Healthy Living
Why the Term "Prediabetes" May Soon Disappear
More than one in three American adults fall into the range currently labeled “prediabetes,” but that term may soon change. Dr. Jen and endocrinologist Dr. Anne Peters discuss why earlier staging of type 2 diabetes could matter, how gestational diabetes and PMOS/PCOS affect long-term risk, and what you can do to better understand and manage your blood sugar.
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You can't be a little bit pregnant, and according to a growing number of diabetes experts, you can't really be “prediabetic” either. This matters because more than one in three American adults, over 115 million people, now fall into the “prediabetes” range.
That idea is at the heart of my conversation with endocrinologist Dr. Anne Peters on this week's episode of Dear Dr. Jen. Dr. Peters is one of the clearest thinkers in endocrinology. She literally writes the book on glucose, diabetes, and GLP-1 guidelines, and she’s a cool person! I love talking to her and know you will love listening to her.
You can’t have a PRE-disease
In January, a commentary in The Lancet Diabetes & Endocrinology argued that the time to start staging prediabetes and type 2 diabetes is now. The problem with the current label is that it implies you're healthy, when many people in this range actually carry a higher risk of complications, especially cardiovascular ones. Elevated blood sugar below the diabetes threshold has long been linked to heart disease, chronic kidney disease, early-onset dementia, and certain cancers.
The proposed fix is a three-stage classification of type 2 diabetes, similar to the staging already used for type 1 diabetes and to the 2017 change that retired the term "prehypertension."
In fairness, this is not official yet. The American Diabetes Association's 2026 Standards of Care still use the term prediabetes. But the direction is clear, and I think it's the right one.
Here's the part that should make you feel hopeful rather than scared. A pooled analysis of 19 cohort studies in The Lancet Global Health found that more people with prediabetes returned to normal blood sugar than progressed to type 2 diabetes, across age, sex, and ethnic groups. Renaming this stage is about creating urgency, not doom.
A history of gestational diabetes matters too
Even if it was decades ago. A 2009 meta-analysis in The Lancet found it raises your lifetime risk of type 2 diabetes roughly sevenfold.
According to Dr. Peters, any woman who has had diabetes during pregnancy or has PMOS (formerly known as PCOS) should be screened for diabetes every year, and I agree. This is an inexpensive, easy, and accurate test. Overlooking these OBGYN factors is one of the biggest errors that women in midlife find themselves dealing with.
What to say to your doctor
"My A1C is in the prediabetes range. Under the newer staging approach, where would that put me, and what's our plan to bring it back to normal?”
And if you had gestational diabetes, be sure to request that be factored in as well.
There's more where that came from
In the podcast, Dr. Peters and I also cover how to read a continuous glucose monitor if you don't have diabetes, without panicking over every spike. And we talk about what GLP-1 medications are really doing to your metabolism, including the risks and the benefits. Plus, Dr. Peters’ pick for the perfect breakfast to keep your blood sugar stable (this is important because cortisol naturally peaks in the morning, and one of its jobs is to raise blood sugar).
For the full conversation, listen to this week’s episode of Dear Dr. Jen—out now!
