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Approximately 38.1 million adults in the U.S. — or 14.7 percent — have diabetes, whether it be diagnosed or undiagnosed, according to 2024 figures from the Centers for Disease Control and Prevention (CDC). Of them, 14.5 percent between 45 and 64 years old are diagnosed, while 24.4 percent are over 65.
Many more, about 1 in 3 U.S. adults, have prediabetes, where blood sugar has risen above healthy levels but isn’t high enough yet to be classified as diabetes.
Naturally, then, it might feel daunting to try to get high blood sugar under control. But, fortunately, experts say a number of simple (read: straightforward, not necessarily all easy, but doable) steps can bring glucose levels back into a healthy range. You also have plenty of reasons beyond diabetes prevention to do just that: A Dec. 12 study in The Lancet Diabetes & Endocrinology, using data from two landmark diabetes prevention studies, found that regulating blood sugar back to normal levels with lifestyle changes can cut the risk of death from heart disease or heart failure by half.
People with prediabetes have a higher risk of suffering from a heart attack or stroke in the future — along with other heart disease issues — “even without full-blown diabetes,” says Dr. Zhenqi Liu, James M. Moss professor of diabetes at the University of Virginia School of Medicine.
For those with the chronic disease, as the CDC notes in its November report updating prevalence figures, “uncontrolled blood glucose levels over a long period of time can affect multiple organ systems, including the nervous system, kidneys, eyes, heart and blood vessels.”
The takeaway is clear: Getting your blood sugar levels under control now can be a lifesaver and improve your quality of life. Here are steps you can take to reduce your risk and lower your blood sugar.
1. Know your numbers
To start, you need to know where you stand. The vast majority with prediabetes — more than 80 percent — don’t know they have it, according to the CDC.
The U.S. Preventive Services Task Force recommends people ages 35 to 70 who are overweight or obese get screened for prediabetes and diabetes. The American Diabetes Association (ADA) recommends screening for all people 45 and up and testing blood sugar earlier in those at higher risk for diabetes. You can assess your individual risk using an online tool provided by the ADA, answering questions about risk factors ranging from age and immediate family history of diabetes to activity level and race.
What’s considered a healthy blood sugar number depends on the test. For example, with a fasting blood sugar test, anything below 100 milligrams per deciliter is considered healthy. A glucose level of 100 to 125 mg/dL is considered prediabetes, and 126 mg/dL or higher is diabetes. Another test, hemoglobin A1C, measures a person’s average blood sugar over two to three months as a percentage. A result of 5.7 to 6.4 percent is considered prediabetes, and 6.5 percent or higher is diabetes. For more about testing, see Your Prediabetes Questions Answered.
2. Consider using a glucose monitor
Many with diabetes who rely on insulin to help with blood sugar control use continuous glucose monitors — wearable devices that provide ongoing data on blood sugar — to track their levels. While some people who don’t have diabetes use the technology as well to keep tabs on their blood sugar, there is currently no strong data on the effectiveness of this strategy for people with prediabetes.
Continuous glucose monitors help with better understanding the immediate impact of lifestyle on glucose levels, explains Dr. Megan Kristan, endocrinologist and assistant professor of medicine at the University of Minnesota. “Seeing how different food choices, different activity levels impact your blood sugar,” she notes, “so then you can use that information to make a different choice the next time.” If you’ve been diagnosed with prediabetes or diabetes, talk to your doctor about how to best monitor your blood sugar as you make lifestyle changes.
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