort, case-control, and cross-sectional human studies.
Wu H, Lv B, Zhi L, Shao Y, Liu X, Mitteregger M · Nature medicine · 2025
Type 2 diabetes (T2D) is a complex disease shaped by genetic and environmental factors, including the gut microbiome. Recent research revealed pathophysiological heterogeneity and distinct subgroups in both T2D and prediabetes, prompting exploration of personalized risk factors. Using metabolomics in two Swedish cohorts (n = 1,167), we identified over 500 blood metabolites associated with impaired glucose control, with approximately one-third linked to an altered gut microbiome. Our findings identified metabolic disruptions in microbiome-metabolome dynamics as potential mediators of compromised glucose homeostasis, as illustrated by the potential interactions between Hominifimenecus microfluidus and Blautia wexlerae via hippurate. Short-term lifestyle changes, for example, diet and exercise, modulated microbiome-associated metabolites in a lifestyle-specific manner. This study suggests that the microbiome-metabolome axis is a modifiable target for T2D management, with opt
Zahalka SJ, Akturk HK, Galindo RJ, Shah VN, Low Wang CC · Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2025
Continuous glucose monitoring (CGM) has transformed the care of patients with diabetes, and there is great potential to extend these benefits to prediabetes. The recent US Food and Drug Administration approval of over-the-counter CGMs has increased interest for use in individuals with prediabetes. It is of particular interest to use CGM to guide early individualized lifestyle interventions to prevent the progression of prediabetes to diabetes and support reversion to normoglycemia. In this review, we discuss published evidence regarding CGM metrics in normoglycemia, briefly review the use of CGM to diagnose prediabetes, and review available evidence for CGM use during lifestyle interventions in individuals with prediabetes. Future studies are needed to validate CGM metrics for prediabetes and evaluate effects of early intervention with CGM in this population.
Dimba NR, Mzimela N, Sosibo AM, Khathi A · Nutrients · 2024
A high-calorie diet results in the development of prediabetes (PD) or type 2 diabetes mellitus (T2DM). This diet has been reported to cause changes in microbial composition, concentration levels of glycemic parameters, and immune cells or inflammatory cytokines. This systematic review and meta-analysis aimed to evaluate the effects of prebiotics, as well as Mediterranean and plant-based dietary interventions, on gut microbiota composition and glucose homeostasis in individuals with PD or T2D.
This systematic review and meta-analysis was developed according to the 2020 PRISMA guidelines and checklist. PubMed, EBSCOhost and Google Scholar were the three databases that were used to search for electronically published studies. Data extraction was conducted and examined by the reviewers and all the eligible studies were selected. To test for the quality and biases of the included studies, the Downs and Black checklist was used, followed by the use of Review Manager 5.4. A forest plot was u
This NCCIH fact sheet provides general information about fenugreek, including its traditional uses, potential health benefits, and safety concerns. It notes that some studies suggest fenugreek may help lower blood glucose in people with diabetes, but more research is needed.
The National Center for Complementary and Integrative Health (NCCIH) offers an overview of green tea, detailing its purported health benefits, safety concerns, and what the science says. It discusses research findings related to various health conditions, potentially including metabolic health.
Government SourceNCCIHHigh Quality
Clinical Trial Registries(87)
Registered ongoing or completed trials (ClinicalTrials.gov).
Purpose Phototherapy has an array of potential benefits in human health. The effects of a non-transdermal Fos Biomedical product (which utilizes the concept of phototherapy) on diabetes risk factors and sleep quality in people at risk for type 2 diabetes are unclear. Proposed is a single-blind randomized crossover placebo-controlled trial to assess the impact of daily use of the Fos Biomedical product for a 12-week period on cardio-metabolic risk factors and self-reported sleep quality among adults at risk for type 2 diabetes.
Specific Aims
* To determine the effects of the use of the Fos Biomedical product daily for 12 weeks, as compared to placebo patch, on glycemic control in adults at risk for type 2 diabetes. Specifically, to show that the use of the Fos Biomedical product for 12 weeks, as compared to placebo patch, will improve glycated hemoglobin in adults at risk for type 2 diabetes.
* To assess the effects of the use of the Fos Biomedical product, versus placebo patch, for a 12-week period on insulin sensitivity, serum lipids, C-reactive protein, anthropometric measures, self-reported sleep quality, and endothelial function in adults at risk for type 2 diabetes. Specifically, to show clinically meaningful improvement or neutral effects in insulin sensitivity, serum lipids, C-reactive protein, anthropometric measures, self-reported sleep quality, and endothelial function in adults at risk for type 2 diabetes.
* To assess the impact of Fos Biomedical product on liver function and kidney function in adults at risk for type 2 diabetes
Hypotheses
* Daily use of the Fos Biomedical product for 12 weeks will improve glycated hemoglobin in adults at risk for type 2 diabetes.
* Daily use of the Fos Biomedical product for 12 weeks will improve or have neutral effects on insulin sensitivity, serum lipids, C-reactive protein, anthropometric measures, self-reported sleep quality and endothelial function in adults at risk for type 2 diabetes.
* The use of the Fos Biomedical product will have no clinically meaningful adverse effects on liver function and kidney function in adults at risk for type 2 diabetes.
Clinical TrialClinicalTrials.govModerate Quality
Evidence Summaries(1)
Curated cross-source summaries (TRIP Database and similar).
The Cochrane Library provides high-quality, independent evidence to inform healthcare decision-making, offering systematic reviews on interventions for prediabetes.
Evidence SummaryCochraneHigh Quality
Working alongside conventional care
Conventional medical care for prediabetes primarily focuses on intensive lifestyle intervention programs, often including dietary changes and increased physical activity. In some cases, medication like metformin may be prescribed, especially for individuals at very high risk of developing type 2 diabetes, those with a history of gestational diabetes, or those with a higher BMI. Regular monitoring
This information is for educational purposes only and should not be considered medical advice. Prediabetes requires professional medical diagnosis and management. Always consult with a qualified healthcare provider before making any decisions about your health or treatment plan, especially if you ar
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