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Hello Sarah, Come in and take a seat. As you know, we got your blood tests back, and it looks like you have pre-diabetes. Now, the first thing is to try and not to worry about this. I am actually glad we did the bloods and caught the condition at this stage. Let’s start with your first question, shall we? What does pre-diabetes mean? People with pre-diabetes have blood sugar levels that are higher than normal. That’s right. Now, what we consider normal level is around 5.9%. Anything higher indicates pre-diabetes. It is actually a very common condition, although it is only very recently that we developed the testing technology that allows us to measure the levels of glycated hemoglobin—see that indicator here on your test results?—that tells us that you are pre-diabetic. Right, I was just going to answer this question. Yes, having pre-diabetes does mean you are at a significant risk of developing full type 2 diabetes, but this is not inevitable. OK, there are several things we can do at this stage. First of all, let’s look at your BMI. Currently, your BMI is above 28 which is higher than the recommended 25. So losing excess weight is the most important thing you can do, starting now. I understand that it is easier said than done, because we’ve had this conversation before, haven’t we? That’s right. So, what I would like you to do is to set up a meeting with our nurse so she can talk you through a diabetes prevention programme which includes weight monitoring and weight loss programme. Are you willing to do that? This is why knowing about the risk is important at an early stage, when we still can do something about it. Another thing is to increase your level of exercise. How are your knees now? What exercise do you do currently? I see. I can appreciate you have a lot on your plate at the moment, looking after your brother and having to work from home. I can also hear that you recognise how some of your lifestyle choices might be contributing to a lack of exercise and weight gain. What about going for a walk in the park, maybe once a day at least? Something else you might want to discuss with the nurse is keeping a food diary. Now, the next thing we need to think about is to get your back for further blood tests in three months’ time. A one-off reading like we did a week ago should still be accurate, but it is important to keep monitoring the situation and to see which way the blood sugar is going. If it goes up, we need to think of putting you on medication. As I said, I think we should start with trying to lower your BMI and let’s see how we get on, shall we?