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10 November 2025

•

3 minute read

Reversing Prediabetes

By Dr. Ting Pey Woei

Patinets are often surprised when told that they have prediabetes. Some feel relieved that it is “not yet diabetes”, while others are uncertain about what prediabetes really means. Despite the fact that prediabetes is not a harmless condition, it offers a crucial opportunity — to take timely action so that diabetes can be prevented.

What Is Prediabetes?

Prediabetes occurs when blood sugar levels are higher than normal, but not yet in the range of diabetes. It signals a stage of increased risk, just like a yellow traffic light — a clear signal that changes are needed before the condition results in diabetes. 

Doctors typically diagnose prediabetes using the following tests:

→ Fasting blood glucose: 5.6 to 6.9 mmol/L

→ Two-hour glucose test after a sweet drink: 7.8 to 11.0 mmol/L

→ HbA1c (average sugar over 3 months): 5.7% to 6.4%

Values above these thresholds indicate diabetes.

Can Prediabetes Be Reversed?

Yes. The encouraging fact is that prediabetes does not always result in diabetes. With appropriate lifestyle changes, a lot of individuals have been able to return their sugar levels to the normal range. While this does not mean one is permanently “cured”, it demonstrates that diabetes is not inevitable.

In clinical practice, I have witnessed a lot of patients who have successfully reversed prediabetes through consistent lifestyle adjustments. The earlier action is taken, the greater the likelihood of preventing diabetes.

Most Effective Lifestyle Changes

The following strategies have been shown to be most effective:

→ Weight management – Losing even 5–7% of body weight (for example, 4–5kg if one weighs 70kg) significantly reduces the risk of diabetes.

→ Healthy eating patterns – Emphasise on vegetables, fruits, whole grains, legumes, fish and lean protein. Reduce sugary drinks, refined carbohydrates such as white bread and cakes, and processed foods.

→ Physical activity – Aim for at least 150 minutes of moderate exercise per week, such as brisk walking, cycling or swimming. The key is consistency and choosing an enjoyable activity.

→ Avoid smoking and limit alcohol – Both worsen blood sugar control and increase the risk of cardiovascular diseases.

Why Lifestyle Interventions Matter Most

Researches from large international trials, supported by local findings, has consistently shown that lifestyle changes are more effective than medication in preventing diabetes among those with prediabetes. Lifestyle intervention can reduce the risk of diabetes by nearly half. The foundation of diabetes prevention remains in lifestyle modification.

Recognising Warning Signs

Most individuals with prediabetes have no symptoms. However, as sugar levels rise, one may experience excessive thirst, frequent urination, persistent fatigue, blurred vision and unexplained weight loss.

Even without symptoms, screening is important, especially for those who are overweight, above 35 years old and have a family history of diabetes, high blood pressure, obesity or abnormal cholesterol.

Patients are encouraged to keep track of their results, as seeing measurable progress is often motivating.

Meas­ur­ing Pro­gress

The best way to know whether life­style changes are work­ing is through blood tests. Improve­ments after going on a gluc­ose fast as indic­ated on a HbA1c are clear signs that efforts of life­style changes are pay­ing off.

Patients are encour­aged to keep track of their res­ults, as see­ing meas­ur­able pro­gress is often motiv­at­ing.

Beyond Diet and Exercise

Other lifestyle factors also play a crucial role:

→ Sleep: Poor or insufficient sleep increases insulin resistance. Aim for seven to nine hours of quality sleep.

→ Stress management: Chronic stress elevates hormones that raise blood sugar. Relaxation techniques, mindfulness, prayer or simple hobbies can help.

→ Abdominal obesity: Excess fat around the waistline is particularly harmful. Aiming for a healthier waist circumference lowers risk.

Role of Family History

A family history of diabetes increases risk, but it does not make diabetes unavoidable. Genetics may create a predisposition, but lifestyle largely determines the outcome.

By maintaining a healthy weight, staying active and eating healthily, a lot of people with strong family histories of diabetes have remained well throughout life.

Why This Should Matter to Malaysians?

The National Health and Morbidity Survey 2023 reported that 15.6% of Malaysian adults live with diabetes, many of whom are undiagnosed. Should prediabetes be included, the figures are even more concerning, indicating that millions of Malaysians are at risk. Yet, the hopeful message is that a large proportion of these cases could be prevented through early detection and simple lifestyle changes.

Final Thoughts

Prediabetes should not be viewed as a minor or temporary issue. Instead, it is a valuable warning signal and — more importantly — a window of opportunity.

If you have been told that you have prediabetes, take it seriously — while staying rooted in positivity. It is not too late. Through balanced nutrition, regular physical activity, adequate sleep, and effective stress and weight management, you can prevent diabetes and safeguard your long-term health.

Small, consistent lifestyle changes made today can prevent a lifetime of complications tomorrow. The power to prevent diabetes truly lies in your hands.

This article first appeared in Pressreader, 10 November 2025.

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10 November 2025

•

3 minute read

Reversing Prediabetes

By Dr. Ting Pey Woei

Dr. Ting Pey Woei

Internal Medicine

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