How to reverse prediabetes, according to a board-certified clinician

As a board-certified clinician with a background in obesity medicine, I’ve seen firsthand the importance of addressing prediabetes early. 

Prediabetes is a condition where blood sugar levels are higher than normal but not yet high enough to be classified as type 2 diabetes. The good news? It can be reversed. 

Rates of success improve particularly when lifestyle changes are supported by a comprehensive program like Calibrate’s—where, notably, 78% of members with prediabetes or diabetes normalized their hemoglobin A1c levels within 12 months (see report). 

In this article, I’ll walk you through the steps to reverse prediabetes and prevent the progression to type-2 diabetes based on medical evidence.

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Understanding prediabetes

Prediabetes is more common than many people realize—millions of Americans are affected, and most don’t even know they have it. 

Left untreated, prediabetes often leads to type 2 diabetes, significantly increasing your risk of heart disease, stroke, and other complications. However, with the right interventions, you can lower your blood sugar and reverse prediabetes before it becomes diabetes.

Symptoms of prediabetes

One of the challenges with prediabetes is that it often presents with no noticeable symptoms. Many people with prediabetes feel healthy and are unaware of their elevated blood sugar levels until they undergo routine blood tests. 

However, some may experience subtle symptoms such as:

• Increased thirst
• Frequent urination
• Fatigue
• Blurred vision. 

These signs can be easy to overlook but may indicate that blood sugar levels are higher than normal.

How is prediabetes diagnosed?

Diagnosing prediabetes typically involves a simple blood test. The three most common diagnostic tests are:

1. The A1c test, which measures average blood sugar levels over the past three months
2. The fasting plasma glucose test (FPG), which measures blood sugar after an overnight fast
3. The oral glucose tolerance test (OGTT), which checks how your body processes sugar over a two-hour period after drinking a glucose solution

An A1c level between 5.7% and 6.4% or a fasting blood glucose level between 100 and 125 mg/dL are common indicators of prediabetes. Early diagnosis with a plan to treat is key to preventing progression to type 2 diabetes.

How long does it take to reverse prediabetes?

As a clinician, I’m often asked how long it takes to reverse prediabetes. The answer depends on several factors, including your starting point, your commitment to lifestyle changes, and your body’s response to interventions like diet, exercise, and weight loss.

For some, significant improvements in blood sugar levels can be seen in as little as a few weeks, while others may take longer. The key is consistency in adopting healthy habits.

Again, as illustrated in our 2024 Member Results Report, 78% of Calibrate members with prediabetes or diabetes normalized their hemoglobin A1c levels within 12 months. 

Steps to reverse prediabetes

1. Prioritize weight loss

One of the most effective ways to reverse prediabetes is to lose weight. Even modest weight loss—5-7% of your body weight—can significantly lower blood sugar levels and improve insulin sensitivity. 

At Calibrate, we combine FDA-approved GLP-1 medications like Zepbound® (tirzepatide) and Wegovy® (semaglutide) with a curriculum focused on comprehensive lifestyle interventions to help our members lose weight sustainably.

Members who engage in our Metabolic Reset program typically lose over 16% of their body weight in the first year​. This kind of sustained weight loss has a profound impact on blood sugar regulation.

2. Eat balanced, nutrient-rich meals

Food plays a crucial role in reversing prediabetes. Focus on a whole-food, nutrient-dense diet rich in fiber, healthy fats, lean proteins, and complex carbohydrates. Here are some general dietary guidelines I recommend:

• Increase fiber intake: Fiber slows the absorption of sugar and improves blood sugar control. Opt for fruits, vegetables, whole grains, and legumes.
• Choose lean proteins: Proteins from sources like fish, chicken, tofu, and legumes can help stabilize blood sugar.
• Limit refined sugars and processed foods: These can cause rapid spikes in blood sugar and exacerbate insulin resistance.

At Calibrate, we see that members who adopt these changes report a 69% improvement in their food habits​ (see report).

3. Exercise regularly

Physical exercise is essential for reversing prediabetes. It helps muscles use glucose more efficiently, reducing blood sugar levels. 

You don’t need to go extreme, like signing up for a marathon or investing in a personal trainer. I simply recommend aiming for at least 150 minutes of moderate exercise per week, such as brisk walking, swimming, or cycling (which translates to 30 minutes, 5 days a week). Resistance training is also beneficial in improving insulin sensitivity. 

In our program, members who incorporate regular exercise see significant metabolic improvements. Again, you don’t need to start with intense workouts; even small, consistent changes can lead to meaningful progress within 30 days.

4. Improve sleep quality

Poor sleep is linked to insulin resistance and higher blood sugar levels. Aim for 7-9 hours of quality sleep each night to support metabolic health. 

Inadequate sleep has been shown to worsen blood sugar control, making it harder to reverse prediabetes. Members of Calibrate report a 38% improvement in sleep after participating in the program (see report).

5. Manage emotional health

Stress and emotional health play a significant role in blood sugar levels. Chronic stress can increase cortisol, a hormone that raises blood sugar. Incorporating mindfulness techniques, such as meditation, yoga, or deep breathing exercises, can help manage stress.

The Calibrate program includes 1:1 accountability coaching that supports members not just in diet and exercise, but also in emotional well-being, ensuring a holistic approach to reversing prediabetes.

How to reverse prediabetes naturally in 30 days

While reversing prediabetes fully in 30 days may not be realistic for everyone, significant progress can be made with intense lifestyle changes. In the first 30 days, focus on:

• Cutting out sugary beverages: Replace sodas and sugary drinks with water, herbal teas, or black coffee.
• Eating a high-fiber breakfast: A breakfast rich in fiber and protein helps stabilize blood sugar for the rest of the day.
• Incorporating daily exercise: Aim for 30 minutes of exercise each day. Even a brisk walk can make a difference.
• Getting quality sleep: Make sleep a priority by establishing a consistent bedtime routine and avoiding screens before bed.

Can you reverse prediabetes permanently?

The key to reversing prediabetes permanently lies in sustaining the healthy habits that helped lower your blood sugar in the first place. 

Prediabetes can return if old habits—such as poor diet or inactivity—are resumed. Calibrate’s long-term approach to weight loss, combining GLP-1 medications and intensive lifestyle interventions (ILI), prioritizes sustained results so that the changes you implement during the program are easy to maintain, even after you graduate.  

Even after tapering off medications, 92% of Calibrate members maintained at least 10% of their weight loss six months post-taper, showing that lifestyle changes play a crucial role in maintaining metabolic health (see report).

Reversing prediabetes: Key takeaways

Reversing prediabetes is not only possible—it’s within reach for many people who commit to the right lifestyle changes. The key is to take a comprehensive, sustained approach to weight loss, food choices, exercise, sleep, and emotional health. 

While results may take time, significant improvements can often be seen within three months, and even more progress is possible within a year.

At Calibrate, our program’s combination of GLP-1 medication, coaching, and intensive lifestyle intervention has helped many of our members successfully reverse prediabetes. If you’re looking for a medically-guided, sustainable way to improve your metabolic health, consider learning more about your eligibility for membership.

Ready to take the first step? Join Calibrate today and start your journey to lasting, sustainable weight loss.

Sources:

American Diabetes Association. "Diagnosis." Diabetes Care 37, no. 1 (2014): S81-S90. https://doi.org/10.2337/dc14-S081. 

Calibrate Health. "Prediabetes and Diabetes." Last modified August 17, 2022. https://www.joincalibrate.com/resources/prediabetes-and-diabetes.

Calibrate Health. "How to Lower A1c & Improve Metabolic Health." Last modified June 28, 2023. https://www.joincalibrate.com/resources/how-to-lower-a1c--improve-metabolic-health.

Calibrate Health. "Understanding Diabetes and Metabolic Health." Last modified March 14, 2023. https://www.joincalibrate.com/resources/understanding-diabetes-and-metabolic-health.

Calibrate Health. 2024 Results Report. Calibrate Health, 2024. https://www.joincalibrate.com.

Douglass, David, et al. "The Diabetes Prevention Program (DPP): Description of Lifestyle Intervention." Diabetes Care 25, no. 12 (2002): 2165-2171.

Knowler, William C., et al. "Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin." New England Journal of Medicine 346, no. 6 (2002): 393-403. https://doi.org/10.1056/NEJMoa012512.