Dr Hilary's answer: Pre-diabetes means that you are not yet overtly diabetic but that your body is struggling to tolerate glucose in a normal healthy way. Usually our bodies control our blood glucose level within a narrow range, an equilibrium that is maintained by the action of the hormone insulin. When our bodies become resistant to insulin, the body is less able to make blood glucose available to the cells of the body for use as energy and blood sugar levels may rise as a result.Initially, this rise is seen after meals, but as the condition worsens, raised blood sugar levels are present all of the time, and the person becomes diabetic.This situation is most often seen in type 2 diabetes, where people have become overweight and are over the age of 40 or so.The pre-diabetic state does not necessarily progress to a diabetic one if the person involved can lose weight and increase their regular level of exercise. Both of these reduce insulin resistance and the weight loss may be achieved by eating less carbohydrate in the form of sugar and starch and by increasing the amount of fibre from fresh fruit and vegetables. Low-Gi foods are preferable, as these allow the body to absorb the glucose within them more slowly, thereby avoiding the peaks and troughs of blood sugar that result.If you are pre-diabetic, I would recommend you embark on these lifestyle changes immediately, in the realistic expectation that you may avoid diabetes altogether in the future. You will, however, need to have regular blood checks to assess progress.