Prediabetes, Type 2 Diabetes and Metabolic Syndrome

Overview

These three terms describe overlapping patterns of how the body handles blood sugar (glucose), blood pressure and blood fats. They often have no symptoms, so testing matters. This page is educational. It cannot tell you whether you have any of them, and it does not replace care or change any prescribed medicine.

What each term means

How common and how found

In 2021, about 97.6 million US adults had prediabetes. [1] People with prediabetes usually have no symptoms. [1] Blood tests find it: an A1C result of 5.7% to 6.4% or a fasting plasma glucose of 100 to 125 mg/dL suggests prediabetes. [1] NHS says metabolic syndrome is usually found after a blood test or check-up, and a doctor will check BMI and waist size, blood pressure, blood glucose and blood fats. [4] Type 2 diabetes symptoms can develop slowly over several years, and many people have none or very mild ones. [2]

What the evidence shows about weight and lifestyle

• Weight loss and diabetes prevention (established). In the Diabetes Prevention Program, people at high risk who joined a lifestyle program (aiming for 7% weight loss and 150 minutes of exercise a week) lowered their chances of developing type 2 diabetes by 58% over about 3 years compared with placebo; metformin lowered it by 31%. [5] NIDDK says losing 5% to 7% of starting weight helped reduce chances of developing the disease. [1] Follow-up showed the benefit lasted at least 15 years. [5]
• Lifestyle basics (established recommendation). NHS advises for metabolic syndrome: lose weight if overweight, eat less saturated fat and more fruit, vegetables and whole grains, aim for at least 150 minutes of moderate to intense exercise a week and cut down or stop smoking. [4] NIDDK lists healthy foods and drinks, physical activity, weight management and enough sleep as healthy living for prediabetes. [1]
• Intensive weight loss and remission (promising, specialized). In the DiRECT trial in Scotland and England, adults diagnosed with type 2 diabetes in the past 6 years who were offered a primary care-led program of total diet replacement, stepped food reintroduction and long-term support had diabetes remission at 12 months in 46%, versus 4% with best-practice care. [6] The program also began with withdrawing diabetes and blood-pressure medicines, so it is a clinician-led approach and should not be tried alone. [6]
• Medicines. Health care professionals may also prescribe medicines to help manage blood glucose, lose weight or prevent type 2 diabetes. [1] Some diabetes medicines such as insulin and sulfonylureas can contribute to weight gain. [7] Never stop or change a diabetes medicine on your own because of weight; see Medicines that can change weight.

Supplements and "natural" approaches

This page does not review supplements for blood sugar, so it makes no claims about them. They are not a substitute for testing and care. If you take diabetes medicines, ask your pharmacist or clinician before adding herbs or supplements: see How interactions work.

When to get help

Ask about testing if you have risk factors. NIDDK says clinicians may test if you are 35 or older, or have overweight or obesity plus other risk factors. [1] Common diabetes symptoms include increased urination and feeling very thirsty; talk to a clinician about any symptoms you have. [2] NHS advises seeing a GP if you think you are at risk of metabolic syndrome. [4] Related: Overweight and obesity: health context and Healthy weight basics.