What is the difference between prediabetes and diabetes?

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Prediabetes and diabetes sit on one continuum of blood sugar regulation, separated by lab thresholds, and the differences that matter are three. The numbers: prediabetes is A1c 5.7 to 6.4 percent or fasting glucose 100 to 125 mg/dL; diabetes is A1c 6.5 or higher, fasting 126 or higher, or a 2-hour glucose tolerance test of 200 or higher, per NIDDK. The reversibility: prediabetes responds to lifestyle change strongly enough that the landmark prevention study cut progression by 58 percent with diet and exercise - better than metformin; established diabetes can be managed into remission for some, but the earlier the intervention, the better the odds. The damage: the organ harm of diabetes - eyes, kidneys, nerves, vessels - tracks with time spent above the line, which is why the prediabetes years are the highest-leverage window in all of chronic disease.

One nuance: prediabetes is not pre-problem. It signals insulin resistance already underway, and it raises cardiovascular risk even before the diabetes line - worth treating as a condition, not a warning label.

The practical posture: a prediabetes result earns a real program - the structured diabetes prevention programs have the strongest evidence - plus yearly re-testing. A diabetes result earns a care team, not a lecture. Both are conversations worth having early, because the curve is still shapeable.

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What is the difference between prediabetes and diabetes?

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