What is the difference between prediabetes and diabetes?

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. Pymander is a free AI doctor, 24/7 by text. Share your numbers, and it can help you understand where you sit and what changes it.