By Dr Chandrakant Lahariya, Senior Consultant Physician, Pacific OneHealth, Lajpat Nagar

You open your blood test report. Your fasting blood sugar and HbA1c – the three-month sugar levels – are higher than normal. This is not diabetes yet, your doctor says. You ask a friend and he says, “It’s only borderline. Don’t worry.”

So, you put the report away. You promise yourself you will eat better from Monday, walk more when work gets less hectic and repeat the test sometime next year.

But what if this “borderline” result is the most useful warning your body has given you?

Prediabetes means your blood glucose is higher than normal, but not yet in the range used to diagnose type 2 diabetes. It usually causes no obvious symptoms. You can feel perfectly well, go to work, eat out and carry on with life without realising that your risk is rising.

Prediabetes is not diabetes. But it is not a harmless result either.

It is an opportunity to act before blood sugar rises further. And for many people, that opportunity can be significant.

The first step is to understand your numbers. A doctor may use a fasting blood glucose test, Two hour post breakfast sugar test, HbA1c- or an oral glucose tolerance test, depending on your situation. HbA1c gives an indication of average blood glucose over roughly the previous three months. A single result should always be interpreted in the context of your health and, where appropriate, confirmed with repeat testing.

What can you do if you have prediabetes?

You do not need to transform your life overnight  but you need to modify your lifestyle in a way which is healthy and sustainable for long term. In fact, dramatic plans that last only a week are less useful than small changes you can sustain.

Start with these:

1. Move after meals. A short walk after lunch or dinner is a practical way to add activity to your day. Build towards at least 150 minutes of moderate physical activity a week, preferably 300 minutes in a week. 30 to sixty minutes of walk every day, at least five days a week is recommended. You can do this in various spurts of 10 min each after breakfast, lunch and dinner or in any combination.
2. Rethink your plate. You do not necessarily have to give up every food you enjoy. Pay attention to portions, include vegetables and protein, choose high-fibre foods more often and reduce sugary drinks and frequent refined-carbohydrate snacks. Ensure half of your plate has fruits, salads and green leafy vegetables. The refined carbohydrates and free sugars need to be removed.
3. Look beyond the weighing scale. If you carry excess weight, even a modest, sustained reduction can help lower diabetes risk. Waist measurement, blood pressure and cholesterol also matter. Know your optimal weight and try to achieve that. If overweight or obese, even 7 to 10% of weight reduction from your current weight can help in reducing diabetes and other metabolic health issues.
4. Take sleep and routine seriously. Irregular sleep, long sedentary hours and chronic stress can make healthy habits harder to maintain. Work on a routine that is realistic for your life.
5. Follow up. Prediabetes needs monitoring. Your doctor can advise when to repeat blood tests and whether you need additional assessment for blood pressure, cholesterol or other risk factors. Some people may also benefit from medication, depending on their individual risk.

Research from structured diabetes-prevention programmes has shown that lifestyle changes—including modest weight loss where appropriate and regular activity—can substantially reduce the likelihood of developing type 2 diabetes. The exact benefit varies from person to person; prevention is not a guarantee.

The most important thing is not to treat the word “borderline” as permission to do nothing.

At Pacific OneHealth, preventive medicine and cardio-metabolic care focus on identifying risks early and helping people make changes they can actually sustain. Dr Chandrakant Lahariya’s approach is centred on a simple principle: understand your risk, act on it and keep track of your progress.

Your report has not given you a reason to panic. It has given you a reason to start. Don’t wait for the next report to say diabetes. We will bring a right balance of minimum medicines and maximum benefits with suitable advice on improving your lifestyle. That will ensure you stay healthy.

(The author is a Senior Consultant Physician, Preventive Medicine & Cardio-Metabolic Health, Pacific OneHealth, Lajpat Nagar, New Delhi.)