Early identification and management of prediabetes (when a person's blood glucose levels are higher than normal but not high enough to be type 2 diabetes) can delay or prevent the onset of type 2 diabetes. If left untreated, most people with prediabetes develop type 2 diabetes within 10 years. [2, 3] People with prediabetes also have a 1.5 times greater risk of cardiovascular disease compared to people with normal blood glucose levels. To prevent progression to type 2 diabetes, patients usually need to make lifestyle changes.
Community Resources – for Diabetes Prevention
Physical Activity Guidelines for Americans Toolkit for Organizations and Communities (2008): includes a user’s guide and printed and CD-rom versions of fact sheets, posters, and FAQ sheets for organizations and communities.
Federal resources to help schools reduce student obesity. NASN School Nurse 2012; 27(3): 119-21.
HEALTHY study* resources: All middle school study resources are online including
the physical education curriculum, student and teacher workbooks, nutrition messaging,
posters, newsletters, and more, in English and Spanish.
* The HEALTHY Study Group: A School-Based Intervention for Diabetes Risk Reduction. N Engl J Med 2010; 363: 443-453.
Weight loss strategies and approaches for communities
Implementation and Measurement Guide (2009): shows how local governments can use community strategies and measures of environmental and policy change.
Recommended Community Strategies and Measurements to Prevent Obesity in the United States. Morbidity and Mortality Weekly Report. July 24, 2009;58(RR–7). Twenty-four strategies that communities can use to assess local policies and environments that support healthy eating and active living.
National Diabetes Prevention Program: tools to help you deliver or support a lifestyle change program in your organization or community.
YMCA Diabetes Prevention Programs: Many programs are being offered across the country. Contact your local YMCA.
Decision Support – for Diabetes Prevention
Action steps for diabetes prevention
- Identify patients in your practice who are at risk for type 2 diabetes who should be tested for diabetes and prediabetes
- Test for diabetes and prediabetes
- Counsel patients to lose weight through lifestyle changes - by making healthy food choices and increasing physical activity
- Consider metformin for patients under 60 years old with prediabetes plus other risk factors.
- Refer patients to a structured diabetes lifestyle intervention program. See tools and resources below.
Note: The Affordable Care Act (the health care law of 2010) includes several provisions that directly address gaps in diabetes prevention, screening, care, and treatment. Funding was authorized for the CDC’s National Diabetes Prevention Program (NDPP) that provides lifestyle modification programs to help prevent diabetes. Expansion of this program could make community-based, cost-effective diabetes prevention programs more widely available to people with prediabetes.
For more information on health care provisions in the Affordable Care Act, visit www.healthcare.gov. For more information on the National Diabetes Prevention Program, visit http://www.cdc.gov/diabetes/projects/prevention_program.htm.
Overweight and Obesity website - Centers for Disease Control and Prevention (CDC): offers for children and adults Body Mass Index Calculators, obesity trends and contributing factors, health and economic consequences, and state-based programs.
Physical Activity Counseling – The five A's (Assess, Advise, Agree, Assist, Arrange): a model to help physicians deliver brief, individually tailored physical activity messages to patients American Family Physician 2008 Apr 15; 77(8): 1129-1136.
Physical Activity Guidelines for Americans (2008) – for health professionals and policymakers: describe the types and amounts of physical activity that offer substantial health benefits to Americans from age six.
Pedometer: Free pedometers are often available from health insurance companies, states’ Department of Health, pharmacies, large stores, etc.
Motivational interviewing for behavior change
Training modules for effective motivational interviewing to affect patient behavior:
Screening (testing) recommendations
United States Preventive Services Task Force:
Screening for Diabetes Mellitus, Adult type 2 (2008) ; Screening for Gestational Diabetes Mellitus (2008); Screening for and Management of Obesity in Adults (2008); Screening for Obesity in Overweight in Children and Adolescents (2010).
Weight loss strategies and approaches
A New You: Health for Every Body: a ten-session multi-method, experiential learning program that offers tools for setting and achieving goals for behavior changes in the areas of food, physical activity and body image.
Diabetes Prevention Program (DPP) curriculum: manuals may be downloaded, duplicated, transmitted, and otherwise distributed for educational or research purposes provided proper credit is given to the DPP Research Group.
University of Pittsburgh Diabetes Prevention Support Center: Group Lifestyle BalanceTM Program is a comprehensive lifestyle behavior change program adapted directly from the successful lifestyle intervention used in the National Institutes of Health funded DPP.
Self-management Support – for Diabetes Prevention
Diabetes prevention - lifestyle changes
Diabetes prevention tip sheets: for African American, Hispanic or Latino, Asian and Pacific Islanders, American Indians and Alaska Natives, youth, women with a history of gestational diabetes, and older adult audiences.
Information to help people at risk to prevent diabetes: American Association of Clinical Endocrinologists: Empower Your Health.
Prevent diabetes through healthy eating and exercise: American Diabetes Association
Small Steps Big Rewards Toolkit : based on the lifestyle modification strategies used in the Diabetes Prevention Program clinical trial, including a Fat and Calorie Counter and a Food and Activity Tracker (NDEP)
Nutrition and fitness
Women with or at risk for gestational diabetes
American Diabetes Association
National Institute of Child Health and Development: free brochure Am I at Risk for Gestational Diabetes?
Reduce risk for diabetes, National Diabetes Education Program
There is considerable evidence for a consistent and significant positive relationship between self-monitoring of diet, physical activity, or weight and successful outcomes related to weight management. 
There are many resources such as journals, logs, spreadsheets, calorie counting websites, and APPS to help people track self-care behaviors such as food intake and physical activity. Several such resources can be found in NDEP's Diabetes HealthSense. Diabetes HealthSense visitors can tailor their search for tracking tools by selecting the targeted behavior under Help Me and the preferred resource under Type of Resource.