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National Diabetes Month: Prediabetes, Blood Sugar Testing, and Where Metformin Fits
By Our Editorial Team
November is National Diabetes Month, which makes it a good time to talk about prediabetes: blood sugar levels that are above normal and raise the risk of developing type 2 diabetes. It gets far less attention than diabetes itself, and many people who have it don’t know it. The encouraging part is that it’s often a window for change. This guide covers what prediabetes and metformin have to do with each other, how blood sugar is tested, and which steps tend to matter most.
Quick Answer
Prediabetes means your blood sugar is higher than normal but not yet in the diabetes range. It usually has no symptoms, so testing is the only reliable way to know. Lifestyle changes such as nutrition, physical activity, sleep, and gradual weight loss are the foundation of care. For some people at higher risk, a provider may also consider metformin, a long-used medication that helps lower blood sugar. A licensed provider can help decide what fits.
Key Takeaways
Prediabetes is common and often silent, so blood sugar testing matters even if you feel fine.
A1C and fasting glucose tests are the most common ways to check for prediabetes.
Lifestyle changes are the first-line approach and can lower the risk of progressing to type 2 diabetes.
Metformin is sometimes considered for people with prediabetes who are at higher risk, but it isn’t right for everyone.
Metformin is not a weight-loss drug, and it requires a provider’s review of your kidney function and health history.
What Is Prediabetes?
Prediabetes means your blood sugar, or glucose, is running higher than it should but hasn’t reached the level used to diagnose type 2 diabetes. It usually develops when your body becomes less responsive to insulin, the hormone that moves sugar from your blood into your cells for energy. This is called insulin resistance.
Most people with prediabetes feel completely normal. That’s exactly why it goes unnoticed so often, and why routine testing is worth it.
Who is more likely to have prediabetes?
Your risk tends to be higher if you:
Are 35 or older
Carry extra weight, especially around the waist
Have a parent or sibling with type 2 diabetes
Are physically active fewer than a few times a week
Had diabetes during pregnancy (gestational diabetes)
Have polycystic ovary syndrome (PCOS)
Have high blood pressure or abnormal cholesterol levels
How Is Prediabetes Diagnosed?
A simple blood test can tell you where you stand. The two most common tests are the A1C, which reflects your average blood sugar over roughly the past three months, and fasting plasma glucose, which measures blood sugar after at least eight hours without eating.
Test | Normal | Prediabetes | Diabetes range |
A1C | Below 5.7% | 5.7% to 6.4% | 6.5% or higher |
Fasting plasma glucose | Below 100 mg/dL | 100 to 125 mg/dL | 126 mg/dL or higher |
These are common diagnostic ranges for people who are not pregnant; pregnancy uses different criteria. A diagnosis of diabetes is usually confirmed with repeat testing. Your provider will interpret results alongside your health history, so treat these ranges as a guide rather than a self-diagnosis.
What Can You Do About Prediabetes?
Prediabetes isn’t a guarantee that type 2 diabetes is coming. Research has shown that lifestyle changes can lower the risk of progressing, and they remain the foundation of care.
Build meals around fiber and protein
Vegetables, beans, whole grains, fruit, lean proteins, and healthy fats help keep blood sugar steadier than refined carbohydrates and sugary drinks. You don’t need a perfect diet. Small swaps, repeated often, add up.
Move most days
Physical activity helps your muscles use glucose more effectively. Brisk walking, cycling, swimming, and strength training all count. Even a short walk after meals can help blunt blood sugar spikes. A common prevention goal is at least 150 minutes of moderate activity each week, and your provider can tailor that to your health and abilities.
Aim for gradual weight loss if it’s part of your plan
For people with overweight or obesity, losing about 5% to 7% of starting body weight can help reduce diabetes risk and improve insulin sensitivity. Steady progress you can maintain matters more than rapid changes, and your provider can help you set a goal that fits.
Protect your sleep and manage stress
Short or poor-quality sleep and ongoing stress can both affect blood sugar regulation. They’re easy to overlook, but they’re part of the picture.
Where Does Metformin Fit?
Metformin is one of the most widely prescribed and longest-used medications for type 2 diabetes. It works mainly by reducing how much glucose your liver releases into the bloodstream and by helping your body respond better to insulin.
Metformin isn’t automatically part of a prediabetes plan. Providers may consider it alongside lifestyle changes for people at higher risk, particularly adults ages 25 to 59 with a BMI of 35 or higher, people with higher blood sugar readings within the prediabetes range, and those with a history of gestational diabetes. Metformin isn’t FDA-approved specifically for prediabetes, so prescribing it this way is an off-label use that calls for an individual assessment with your provider.
Is metformin a weight-loss medication?
No. Some people lose a small amount of weight while taking metformin, but it isn’t approved or designed as a weight-loss drug. Its main role is supporting blood sugar regulation as part of a broader metabolic health plan.
What side effects should you know about?
The most common side effects are digestive, such as diarrhea, nausea, gas, and stomach upset. They’re often most noticeable when starting and tend to ease over time. Taking metformin with meals and following your provider’s gradual dose increases can help, and extended-release versions may be gentler for some people.
Long-term use can lower vitamin B12 levels, so your provider may check your B12 periodically. Lactic acidosis is rare but serious, and it’s one reason providers review kidney function and alcohol use before prescribing. Stop taking metformin and seek medical care immediately if you develop symptoms such as unusual muscle pain, trouble breathing, marked weakness, unusual sleepiness, or stomach pain while feeling very unwell.
Who may not be a good fit?
Metformin should not be used by people with severely reduced kidney function. Your provider will check your kidney function before prescribing and periodically during treatment. Liver disease, heavy alcohol use, and certain other conditions can also make it unsuitable. Tell your provider about all of your medications, plus any upcoming surgery or imaging that uses iodinated contrast dye, since a temporary pause may be needed.
Questions to Ask Your Provider
Based on my risk factors, how often should I have my blood sugar checked?
What do my A1C and fasting glucose results mean for me?
Which lifestyle changes would make the biggest difference for me?
Would metformin make sense for me, and why or why not?
Do my kidney function or other medications affect my options?
Should my B12 level be monitored?
Frequently Asked Questions
Can prediabetes be reversed?
Blood sugar can return to the normal range, but that doesn’t mean the underlying risk has disappeared. Healthier eating, regular physical activity, better sleep, and gradual weight loss when appropriate can all help. Keeping those habits going and testing regularly matters, since results vary and some people need additional support.
Do you need medication for prediabetes?
Not necessarily. Lifestyle changes are the foundation of prediabetes care. A provider may consider medication such as metformin for people at higher risk of developing type 2 diabetes, alongside lifestyle changes, when their individual risk warrants it. The decision depends on your test results, health history, and personal goals.
How often should blood sugar be tested?
It depends on your risk. Many adults with risk factors are screened every few years, while people with prediabetes are often retested about once a year. Your provider may recommend a different schedule based on your results and health history. If you’ve never been tested and have risk factors, it’s worth asking.
Does metformin cause B12 deficiency?
Long-term metformin use is associated with lower vitamin B12 levels in some people. That doesn’t mean everyone taking it will become deficient, but it’s why providers may check B12 periodically. Signs of low B12 can include fatigue, numbness or tingling in the hands and feet, and memory problems. Mention any of these to your provider.
The Bottom Line
Prediabetes is common, usually silent, and often a real window for change. Testing tells you where you stand, lifestyle changes do most of the heavy lifting, and metformin may help some people at higher risk. National Diabetes Month is a good nudge to get checked if you haven’t recently.
If you want support with your metabolic health, Trava’s licensed providers can review your health history, talk through your results, and help you decide whether options like metformin fit your goals. It starts with a short online assessment.
Sources and References
Prediabetes & Insulin Resistance. National Institute of Diabetes and Digestive and Kidney Diseases, NIH.
Diabetes Tests & Diagnosis. National Institute of Diabetes and Digestive and Kidney Diseases, NIH.
Prevention or Delay of Diabetes and Associated Comorbidities: Standards of Care in Diabetes. American Diabetes Association, Diabetes Care.
Metformin Hydrochloride Prescribing Information. DailyMed, U.S. National Library of Medicine.
Last reviewed: November 2026
Disclaimer: This article is for general educational purposes and is not medical advice. Talk with a licensed healthcare provider about your individual needs before starting, stopping, or changing any treatment.
