Prediabetes can be seen as a transition period where person has elevated blood glucose (let us call it blood sugar) but not high enough to be called diabetes. Fasting blood sugar of 125 mg/dl, or HbA1C reading between 5.5 to 6.4, or random blood sugar between 140 and 200 mg/dl is normally diagnosed as prediabetes.

In prediabetes insulin resistance is developing, and though blood sugar is elevated is still under tight control through overworking pancreatic beta cells. In most cases there are no complications seen and there is still a possibility to reverse to normal state.

The prediabetes state lasts from 5 to 10 years and just before diabetes (a year or two) there is a fast decline in control over sugar and classical symptoms of diabetes viz. excessive urination, thirst, hunger, etc.

Yes, and it requires serious medical intervention and lifestyle modifications. Moreover, prediabetes increases your risk of type II diabetes, heart disease and stroke.

Currently, there are no medicines approved in allopathy for the treatment of prediabetes; however there are efforts to repurpose rifampicin. According to Ayurveda prediabetes is called Prameha and is reversible through diet, exercise and certain herbals.

Through intensive management risk of turning prediabetes to diabetes can be reduced by as much as 60 % (below age of 60) or 70% (if above 60).

Diabetes is a result of several factors going wrong over a course of time. Presence of diabetes in immediate relatives predisposes you to have diabetes. This coupled by excessive and inappropriate food intake, sedentary lifestyle, stress slowly progresses to diabetes. Diabetes is marked by resistance of skeletal muscle to insulin action, loss of beta cell function, continuous low grade inflammation and consequent uncontrollable blood sugar. Several other factors are beginning to be realised as playing a crucial role in progression to diabetes vis. epigenetic modifications, gut dysbiosis, etc.

So far diabetes is not curable but controllable. There are only a few cases of total remission from diabetes, which were due to extreme calorie restriction. However in most cases, diabetes is not cure. This situation may change in near future though, due to fast scientific discoveries. For example, beta cells which previously were thought to be non-re-generable are now shown to be re-generable. Similarly various hormones other than insulin that are linked to behaviour are suspected to be contributing to diabetes opening a possibility of behavioural interventions in the treatment of diabetes. Also importance of epigenetic changes (possibly reversible) and dysbiosis (possibly reversible) links with diabetes are beginning to show new lights on diabetes aetiology. These new possible diabetes targets and causes are throwing a more comprehensive light on diabetes and because of which cure of diabetes is definitely not beyond reach.

Strict diet, exercise and medicines that progressively incorporate the evolving science can effectively halt progression of diabetes. Herbal supplements have an inbuilt adaptiveness that can respond to the newer discoveries by finding some herbs effective in the discovered direction. This makes constantly evolving herbal supplements an integral part of diabetes management.