Written by Kyle Bowen

Pre-diabetes is a common health issue, and many people are surprised to learn they have it because they often feel completely normal even while their blood sugar levels are starting to trend in the wrong direction.

The good news is that pre-diabetes is typically very responsive to lifestyle changes, with one of the most effective tools being regular physical activity.

This blog will explain what pre-diabetes is, why it occurs, and how engaging in physical activity can help reduce the risk and impact of pre-diabetes.

What is pre-diabetes?

Pre-diabetes is a condition in which your blood glucose levels are higher than normal, but not high enough to meet the criteria for type 2 diabetes. At this stage, there are usually no noticeable signs or symptoms. However, some individuals affected by the condition have reported experiencing increased dehydration, numbness in the hands and feet, and frequent urination. While you may not feel the changes, pre-diabetes can be identified through blood tests such as: 

• HbA1c (average blood sugar over the past ~2–3 months) 

• Fasting blood glucose 

• Oral glucose tolerance test (OGTT) 

Your GP will then interpret these results for you, so there is no need to remember these.  

Why does pre-diabetes happen?

Pre-diabetes usually develops when the body becomes less responsive to insulin, a hormone that helps transport glucose from the bloodstream into cells, especially muscle and liver cells.

Over time, several factors can contribute to Pre-diabetes including:

• Long periods of low daily movement

• Excess body fat, particularly around the waistline

• Poor sleep quality

• Chronic stress

• Smoking habits

• High-blood pressure

• Genetics and family history

• Age-related changes in muscle mass and activity patterns

Pre-diabetes should not be dismissed as "personal failure." The condition often results from individual risk factors combined with unhealthy lifestyle choices. The modern world tends to prioritise unhealthy options in our daily lives.

Why it matters (even before diabetes)

Identifying pre-diabetes is important because it signals an increased risk of:

• Type 2 diabetes
• Cardiovascular disease
• Fatty liver disease
• Long-term complications associated with higher blood glucose include heart attack, stroke, vision loss, kidney disease, and nerve damage.

It's also a window of opportunity, as addressing it early can significantly shift the trajectory of your overall health.

How movement helps (without needing insulin to do the work)

One of the coolest things about the human body is that muscle contractions help clear glucose from the blood. When you move, muscles can take up glucose through pathways that are less dependent on insulin. That means:

• Blood sugar control can improve right after physical activity
• Over time, the body often becomes more insulin sensitive (insulin works better)

This is why movement is such a cornerstone for managing pre-diabetes — it helps in both the short term and the long term.

The role of muscle mass and strength

Skeletal muscle is one of the main places your body stores and uses glucose. Generally speaking:

• More active muscle tissue = more "space" for glucose storage
• Better muscle function = better ability to use glucose efficiently

This helps explain why improving muscle health is often linked with better metabolic health — even when the scale doesn't change quickly.

Movement also helps the "big picture" risk factors

Pre-diabetes rarely exists in isolation. Exercising improves many related factors, including:

• Blood pressure
• Cholesterol and triglycerides
• Sleep quality
• Stress regulation and mood
• Energy levels and daily function

So even if your blood sugar numbers take time to shift, there are usually benefits happening behind the scenes.

Why small, consistent changes beat "all-out" efforts

A common misconception is that you need extreme workouts to make progress. In reality, the body responds strongly to consistency.

• Regular movement adds up because:
• It reduces long periods of sitting
• It creates repeated "glucose-clearing" opportunities
• It supports habit-building and long-term adherence
• The goal isn't perfection, it's building a routine you can maintain.

What else helps alongside movement?

Movement is a major piece, but pre-diabetes improvement is usually best when paired with:

• Better sleep (quality and regularity)
• Nutrition that supports stable energy levels
• Managing stress
• Reducing excess body fat if appropriate (even modest reductions can help)
• Regular check-ins with a GP for monitoring

Many people benefit from guidance from an Accredited Exercise Physiologist and/or dietitian, especially if they have injuries, long gaps in training, or other health conditions.

When to speak to a professional

It's worth speaking with your GP if you:

• have persistent fatigue, thirst, or frequent urination
• have a strong family history of diabetes
• are unsure what your blood test results mean
• want a safe plan if you have other medical conditions

Bottom line

Pre-diabetes is a signal — not a sentence.

It means your body is having a harder time regulating blood sugar, but it also means there's time to intervene.

If you're concerned, the best next step is to pair lifestyle changes with regular medical monitoring so you can track progress over time. Our Exercise Physiology services involve both diabetes and pre-diabetes help. If you would like to see how we do that, you can click here for more information. If you are interested in booking a consult, you can book online here, or find your nearest Achieve clinic here.

References

Færch, K., Witte, D. R., Brunner, E. J., Kivimäki, M., Tabák, A., Jørgensen, M. E., Ekelund, U., & Vistisen, D. (2017). Physical activity and improvement of Glycemia in prediabetes by different diagnostic criteria. The Journal of Clinical Endocrinology & Metabolism, 102(10), 3712-3721. https://doi.org/10.1210/jc.2017-00990

Iglesies-Grau, J., Garcia-Alvarez, A., Oliva, B., Mendieta, G., García-Lunar, I., Fuster, J. J., Devesa, A., Pérez-Herreras, C., Fernández-Ortiz, A., Brugada, R., Ibanez, B., Fernandez-Jimenez, R., & Fuster, V. (2023). Early insulin resistance in normoglycemic low-risk individuals is associated with subclinical atherosclerosis. Cardiovascular Diabetology, 22(1). https://doi.org/10.1186/s12933-023-02090-1

Jadhav, R. A., Hazari, A., Monterio, A., Kumar, S., & Maiya, A. G. (2017). Effect of physical activity intervention in prediabetes: A systematic review with meta-analysis. Journal of Physical Activity and Health, 14(9), 745-755. https://doi.org/10.1123/jpah.2016-0632

Mutie, P. M., Pomares-Millan, H., Atabaki-Pasdar, N., Jordan, N., Adams, R., Daly, N. L., Tajes, J. F., Giordano, G. N., & Franks, P. W. (2020). An investigation of causal relationships between prediabetes and vascular complications. Nature Communications, 11(1). https://doi.org/10.1038/s41467-020-18386-9

Pencina, K. M., Thanassoulis, G., Pencina, M. J., Toth, P. P., & Sniderman, A. D. (2024). Hemoglobin A1c and abdominal obesity as predictors of diabetes and ASCVD in individuals with prediabetes in UK Biobank: A prospective observational study. Cardiovascular Diabetology, 23(1). https://doi.org/10.1186/s12933-024-02525-3