Will I Develop Type 2 Diabetes If I Have Prediabetes?

So you got the lab results, saw the word “prediabetes” and now there’s one question running on repeat through your mind: is type 2 diabetes (T2D) inevitable?

It’s a fair question, and it’s usually the first one people ask.

The honest answer that most people don’t like to hear is: it depends. Prediabetes means your blood sugar is running higher than the target range, but not high enough yet to cross into T2D territory. What happens from here isn’t fixed in stone. Some of it is out of your hands, but a surprising amount of it isn’t.

More than 2 in 5 U.S. adults have prediabetes, according to the CDC, and most of them don’t even know it yet. You’re not alone on this journey, and you’re not the only one asking this important question about your health.

Getting information means having awareness you can act on, so you’re already taking a powerful step by getting curious today.

What’s actually happening in your body when you have prediabetes

Two things are usually going on when you have prediabetes, and understanding them explains a lot about why the odds shift the way they do.

The two things that are usually happening when someone is diagnosed with prediabetes are:

• Insulin resistance: insulin’s job is to unlock your cells so blood sugar can get in and become energy. When your cells stop responding to that key the way they used to, your pancreas compensates by pumping out more and more insulin just to keep up.
  
• Wear on the pancreas: Push it hard enough for long enough, and it starts making less insulin than your body actually needs. 

Sometimes these two problems show up together, or just one shows up at a time. Either way, neither is a life sentence. You can slow them down, stall them out or even reverse them through forming new habits that benefit your health.

The diabetes risk factors you can’t change

Some of what shapes your odds has nothing to do with willpower. And while this can feel defeating to hear, it’s also a wake-up call that shame and blame will get you nowhere. Factors like genetics or other circumstances don’t always play fair. Unfortunately, that’s just the way diabetes goes sometimes.

Factors outside of your control may include:

• Age
• Family history
• Race or ethnicity

Among the factors you can’t do much about! National screening guidelines have shifted to reflect it. The American Diabetes Association now recommends adults start getting screened at 35 instead of 40, because risk climbs earlier than  healthcare providers (HCPs) used to assume. 

Factors that are simply part of your biology or history and influence your prediabetes risk include:

• A parent or sibling with T2D
• Being Black, Latinx, Native American, Alaska Native, Asian American or Pacific Islander
• A history of gestational diabetes during a pregnancy
• A history of polyendocrine metabolic ovarian syndrome (PMOS)
• Being physically inactive
• Waist size and weight
• Smoking
• A cardiovascular disease (CVD) diagnosis
• Giving birth to a baby weighing more or less than the baby’s target birth weight 
• History of gestational diabetes
• High blood pressure (130/80 mmHg or above) or being treated for high blood pressure
• HDL cholesterol level below 0.9 mmol/L (35 mg/dL) or a triglyceride level above 2.8  mmol/L (250 mg/dL)
• People in high-risks groups (for example, those living with HIV)
• People taking high-risk medicines including certain medications that are diuretics,, treat cancer, HIV or manage mental health, 
• People with periodontal (gum) disease
• People with a history of pancreatitis

None of that is your fault or is a fault in and of itself. None of it guarantees anything either—genetics set the stage, but what you do afterward still has a lot of say in how the story goes. Genetics give you information you can act on.

3 important lifestyle habits that move the needle in your favor

This is the part you can control, and it carries more weight than people expect. 

There are three important habits you can start building today to help slow down the progression of prediabetes into T2D:

1. Build a well-rounded nutrition plan: a lifestyle that focuses heavily on processed and sugary foods forces your body to release more insulin just to keep blood sugar steady, and that extra strain is exactly what wears the pancreas down and makes it work overtime. Eating in a way that leads to ongoing weight gain also worsens insulin resistance. Incorporating whole foods and making sure your plate is balanced goes a long way. Read our guide on eating well with prediabetes here to move the needle in your favor.
2. Incorporate movement you enjoy: getting regular physical activity pulls the needle in the opposite direction. It helps with weight loss and management, of course, but it also makes your muscle cells better at using the insulin you’ve already got, so your body doesn’t have to work as hard to do the same job. The CDC’s baseline target is 150 minutes of moderate activity a week. Sounds like a lot until you break it into something like a 30-minute walk most days. And remember: you can’t out-exercise poor nutrition habits! Both work together in harmony to help you improve your overall health. Try different exercises until you find something you enjoy, as this can make regular activity feel much more manageable. You might even trick your brain into thinking you aren’t moving your body at all.
3. Reduce your stress: your emotional and mental wellbeing really matter, even though it’s often overlooked. An abnormal amount of stress triggers hormones like cortisol, which can raise your blood sugar levels and make your insulin resistance worse. Sleep, movement or even just naming what’s stressing you out can help you start reducing your stress. Talking to a mental health professional with experience in diabetes is also a good option.

Start with small steps to make changes that last

None of this requires an overhaul. Doing too much at once can lead to burnout. Make small changes over time to make sure they stick.

Here are a few places you can start:

• Walk for 15 to 20 minutes after your biggest meal of the day
• Swap sugary drinks for water most days
• Ask your HCP whether a National Diabetes Prevention Program (National DPP) class is available near you
• If weight management is part of your goals, aim for a weight loss of 5 to 7% of your current weight
• Get screened if you’re 35 or older, or earlier if any of the risk factors above apply to you

Pick one. See how it feels for a week or two. Add another when it does.

Prediabetes programs and support options worth looking into

You don’t have to figure this out solo. The National DPP is a yearlong, CDC-backed program that teaches practical food and movement habits in a group setting, and it’s not just a nice idea—research shows people who complete it cut their risk of developing T2D by more than half. Losing just 5 to 7% of your body weight, on its own, can meaningfully shift your odds too!

For some people, doctors also bring up metformin. Current American Diabetes Association (ADA) guidance, laid out in its 2026 Standards of Care, supports it as an option for adults at higher risk, especially when lifestyle changes alone aren’t moving the needle enough. It’s a conversation worth having with your HCP, not something to chase down on your own.

When you should get screened for other types of diabetes

Prediabetes itself usually has no symptoms, which is exactly why screening matters more than waiting to feel something. But if you ever notice excessive thirst, frequent urination, exhaustion that won’t let up or unexplained weight loss, that’s worth a call to your HCP right away. Don’t ignore those symptoms! They could mean something more serious is brewing in your body.

What if it turns into type 2 diabetes anyway?

Say the odds don’t go your way. That’s not the end of the story (or end of the world) either. T2D can be managed, and plenty of people find ways to ease their symptoms substantially or even reach remission with the right mix of care, medication, tools, devices and habits. A prediabetes diagnosis you caught early is a head start, not a failure or an inevitable conclusion of T2D.

Prediabetes can be a challenging diagnosis. It can be hard to accept, but the good news is—especially if it’s caught and managed early—that there’s a lot you can do about it!

Beyond Type 1’s #SeeTheSigns campaign exists for exactly this moment. It’s designed to help people recognize early, often-missed warning signs and get a simple blood sugar check before things escalate. Take a look, and pass it along to anyone in your life who might need a nudge.