The way most people in the UK find out they’re pre-diabetic is by text message.
A blood test had been done for something else. Cholesterol, an HRT review, fatigue that hadn’t been investigated, an NHS Health Check. The blood was drawn, the patient was told someone would be in touch if there was anything to discuss, and life carried on. A few days later, a text from the surgery: Your HbA1c is in the pre-diabetic range, please book an appointment to discuss. Sometimes not even that. Sometimes a link to a leaflet, and that’s it.
I want to write to you, today, about that week. The one between the text arriving and the patient actually understanding what they’ve just been told. Because that week is, in my experience, one of the most disorienting and lonely periods of the whole process, and almost nobody is given any meaningful support inside it.
The thing nobody quite says clearly is that the diagnosis is information. It is not a verdict. It does not tell you who you are. It tells you that a measurement of something inside your body has crept past a clinical threshold that someone, somewhere, drew a line at. The line is useful - it gives clinicians a way to act before things deteriorate further. But the line is also slightly arbitrary, in the sense that the body was already drifting before it crossed it, and would have kept drifting if the test hadn’t happened to catch it. The diagnosis is the moment a measurement caught up with a reality. It isn’t the moment the reality began.
Once you understand that, a lot of the panic eases. Not all of it, but at least some.
The next thing worth knowing is that the period you’re in now is one of the most responsive windows in the whole metabolic continuum. Pre-diabetes sits in a place where the pancreas is still working, the cells haven’t given up on insulin signalling, and the system is strained but not broken. The research on what happens at this stage, when people are supported properly, is consistently encouraging in a way that’s harder to replicate later. So if you’re going to make the changes (you don’t have to, but if you’re going to) the next three to six months matter in a way that the next three to six years won’t.
And the third thing, which I think is the most honest of the three, is that you almost certainly won’t be given much in the way of structured help. The NHS Diabetes Prevention Programme exists, and it does good work, but it’s heavily oversubscribed in most areas and the waiting list is long. Some people get referred and never hear back. Many don’t get offered it at all. So the period in which you’re best able to act is, paradoxically, often the period in which you receive the least support.
This is the gap I do my work inside.
I’d say it even if I weren’t a Qualified Nutrition and Lifestyle Advisor. Having someone in your corner who actually has the time to look at your specific pattern, like your bloods over the last few years, your meals, your sleep, your stress, your family history, the symptoms you’ve been ignoring, and to help you build something that fits your actual life rather than a generic leaflet, is one of the single most useful things you can do at this stage of the work.
What I’d want anyone newly diagnosed to know is that the response, in the first few weeks, doesn’t need to be dramatic. The body that’s been compensating quietly for years is still capable of responding when you give it what it needs. Often the first changes are smaller than people imagine: a slightly modified breakfast, a walk after dinner, and an honest look at what the evenings have been doing to the mornings. The changes that actually hold are the ones that fit the life you have, not the ones that look impressive in a meal plan.
The diagnosis is information. It isn’t a sentence. And the body will tell you what it needs, when someone takes the time to listen.
If you’ve recently been told you’re pre-diabetic and you’re not sure where to start, my free guide Pre-Diabetes: What Your GP Didn’t Have Time to Tell You walks through what the diagnosis actually means and the first practical steps. Download it at francesnorgate.com/prediabetes-guide.
And if you’d like a proper conversation about your specific numbers and what to do next, my free 30-minute Blood Sugar Audits are open this month. Book at francesnorgate.com/blood-sugar-audit.
Thank you for being here.
See you next week,
Frances x
Frances Norgate
Qualified Nutrition and Lifestyle Advisor
