How many people with prediabetes actually develop diabetes?

This is an excellent and very common concern.

Prediabetes is not diabetes, but it is an early warning stage. What happens next depends largely on what is done during this phase.

What exactly is prediabetes?

Prediabetes means:

• Blood sugar levels are higher than normal.
• But not high enough to be labeled diabetes.

In simple terms:

• The body is starting to struggle with insulin, but permanent damage has not yet occurred.
• That is why this stage is partly reversible, especially when caught early.

How many people with prediabetes develop diabetes?

If no lifestyle changes are made.

Studies across different countries show that:

• About 5-10% of people with prediabetes develop diabetes every year.^{[2, 4, 3]}
• Over time.
• 25-30% develop diabetes within 3-5 years.^{[4, 6]}
• Up to 70% may develop diabetes at some point in their lifetime.

These figures are broadly consistent across large cohort studies, though exact risk varies by age, ethnicity, and how prediabetes is defined.

If lifestyle changes are made

Strong scientific evidence shows that:

• Losing 5-7% of body weight.
• Doing regular physical activity (about 150 minutes per week).

can:

• Reduce the risk of diabetes by about 50-60% in high‑risk people with impaired glucose tolerance.^[2]
• Delay diabetes for many years.
• In some people, prevent diabetes altogether during long‑term follow‑up.

This is why lifestyle changes are strongly recommended at the pre-diabetes stage.

Why do some people progress and others don’t?

Higher risk if:

• Weight continues to increase.
• Physical activity is low.
• There is strong family history of type 2 diabetes.
• There is a history of gestational diabetes, PCOS, fatty liver, or poor sleep.
• Follow-up is ignored because sugars are “only borderline”.

Lower risk if:

• Even modest weight loss is achieved.
• Physical activity is regular.
• Sleep and stress are addressed.
• Follow-up testing is done regularly.

Is prediabetes the same as early diabetes?

No.

Think of it this way:

• Prediabetes = warning stage
• Diabetes = established disease

Pre-diabetes means the condition is not fixed yet, but action is needed.

Simple takeaway for patients

• Prediabetes does not mean diabetes is inevitable.
• Ignoring it greatly increases the risk.
• Early lifestyle changes are often more powerful than medicines in this stage.
• Regular monitoring is essential, even if numbers improve.

Early action gives long-term protection.