The Prediabetes Explosion: More than 86 million American adults—approximately one-third of those over age 18 and half of those over 65—have prediabetes, and most of them don’t even know it. If you have prediabetes, it means your blood sugar levels are consistently higher than normal, but not yet high enough to be diagnosed as diabetes. Prediabetes puts you at higher-than-normal risk of developing type 2 diabetes, heart disease, and stroke. According to U.S. Centers for Disease Control, up to 30% of overweight men and women with prediabetes will develop type 2 diabetes within five years of diagnosis. You don’t have to be one of them! Here are five steps you can take to reduce your diabetes risk.

1. Get Tested

Not everyone with prediabetes will develop type 2 diabetes, but everyone with prediabetes is at higher-than-normal risk. So talk to your healthcare provider about determining your own risk and getting a simple blood test for diabetes screening. If necessary, find out what steps you should take right now to avoid or delay the development of type 2 diabetes and related medical conditions.

2. Change Your Diet

If you have prediabetes, you can reduce your risk of developing more serious conditions by eating better and losing any excess weight. Eating better means choosing more healthful foods (e.g., lean meats or protein substitutes, fresh veggies, high-fiber starches, healthful fats); eating a wide variety of these foods to balance your meals and be sure you’re getting all the nutrients you need; and sticking to small portion sizes. It also means eating regularly scheduled meals and snacks to avoid extreme blood sugar highs and lows throughout the day.

3. Reduce Toxic Stress Levels

Researchers have found that while short-term psychological stress can actually be good for you, chronic stress suppresses your immune system and could increase your risk of developing type 2 diabetes by altering your insulin needs. In some people, chronic stress may also trigger a cascade of hormonal events that increase appetite. While it’s not always possible to eliminate your source of stress, coping techniques, such as yoga, meditation, reading and writing poetry, counseling, or exercise, can help reduce overbearing pressure before it makes you sick.

4. Get Moving

When you’re at risk of developing diabetes, too much TV time or other time spent in sedentary activities increases your risk even more. Regular exercise can help you manage your weight, reduce high blood pressure and blood fats, sleep better, improve your mood, and boost your energy levels, all of which can also help alleviate stress. The ADA recommends 30 minutes of moderate-to-vigorous aerobic exercise, such as brisk walking, stair climbing or jogging, at least 5 days a week, and strength training, such as calisthenics or weight training, at least twice a week.

5. Take Your Meds

In many cases, lifestyle changes such as improved diet, stress reduction, increased physical activity, and weight management will help you control your blood sugar and prevent prediabetes from turning into diabetes. But if you are obese, under 60 years old, or have a history of gestational diabetes, your healthcare provider may recommend oral medication, such as metformin, as the first best step toward managing your condition. If you feel you would benefit from medication, ask your doctor if you are a candidate.