LogoSam
Part of the series: Living with Prediabetes →
10 min readSanoLabs Editorial

Prediabetes: what to do next after your result

Prediabetes, what to do now? Repeat tests, who looks after you, what the ADA and NHS recommend, prevention courses and when to see a doctor sooner.

prediabetesborderline diabetesdiabetes preventionblood sugardoctor appointment
On this page

A lab report or your doctor has just said "prediabetes", and you want to know what happens now. Usually it is a conversation, maybe a repeat test and a date for the next check. Keep the report in a folder or in Sam's Health Vault, which, with your consent, reads HbA1c and glucose from a lab report you add and shows up to three values that changed most between your last two reports.

This article covers the path after the result: the label, the repeat test, guidelines and when not to wait. The numbers themselves and how often to retest are in Prediabetes HbA1c: what your results mean. What Sam keeps for prediabetes is on the prediabetes page.

What does a prediabetes diagnosis actually mean?

Prediabetes is not diabetes. The American Diabetes Association (ADA) uses the term for glucose or HbA1c levels in an intermediate range. They do not meet the criteria for diabetes. The NHS says your blood sugar is higher than normal but not high enough for a diabetes diagnosis. It also means a higher risk of getting diabetes in the future.

The ADA's cut-offs are:

  • HbA1c (also called A1C) of 5.7 to 6.4 percent (39 to 47 mmol/mol).
  • Fasting glucose of 100 to 125 mg/dL (5.6 to 6.9 mmol/L).
  • A 2-hour value of 140 to 199 mg/dL in an oral glucose tolerance test (OGTT).

Diabetes UK gives HbA1c in mmol/mol and uses a band of 42 to 47 mmol/mol. It also mentions the name "borderline diabetes". Why the cut-offs differ is explained in the HbA1c article. How your own results are classified is your doctor's call.

What happens next is not fixed. The German diabetes information service diabinfo.de says studies show prediabetes can regress. Germany's national guideline notes the other side. The longer studies follow people with these results, the more of them develop diabetes. Your repeat tests show which way yours are heading.

Will your doctor repeat the test?

Often, yes. Results vary from test to test, and the NIDDK says health care professionals repeat lab tests for confirmation. Without symptoms, it says, an HbA1c in the prediabetes or diabetes range calls for a repeat test on a different day. That can be the same test or another diabetes test.

The second test can point either way. Unless blood sugar is clearly very high, for example in a hyperglycemic crisis, the ADA requires confirmation for a diabetes diagnosis. That can be two abnormal results from different tests, which may be taken at the same time. It can also be the same test at two time points. Then the conversation moves on to type 2 diabetes. The type 2 diabetes page shows what Sam keeps there.

These are lab tests on a blood sample. A watch can't stand in for them. In its February 2024 safety communication, the US FDA said it had not authorized any smartwatch or smart ring that measures or estimates blood glucose on its own. More in Can Apple Watch measure blood sugar?

If your fasting glucose is repeated, you go without food beforehand. Your practice tells you for how long. How often to retest after that is your doctor's decision. The ADA and NICE retest intervals are compared in the HbA1c article.

Who looks after you once you have the result?

Most often the practice that ordered the test. That is where the results come together and where the next check gets planned.

In the UK, Diabetes UK says your GP should refer you to a type 2 prevention course or advice. The NHS Health Check is for people aged 40 to 74 without an existing health condition. You ask for it at your GP surgery or a local pharmacy. It may show whether you are at higher risk of problems such as diabetes.

In the US, the ADA says to consider testing adults with overweight and one or more risk factors at any age. For everyone else, screening should begin at 35. The clinician who ordered your test is the person to go back to with the result.

Did the number come from somewhere else, such as a hospital letter or a workplace check? Take the report to your own doctor. A result that sits in another file is easy to lose.

What do guidelines recommend after a prediabetes result?

Two things come up again and again: regular checks and lifestyle support.

  • Checks: The ADA's 2026 Standards call for a diabetes check at least once a year, adjusted to individual risk. The NIDDK says the same: a test for type 2 diabetes every year.
  • Lifestyle support: The ADA recommends offering diabetes prevention courses to adults at high risk of type 2 diabetes. It also recommends referring adults with overweight or obesity at high risk to such a course.
  • Everyday changes: The NHS suggests talking to your care team about eating more healthily, exercise and other lifestyle changes.

This article gives no diet plan or weight target. Those depend on your results, your other conditions and your medicines, which your doctor knows. Whether medication has any role is also your doctor's decision, case by case.

How do you get into a diabetes prevention course?

It depends on where you live. Diabetes UK lists the routes across the UK:

  • England: the Healthier You course, for adults aged 18 to 80 with prediabetes or a history of gestational diabetes. People with prediabetes usually need a GP referral. It runs for 9 months, as a group course or a digital one.
  • Scotland: an online T2D Prevention e-Learning course, plus courses run by health boards. Ask your GP which ones are available.
  • Wales: people with prediabetes diagnosed by their GP are referred automatically where the local service is available.
  • Northern Ireland: each Health and Social Care Trust runs its own course. Ask your GP for a referral; places are limited.

In the US, the CDC's National DPP offers lifestyle change classes, online or in person. Its eligibility page lists four base requirements. You must be 18 or older and have a BMI of 25 or more (23 or more for Asian American people). You must also have no earlier diagnosis of type 1 or type 2 diabetes and not be pregnant. On top of that, you need one of these:

  • A blood test in the prediabetes range within the past year.
  • A history of gestational diabetes.
  • A high score on the CDC's Prediabetes Risk Test.

Can you have prediabetes if you're thin?

Yes. Diabetes UK says prediabetes is more common in people living with overweight and obesity. But it can also affect people of a healthy weight. Weight alone does not cause it.

Other risk factors are not about weight itself. The NHS and the NIDDK name, among others:

  • Age: the NHS lists being over 40 if you are white, or over 25 for people of South Asian, Chinese, Black African or Black Caribbean background.
  • A parent or sibling with type 2 diabetes.
  • Not being physically active.
  • Having had gestational diabetes.

A slim body is no reason to skip a follow-up test. One practical point: the CDC's National DPP classes have the BMI requirement set out above. If you fall below it, ask your doctor what support fits you instead.

When should you see a doctor sooner?

Prediabetes usually causes no symptoms. Some symptoms can point to much higher blood sugar, though:

  • Feeling very tired.
  • Peeing more than usual.
  • Feeling thirsty all the time.
  • Losing weight without trying.
  • Stomach pain.
  • New vision problems, such as blurred vision.

The NHS symptoms page only advises seeing a GP. Germany's national guideline is stricter: it names these symptoms as signs that suggest diabetes and says glucose should then be measured without delay, because they can point to an emergency. So contact your doctor's office straight away and ask for a blood sugar check. Do not wait for your next scheduled test, and do not wait for it to pass. If the office is closed, use your local out-of-hours service. More on these signs in Prediabetes Symptoms: Why You Usually Feel Nothing.

Call your local emergency number (112 in the EU, 999 in the UK, 911 in the US) if thirst and peeing more come with any of these:

  • Feeling or being sick.
  • Stomach pain.
  • Breathing more deeply or quickly than usual.
  • A faster heartbeat than usual.
  • Fruity-smelling breath.
  • Feeling very drowsy or confused.

The NHS gives these as reasons to call 999. They can be signs of diabetic ketoacidosis, a serious condition in which harmful ketones build up in the blood. It can be life threatening. The NHS says to call even if you have never been diagnosed with diabetes, since the symptoms can belong to diabetes nobody has found yet. Also call if you suddenly cannot see from one or both eyes or have sudden severe eye pain. Don't drive yourself: ask someone to drive you or call an ambulance.

In Sam's symptom diary you can log "Excessive thirst" or "Frequent urination" per day. An entry does not replace calling your doctor.

Which questions should you ask at the follow-up visit?

This is the visit where the next steps get decided. Questions that fit it:

  • Do I need a repeat test, and which one?
  • Which of my risk factors matter most?
  • What do the lifestyle recommendations mean for me?
  • Am I eligible for a prevention course, and how do I join?
  • When is my next test?
  • Which symptoms mean I should call sooner?

Bring all your lab reports, including older ones, and a list of everything you take. What to include on a medication list walks through it. In Sam you can show your medication list in the app.

Keep your first result in Sam and compare it at the next check

At your next check you see what changed since the first report, instead of hunting for two printouts.

  • Instead of a folder: you add the lab report and the doctor's letter as a photo or PDF. With your consent, Sam reads HbA1c and glucose from the lab report, and you check the values before saving.
  • Instead of comparing sheets yourself: Sam shows up to three values that changed most between your last two lab reports. A value is only compared when both reports use the same unit for it.
  • Instead of memory: thirst or frequent urination goes into the symptom diary, per day. That replaces no call to your doctor's office.

Sam doesn't measure blood sugar, can't tell you whether you have prediabetes and has no influence on your results. More on the prediabetes page.

Try Sam for free

Sam is a wellness companion, not a medical device. It does not diagnose, treat, cure or prevent any disease or health condition. Always consult a qualified professional for medical decisions.

Sources

Updated: October 2026

More on Prediabetes

Frequently Asked Questions

I have prediabetes. What should I do first?+

Talk the result through with the doctor who ordered the test. Prediabetes means your glucose or HbA1c is above the normal range but below the diabetes range, which raises your risk of type 2 diabetes later. Your doctor decides whether to repeat the test, which risk factors apply to you and when the next check is. Whether you have prediabetes is your doctor's call.

What does a diagnosis of prediabetes mean?+

It is a label for results between normal and diabetes, not diabetes itself. The ADA uses an HbA1c of 5.7 to 6.4 percent, a fasting glucose of 100 to 125 mg/dL or a 2-hour glucose tolerance result of 140 to 199 mg/dL. In the UK, Diabetes UK uses an HbA1c of 42 to 47 mmol/mol. The NHS says it means a higher risk of getting diabetes in the future. How your own results are classified is your doctor's call.

Will my doctor repeat a prediabetes test?+

Often, yes. The NIDDK says that without symptoms, an HbA1c result in the prediabetes or diabetes range should be repeated on a different day, with the same or another diabetes test. Unless blood sugar is clearly very high, the ADA requires confirmation for a diabetes diagnosis: two abnormal results from different tests, or the same test at two time points.

What do guidelines recommend for prediabetes?+

The ADA's 2026 Standards say people with prediabetes should be checked for diabetes at least once a year and that adults at high risk should be offered a diabetes prevention course. The NHS suggests talking to your care team about eating, exercise and other lifestyle changes. What that means for you is a conversation with your doctor.

Can you have prediabetes if you're thin?+

Yes. Diabetes UK says prediabetes is more common in people living with overweight but can also affect people of a healthy weight, and that weight alone does not cause it. Age, family history and ethnic background raise the risk too. Your lab results, not your weight, are what count.

How do I join a diabetes prevention course?+

In England, the Healthier You course is for adults aged 18 to 80 with prediabetes, usually through a GP referral; Scotland, Wales and Northern Ireland have their own routes. In the US, the CDC lists who can join its National DPP lifestyle change classes, including a BMI of 25 or more (23 or more for Asian American people) and a recent blood test in the prediabetes range.

When should I see a doctor sooner with prediabetes?+

If you feel very tired, pee more than usual, feel thirsty all the time, lose weight without trying, have stomach pain or have new vision problems such as blurred vision. Germany's national guideline says glucose should then be measured without delay, because these symptoms can point to an emergency. Contact your doctor's office straight away and do not wait for your next scheduled test. If the office is closed, use your local out-of-hours service. Call your local emergency number (112 in the EU, 999 in the UK, 911 in the US) if thirst and peeing more come with feeling or being sick, stomach pain, breathing more deeply or quickly than usual, a faster heartbeat than usual, fruity-smelling breath, or severe drowsiness or confusion. The same applies if you suddenly cannot see from one or both eyes or have sudden severe eye pain. This holds even if you have never been diagnosed with diabetes. Don't drive yourself.

Related Articles

October 25, 2026

Prediabetes Symptoms: Why You Usually Feel Nothing

October 24, 2026

Prediabetes HbA1c: what your results mean

October 25, 2026

Back Pain but a Normal MRI: What It Means, What to Log