*Source: https://www.years.co/en/praediabetes-was-tun* The finding where acting demonstrably works # My doctor says prediabetes, what can I do now? Prediabetes is a risk constellation, not a disease, and in many cases reversible. It is also one of two areas where randomised trials show that a finding from early detection genuinely changes the outcome. Free intro call Book appointment ~50 % fewer new cases with a structured programme 2 randomised trials with matching results 3 measurement routes: fasting glucose, HbA1c, OGTT The short answer ## The finding is an opportunity, not a verdict Prediabetes describes a glucose metabolism that deviates measurably from the reference range without meeting the criteria for diabetes. A proportion of those affected never develop diabetes. What matters is what follows the finding: two randomised trials show consistently that a structured lifestyle programme roughly halves the number of new cases compared with the control group. What those trials tested was not advice but a supported programme over years. That distinction is the entire difference between a value in a report and a change in the trajectory. The order ## Four steps after the finding - 1 ### Have the finding interpreted Prediabetes is not a single state. A borderline HbA1c means something different from clearly impaired glucose tolerance in an oral glucose tolerance test. Which value was abnormal and how far it sits from the reference range determines the urgency. - 2 ### Look at the accompanying values Fasting insulin and the HOMA index calculated from it show whether insulin resistance is already present. Liver values and liver ultrasound show whether fatty liver has developed, which frequently occurs alongside. Only together do they give a picture from which something can be derived. - 3 ### A structured programme, not isolated resolutions The trials behind this statement did not test general advice but structured programmes with dietary change, regular exercise and ongoing support over years. The difference between "more exercise" and a supported programme is exactly the difference those trials measured. - 4 ### Track the trajectory A single value says little, the direction says a lot. A repeat after some months shows whether what you are doing is working. Without that second measurement it stays open whether the change is enough. The other question ## Can I prevent diabetes through early diagnostics? For type 2 diabetes this is as well evidenced as in almost any other area of prevention. The two central trials examined exactly the situation in question: people with impaired glucose tolerance, that is, a finding from early detection. They received either a structured programme or the control condition, and in both studies the number of new cases in the programme group was roughly half. That closes the full chain: the finding leads to an intervention, and the intervention changes the outcome. That is the highest level of our claim ladder, and here it is reached — unlike most of the procedures discussed in prevention. ## Frequently asked questions Can I prevent diabetes through early diagnostics? + For type 2 diabetes this is as well evidenced as in almost any other area of prevention, and the reason is the trial evidence: two large randomised studies, the US Diabetes Prevention Program and the Finnish Diabetes Prevention Study, examined exactly the situation in question. Participants with impaired glucose tolerance, that is, a finding from early detection, received either a structured lifestyle programme or the control condition. In both trials the number of new cases in the programme group was roughly half. The finding was the trigger, the intervention the effect — the measurement alone would have changed nothing. What does prediabetes mean exactly? + Prediabetes describes a glucose metabolism that deviates measurably from the reference range without meeting the criteria for diabetes. It is captured through fasting glucose, HbA1c as a long-term value, or the oral glucose tolerance test, which measures the response to a defined amount of sugar. The three methods measure different aspects and do not always agree. The interpretation matters: prediabetes is a risk constellation, not a disease, and in many cases it is reversible. A proportion of those affected never develop diabetes. My doctor says prediabetes — what can I do now? + The first step is to have the finding interpreted: which value was abnormal, how far off it was, and what the accompanying values such as fasting insulin, HOMA index and liver values say. That determines how urgent it is. What worked in the trials was not a single piece of advice but a structured programme over years: dietary change, regular exercise and support that tracks the trajectory. A website cannot give an individual recommendation, that belongs in a medical consultation — but the direction is well evidenced. Which tests belong with prediabetes? + Beyond the abnormal value, fasting insulin and the HOMA index are informative, because they show whether the pancreas is already keeping glucose normal through increased insulin output. An oral glucose tolerance test captures the response to a challenge and detects disturbances that stay invisible in a fasting value. Liver values and liver ultrasound belong with it, because fatty liver and insulin resistance frequently occur together, as do blood pressure and lipid profile, because cardiovascular risk shifts in parallel. At YEARS these values run together within the programme on a single day. Sources - Lifestyle programme in impaired glucose tolerance, Diabetes Prevention Program Knowler et al., N Engl J Med 2002 - Lifestyle programme in impaired glucose tolerance, Finnish Diabetes Prevention Study Tuomilehto et al., N Engl J Med 2001 ## Read on The framework for this answer and the values that belong with it. What prevention can prevent Four disease areas along the same five-level ladder. Heart disease and early detection The second area with a fully evidenced chain. Blood values and biomarkers Which markers run within the programme, including glucose metabolism. Always tired, everything normal The common causes that slip through a standard panel. Our evidence classification The tiers this page refers to. Health check Berlin The programme where these values come together on a single day. ## You have a finding and are unsure how urgent it is? 15 minutes, free of charge. Bring it along. We will also tell you when your GP is the right next step for you. Free intro call (15 min) Reserve appointment ★ 4,9 · 71+ Google- reviews · PKV, Beihilfe & bKV reimbursable Medical Disclaimer This information is provided for general education and is not a substitute for professional medical advice, diagnosis or treatment. Please discuss findings and individual medical decisions with a qualified physician. Content is reviewed periodically against the current state of scientific evidence.