One of the most common health conditions in the United States is technically a precursor to a health condition: prediabetes. According to the CDC, it affects 88 million Americans ages 18 to 64 and 24.2 million Americans over 65. All in all, that means an estimated one in three people is prediabetic. 

But what exactly is prediabetes—and does it mean you’re doomed to develop full-blown diabetes? 

What is prediabetes?

Prediabetes is a high-risk health condition in which your blood sugar levels are higher than what’s considered normal (less than 140 mg/DL) but are not yet quite high enough to be considered type 2 diabetes (more than 200 mg/dL), explains Ping H. Wang, MD., chair of the Department of Diabetes, Endocrinology, and Metabolism at City of Hope.

Unlike other health conditions, prediabetes often sneaks up on patients. “It is often just found in routine blood work by your physician, but sometimes fatigue, caused by fluctuating sugar levels, can be a symptom,” says Romy Block, M.D., endocrinologist and co-founder of Vous Vitamin. 

Risk factors for prediabetes

Being diagnosed with prediabetes can be scary, but it does not automatically mean you will go on to develop diabetes in the near future, or at all. Several factors play a role in whether someone develops prediabetes or type 2 diabetes, notes Angela Forfia, M.A., Senior Manager of Prevention at the Association of Diabetes Care & Education Specialists. “Age, gender, and family history all increase our risk of developing prediabetes and type 2 diabetes,” she says. (Having a parent or sibling with diabetes, for example, increases your personal risk.) “Men also generally have a greater risk than women.” 

Plus, “just like our individual family histories, our ethnic backgrounds may also increase our risk,” Forfia says. “American Indians, African Americans, Latinos, and some Asian Americans have a higher risk of developing prediabetes and diabetes.” 

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Lifestyle factors also play a role. Smoking, being overweight or obese, living a sedentary lifestyle, and having high blood pressure or high cholesterol all increase risk. “The interplay between our genetic risk factors, our lifestyle factors, and the communities where we live and work all come together to create a perfect environment for the development of prediabetes and type 2 diabetes,” Forfia says. 

What you can do to lower your risk for prediabetes

While certain prediabetes risk factors are out of your control, such as family history and ethnic background, there are a few things you can do to lower your risk.

1. Cut back on sugar and processed foods

One of the quickest ways to increase your blood sugar levels is to eat a diet high in sugar and refined carbs, notes Matthew Olesiak, M.D., Chief Medical Director at SANESolution. “A poor-quality diet is a major factor in the development of prediabetes, and has unfortunately become typical for many Americans,” he says. “These foods, including processed foods, fast foods, and starchy carbs, promote insulin resistance that leads to elevated blood glucose levels.” Instead, he recommends consuming a diet that’s filled with a variety of non-starchy vegetables, protein, and healthy fats. 

Not sure where to start? Check out this dietitian-backed guide to cutting out highly-processed foods in two weeks.

2. Lose Weight

You’re probably familiar with the fact that extra weight can increase your risk for myriad diseases, including diabetes, heart disease, and certain cancers. But you may be surprised to know that all it takes to reduce your risk of prediabetes is losing just 10 to 15 percent of your body weight. Doing so, according to one Current Obesity Reports study, can help improve blood glucose, thereby slashing the risk of diabetes in those diagnosed with prediabetes. 

3. Get Moving

You don’t have to be a marathoner or gym rat to lower your risk of prediabetes. All you have to do is live an active lifestyle. That means shooting for 30 minutes of moderate-intensity aerobic activity (such as brisk walking) for 30 minutes a day, five days a week, the CDC recommends. New to fitness? “Simply start off slowly, taking brief 10-minute walks each day, and then increase the time or the effort,” suggests Olesiak. “You would be surprised at the positive effect regular moderate exercise has on your blood glucose levels.” 

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In fact, research published in the British Medical Journal has shown that prediabetic individuals can cut their risk of developing type 2 diabetes nearly in half when they exercise an average of 30 minutes per day and eat a low-fat diet. 

4. Finally Quit Smoking

You’ve already heard plenty about the laundry list of reasons you should quit smoking, but one big incentive is that doing so lowers your risk of diabetes. Decades-worth of research, including one 2015 The Lancet Diabetes & Endocrinology study, has linked first- and second-hand smoke with type 2 diabetes. 

5. Stay up to date with your yearly physicals

Ultimately, the only way to know if your lifestyle efforts are moving the needle is to have your blood sugar tested, which your doctor can do at your yearly physical. 

In between appointments, you can monitor your prediabetes risk with this quick quiz from the American Diabetes Association.