2 February 2026 (Navroze Bureau) : A growing number of physicians are challenging the commonly used term “borderline diabetes,” warning that an HbA1c level of 5.7% should not be taken lightly. According to medical experts, this level already signals metabolic dysfunction and insulin resistance—conditions that, if ignored, can progress to full-blown type 2 diabetes and other chronic illnesses.
The warning has sparked conversations around early intervention, lifestyle changes, and the urgent need to rethink how prediabetes is perceived and managed.
What Is HbA1c and Why It Matters
HbA1c, also known as glycated hemoglobin, measures average blood sugar levels over the past two to three months. Unlike a fasting glucose test, it reflects long-term glucose exposure, making it a more reliable indicator of metabolic health.
According to widely accepted clinical ranges:
- Below 5.7% is considered normal
- 5.7% to 6.4% indicates prediabetes
- 6.5% and above is diagnostic of diabetes
While 5.7% is often labeled as “borderline,” many physicians argue that this classification downplays the seriousness of what is already happening in the body.
“Not Borderline, Already Sick”: What Doctors Mean
When doctors say that a person with an HbA1c of 5.7 is “already sick,” they are referring to early-stage insulin resistance. At this stage, the body struggles to use insulin efficiently, causing blood sugar levels to remain slightly elevated over time.
This metabolic dysfunction does not occur overnight. It is often the result of years of poor diet, physical inactivity, chronic stress, lack of sleep, and excess visceral fat. By the time HbA1c reaches 5.7, damage may already be occurring at a cellular level, increasing the risk of:
- Type 2 diabetes
- Heart disease
- Fatty liver disease
- Hormonal imbalance
- Chronic inflammation
Experts stress that waiting until HbA1c crosses 6.5% to take action is a missed opportunity for prevention.
Why Early Action Is Critical
The good news is that prediabetes is reversible, especially when detected early. Studies show that lifestyle intervention at the prediabetic stage can reduce the risk of developing diabetes by more than 50%.
Doctors emphasize that medications are often not required at this stage. Instead, targeted changes in daily habits can significantly improve insulin sensitivity and bring HbA1c back into the normal range.
How to Reverse an HbA1c of 5.7 Naturally
1. Fix the Diet First
Nutrition plays the most crucial role in reversing insulin resistance. Physicians recommend:
- Reducing refined carbohydrates such as white rice, white bread, sugar, and packaged foods
- Prioritizing whole foods like vegetables, legumes, nuts, seeds, and lean proteins
- Including healthy fats from sources like olive oil, avocados, and nuts
- Avoiding sugary drinks, fruit juices, and excessive desserts
Balanced meals that combine protein, fiber, and healthy fats help prevent blood sugar spikes.
2. Move Your Body Daily
Physical activity improves insulin sensitivity almost immediately. Even moderate movement helps muscles absorb glucose without requiring excess insulin.
Doctors suggest:
- At least 30 minutes of brisk walking five days a week
- Strength training two to three times a week
- Reducing prolonged sitting by standing or walking every hour
Exercise does not need to be intense—consistency matters more than intensity.
3. Focus on Weight and Waist Circumference
Even a 5–7% reduction in body weight can significantly lower HbA1c levels. Visceral fat around the abdomen is particularly harmful, as it releases inflammatory chemicals that worsen insulin resistance.
Physicians emphasize waist size as an important marker of metabolic health, sometimes even more than body weight.
4. Improve Sleep Quality
Poor sleep disrupts glucose metabolism and increases insulin resistance. Adults with chronic sleep deprivation are at a much higher risk of progressing from prediabetes to diabetes.
Experts recommend:
- Sleeping 7–8 hours per night
- Maintaining consistent sleep and wake times
- Avoiding screens at least one hour before bedtime
5. Manage Stress Actively
Chronic stress raises cortisol levels, which in turn increases blood sugar. Long-term stress can sabotage even the best diet and exercise routines.
Stress-management strategies include:
- Meditation or deep breathing
- Yoga or stretching
- Spending time outdoors
- Limiting excessive caffeine
6. Monitor Progress Regularly
Doctors advise retesting HbA1c every three to six months after lifestyle changes. Tracking progress helps reinforce positive habits and allows early correction if levels do not improve.
Some individuals may also benefit from monitoring fasting glucose or using continuous glucose monitoring under medical guidance.
When Medication May Be Considered
While lifestyle changes remain the foundation, some high-risk individuals—such as those with obesity, strong family history of diabetes, or polycystic ovary syndrome (PCOS)—may be advised medication alongside lifestyle intervention. This decision should always be made in consultation with a qualified physician.
Changing the Narrative Around Prediabetes
Medical experts argue that the term “borderline diabetic” creates false reassurance. Instead of minimizing the condition, physicians advocate for viewing HbA1c of 5.7 as an early warning sign—a chance to intervene before irreversible damage occurs.
Early action not only prevents diabetes but also improves overall energy levels, heart health, and long-term quality of life.
Conclusion
An HbA1c of 5.7 is not a harmless number. It is a clear signal that the body’s metabolic system is under strain. The encouraging reality is that with timely lifestyle changes—focused on nutrition, movement, sleep, and stress—this condition can often be reversed.
Listening to early warnings, rather than dismissing them as “borderline,” may be the key to preventing lifelong chronic disease.
Summary:
Doctors warn HbA1c of 5.7 signals early insulin resistance, not “borderline diabetes.” Timely lifestyle changes in diet, exercise, sleep, and stress can reverse prediabetes and prevent future disease.