6.1–6.9mmol/L
Fasting blood sugar
Prediabetes: this is called impaired fasting glucose.1
Health education · Metabolic healthSaint‑Hyacinthe
Prediabetes: understanding your results and taking action before type 2 diabetes
Blood glucose that is higher than normal, without meeting the criteria for diabetes.
Prediabetes is mainly a risk signal: the risk of developing type 2 diabetes is higher, and other cardiovascular or metabolic factors may be present. But it does not automatically progress to diabetes: the Government of Quebec points out that it is possible to prevent diabetes, make it regress or, at least, delay its progression.5
At Clinique IPS du Palais in Saint-Hyacinthe, the assessment aims to understand why your blood glucose is high, your actual level of risk, the other metabolic factors present and the most relevant actions for you.
Canadian thresholds
Three results that define prediabetes
6.0–6.4% HbA1c
Glycated hemoglobin
Prediabetes: average blood glucose higher than normal over the past few months.1
7.8–11.0mmol/L, 2 h after OGTT
After 75 g of glucose
This is called impaired glucose tolerance.1
Prediabetes is not diabetes and does not necessarily progress to type 2 diabetes. It is, however, an important opportunity to act early.
Thresholds published by Diabetes Canada for non-pregnant adults.1
Understanding
What is prediabetes?
After a meal, carbohydrates are converted into glucose, which enters the bloodstream. The pancreas then produces insulin, a hormone that helps glucose enter the cells.
When this regulation becomes less effective, blood glucose rises. Prediabetes is an intermediate zone: higher than normal, but not high enough to meet the criteria for diabetes.
The three tests do not measure exactly the same thing and can sometimes identify different people.
When is it considered diabetes?
TestPrediabetesDiabetes
Fasting blood glucose6.1–6.9≥ 7.0
HbA1c (%)6.0–6.4≥ 6.5
2 h after OGTT7.8–11.0≥ 11.1
Blood glucose in mmol/L. Without symptoms of hyperglycemia, a result in the diabetes range generally needs to be confirmed.1
Does prediabetes cause symptoms?
Usually not.
It is often discovered during a health assessment, a blood test or targeted screening. That is why screening is important for people at risk.
Signs that suggest diabetes instead
The Government of Quebec recommends a prompt assessment if you have an increased amount and frequency of urination, intense thirst, excessive hunger or unexplained weight loss.4
Who should be screened?
Diabetes Canada recommends screening every 3 years starting at age 40, or in people at high risk.1;2
Screening may be done earlier or more often, every 6 to 12 months, in people who have other risk factors.1
In Quebec, a health professional can also estimate your risk using the FINDRISC questionnaire and order a blood test if the risk is high.5
Risk factors
What increases the risk of prediabetes and type 2 diabetes
According to Diabetes Canada, the risk increases with, among other things:1;2
What cannot be changed
Age 40 or older, a family history of diabetes and African, Arab, Asian, Hispanic, Indigenous or South Asian origin.
Health conditions
Previously known prediabetes, previous gestational diabetes, hypertension, abnormal cholesterol, excess weight (especially abdominal), polycystic ovary syndrome, obstructive sleep apnea, HIV infection, acanthosis nigricans (dark patches on the skin).
Certain medications and disorders
Glucocorticoids and atypical antipsychotics, as well as certain psychiatric disorders (schizophrenia, depression, bipolar disorder).
Prediabetes is multifactorial: a person does not need to be living with obesity to have it. Genetics, age, fat distribution, lifestyle habits, medications and sleep also play a role.
Mechanism
Insulin resistance and metabolic syndrome
When tissues respond less well to insulin, the pancreas has to produce more of it to keep blood glucose within an acceptable range. Over time, this compensation may become insufficient.
Prediabetes can be associated with insulin resistance, but the two terms are not synonymous: prediabetes is defined by specific results, while insulin resistance is a mechanism.
Prediabetes is sometimes part of a group of factors that often occur together: this is called metabolic syndrome.
- High blood glucose
- High blood pressure
- High triglycerides, lower HDL
- Abdominal fat
And cardiovascular risk?
Prediabetes is often accompanied by other cardiovascular risk factors, such as hypertension or abnormal cholesterol.
The assessment is therefore not limited to blood glucose: blood pressure, cholesterol, smoking, kidney function, lifestyle habits and family history also count.
The link with cholesterol
High triglycerides, lower HDL or other lipid abnormalities may accompany prediabetes. A lipid profile is part of the assessment.
The link with hypertension
Hypertension and prediabetes share several risk factors and often coexist. Having both makes cardiovascular prevention even more important.
The tests
Understanding your lab tests
Fasting blood glucose
It directly measures glucose in the blood after a period without eating. Follow the fasting instructions given by the laboratory.
HbA1c
Glycated hemoglobin reflects average blood glucose over the past few months. It generally does not require fasting.
Diabetes Canada does not recommend it for diagnosis in children, adolescents, during pregnancy or if type 1 diabetes is suspected. Anemia, a hemoglobinopathy or severe kidney or liver disease can also distort the result.1
OGTT
A first blood glucose measurement is taken, the person drinks a solution containing 75 g of glucose, then another blood glucose measurement is taken two hours later. This test can detect impaired glucose tolerance that does not show up on fasting blood glucose.
A person may have an abnormal result on one test and a less concerning result on another: the results are interpreted together.
Taking action
What to do when you discover prediabetes?
The first step is to assess the overall picture: confirm the results if needed, review diet, physical activity, blood pressure, cholesterol, medications, sleep and family history. The goal is to target what can actually be changed.
Being active
Diabetes Canada recommends at least 150 minutes of aerobic activity per week (walking, cycling, dancing, swimming…).3
A gradual, tailored progression is better than sessions that are too long at the start. Muscles use a lot of glucose: strength training can complement aerobic exercise.
Eating well
Diabetes Canada suggests eating patterns such as the DASH or Mediterranean diet, rich in vegetables, fruit and whole grains, with healthy fats such as olive or canola oil, and fewer processed and sugary foods.3
There is no need to eliminate carbohydrates: their quality, their quantity and how meals are distributed matter more.
Weight, if relevant
For people for whom it is indicated and desired, losing just 5% of initial body weight can help prevent type 2 diabetes, according to Diabetes Canada.3
Metabolic health can improve even before significant weight loss.
Getting enough sleep
The Government of Quebec includes adequate sleep among the habits that help prevent type 2 diabetes.4 Obstructive sleep apnea is one of the risk factors recognized by Diabetes Canada.2
Managing stress
Stress alone does not explain prediabetes, but it affects sleep, diet and physical activity. The Government of Quebec includes stress management in the prevention of type 2 diabetes.4
Quitting smoking
The Government of Quebec counts quitting smoking among the measures to prevent type 2 diabetes.4
Can medications be used?
In certain situations, yes. Management is based first on lifestyle habits, and a health professional can, if needed, recommend drug treatment.5
Medication is not automatically indicated as soon as an HbA1c reaches the prediabetes range: the decision depends on blood glucose, age, other risk factors, the risk of progression and your preferences.
How often should tests be repeated?
There is no single interval. Diabetes Canada recommends screening every 3 years starting at age 40, and every 6 to 12 months in people who have other risk factors.1
Can HbA1c come back down?
Yes, particularly after changes in activity, diet, sleep or weight. However, future risk is not necessarily the same as for a person who has never had prediabetes: monitoring remains relevant.
Prediabetes and pregnancy
During pregnancy, the criteria are different. Diabetes Canada recommends screening for gestational diabetes between 24 and 28 weeks, or earlier in women at high risk.2
Previous gestational diabetes is one of the risk factors for type 2 diabetes: follow-up after pregnancy is important.1
And in children?
The criteria and tools differ: HbA1c is not recommended for diagnosis in children and adolescents.1
This page mainly covers non-pregnant adults.
Prediabetes assessment in Saint-Hyacinthe
At Clinique IPS du Palais, depending on your situation, the assessment may include: interpretation of fasting blood glucose and HbA1c, an OGTT when relevant, your family history, blood pressure, a lipid profile, screening for other metabolic factors, a medication review, sleep, physical activity, diet, smoking and an estimate of cardiovascular risk.
The goal: to understand not only whether your blood glucose is high, but why, and which interventions will reduce your long-term risk.
Frequently asked questions
Frequently asked questions
Does an HbA1c of 6.0% mean I have diabetes?
No. In Canada, an HbA1c of 6.0 to 6.4% corresponds to the prediabetes range in adults, when HbA1c can be used for diagnosis. Diabetes is defined as 6.5% or higher.
Is a fasting blood glucose of 6.5 mmol/L diabetes?
No, according to Canadian criteria. A fasting blood glucose of 6.1 to 6.9 mmol/L corresponds to impaired fasting glucose (prediabetes). The diabetes threshold is 7.0 mmol/L or higher.
Is prediabetes reversible?
Values can return below prediabetes thresholds in some people. It is more accurate to say that prediabetes can regress, rather than claiming it is always reversible or always permanent.
Will I necessarily develop diabetes?
No. The risk is higher, but progression is not inevitable. The Government of Quebec points out that it is possible to prevent diabetes, make it regress or, at least, delay its progression.
Do I have to cut out sugar completely?
No. The approach looks at your diet as a whole rather than eliminating a single food or nutrient. Cutting back on sugary drinks and highly processed products is generally a good starting point.
Do I need to take medication?
Not automatically. Management begins with assessing your risk and your lifestyle habits. Medication may be considered in certain situations.
Can a thin person have prediabetes?
Yes. Weight is only one of the possible factors.
Do I need to fast for an HbA1c test?
No. HbA1c generally does not require fasting, unlike fasting blood glucose.
Key takeaways
Prediabetes is blood glucose that is higher than normal without meeting the criteria for diabetes. In Canada: fasting blood glucose of 6.1 to 6.9 mmol/L, HbA1c of 6.0 to 6.4% or blood glucose of 7.8 to 11.0 mmol/L two hours after a 75 g OGTT.
It is a signal to take action, not a sentence. Early detection makes it possible to act on physical activity, diet, sleep, smoking, blood pressure, cholesterol and other metabolic factors.
Sources
- Diabetes Canada. Screening for and Diagnosing Diabetes (tool for professionals). Accessed October 5, 2026. diabetes.ca
- Diabetes Canada. Assess Your Risk of Developing Diabetes. Accessed October 5, 2026. diabetes.ca
- Diabetes Canada. Preventing Diabetes. Accessed October 5, 2026. diabetes.ca
- Government of Quebec. Diabète. Updated January 29, 2025, accessed October 5, 2026. quebec.ca
- Government of Quebec. Prévenir les problèmes de santé à l’âge adulte. Updated July 22, 2026, accessed October 5, 2026. quebec.ca
- Institut national de santé publique du Québec (INSPQ). Prévalence du diabète (indicator, 2024-2025 data). Accessed October 5, 2026. inspq.qc.ca
The information on this page is provided for informational purposes and does not replace an assessment by a health professional.