Jump to: Understanding prediabetes progression | How Mounjaro helps prevent diabetes | Getting prescribed Mounjaro for prediabetes | Frequently asked questions | Take home message
Mounjaro can help prevent prediabetes from progressing to type 2 diabetes, particularly if you need significant weight loss alongside lifestyle changes.
Recent research shows tirzepatide (Mounjaro) reduced the risk of developing type 2 diabetes by 94% in adults with prediabetes and obesity over three years.
Combining Mounjaro with healthy habits, such as eating a diet based on whole foods, moving more, and sleeping better, is more likely to help prevent type 2 diabetes in the long term than medication alone.
Mounjaro works by mimicking two hormones in the body that lower hunger, helping us eat less to support weight loss.
Additionally, Mounjaro helps our body manage blood sugar levels by improving the action of the hormone insulin, which keeps our blood sugar levels in the healthy range.
So, Mounjaro has two functions that support people living with prediabetes:
- It supports weight loss, which will inherently lower blood sugar levels
- It improves the function of insulin, helping the body manage blood sugar levels better
NHS data shows that 3.6 million people in England were found to have prediabetes in 2023, an 18% increase from the previous year.
This represents a significant opportunity for prevention, as catching blood sugar problems at this stage gives you the best chance to avoid developing type 2 diabetes altogether.
Understanding prediabetes progression
Think of prediabetes as our body’s early warning system; it’s telling us that our blood sugar control isn’t quite right, but we still have time to turn things around.
The NHS defines prediabetes (also called non-diabetic hyperglycaemia) as blood sugar levels above the normal range, but not high enough to be diagnosed as diabetes.
Your GP will have diagnosed this using an HbA1c test, which shows your average blood sugar levels over the past 2-3 months.
Here’s how the HbA1c ranges work:
- Normal: Below 42 mmol/mol
- Prediabetes: 42-47 mmol/mol
- Type 2 diabetes: 48 mmol/mol and above
The progression from prediabetes to type 2 diabetes isn’t inevitable. Research consistently shows that combined lifestyle interventions can reduce the risk of type 2 diabetes by about 50%.
However, without changes, many people with prediabetes do progress to full diabetes.
What’s happening in your body during prediabetes is that your cells are becoming less responsive to insulin, the hormone that helps move sugar from your blood into your cells for energy.
This is known as insulin resistance, and it’s often associated with carrying excess weight, particularly around the waist.
The role of weight in diabetes progression
Weight plays a crucial role in diabetes development, but it’s not just about the number on the scales.
Where you carry weight matters too. Belly fat (what we call visceral fat) is particularly problematic because it releases inflammatory substances that worsen insulin resistance.
UK data shows that obesity significantly increases prediabetes risk, but there’s also considerable prevalence in people typically considered ‘low risk’, 8% of those who weren’t overweight or obese still had prediabetes.
This shows that while weight is important, it’s not the only factor.
How Mounjaro helps prevent type 2 diabetes
Mounjaro works by mimicking two hormones your body naturally makes: GLP-1 and GIP.
These hormones normally help control blood sugar and appetite, but they don’t work as well when you have insulin resistance.
The medication helps in several ways:
- It makes your pancreas release more insulin when your blood sugar is high
- It reduces glucagon secretion, which stops your liver from releasing extra sugar when you don’t need it
- It slows down how quickly food leaves your stomach, helping prevent blood sugar spikes
- It reduces your appetite, making it easier to eat less and lose weight
The weight loss aspect is particularly important for individuals with prediabetes.
In the SURMOUNT-1 trial, people with prediabetes who took the 15mg dose of Mounjaro lost an average of 22.9% of their body weight over three years, compared to just 2.1% with placebo.
This amount of weight loss will improve insulin sensitivity. When our cells respond better to insulin, our blood sugar levels naturally improve, often bringing them back to the normal range.
The diabetes prevention results
The research shows clear benefits. After three years of treatment, 1.3% of people taking Mounjaro developed diabetes, compared to 13.3% of those taking placebo. This represents a 94% reduction in diabetes risk.
Most people taking Mounjaro also saw their blood sugar levels return to normal. After 72 weeks of treatment, 95.3% of people with prediabetes taking tirzepatide had normal blood sugar levels, compared to 61.9% taking placebo.
The placebo group’s relatively high success rate reflects the fact that all participants received intensive lifestyle support including dietary counselling and exercise guidance.
This suggests that Mounjaro doesn’t just delay diabetes, it can help reverse the condition.
Can you get prescribed Mounjaro for prediabetes?
Mounjaro isn’t specifically licensed for prediabetes treatment in the UK; it’s approved for type 2 diabetes management and weight loss in people with obesity.
To get prescribed Mounjaro, you’ll need to meet the BMI criteria for weight loss treatment:
- BMI of 30 or above (obesity)
- BMI of 27-29 with a weight-related health condition (which prediabetes counts as)
As of 2025, there’s a very limited supply of Mounjaro on the NHS as it’s being reserved for patients with the greatest clinical need.
Typically, this means patients living with poorly controlled type 2 diabetes who are at risk of hospitalisation, or those with a BMI above 40 with multiple obesity-related complications.
Your prescription options
You have two main routes:
Private prescription (most common option)
Most people get Mounjaro through private online providers or weight loss clinics. This typically costs £150-250 per month, depending on the dose and provider.
Second Nature’s medication-supported programme comes with the support of a registered nutritionist or dietitian to help develop the healthy habits needed to prevent type 2 diabetes in the long term.
NHS prescription (limited availability)
NHS England has been expanding access to diabetes prevention programmes, but Mounjaro prescriptions remain very limited. Most NHS areas aren’t yet prescribing it for prediabetes prevention.
The lifestyle-first approach
It’s worth noting that lifestyle changes should always be the foundation of prediabetes treatment.
The NHS Diabetes Prevention Programme (NDPP) has helped thousands of people reverse their prediabetes through lifestyle changes alone, including diet and exercise.
For over 5 years, Second Nature has been delivering NDPP programmes within the NHS.
Research published in the British Medical Journal revealed that we achieved the highest average weight loss among all five providers.
Mounjaro works best when it supports lifestyle changes rather than replacing them. The medication can help you achieve appetite control and weight loss momentum, making healthy changes feel easier and more sustainable.
Frequently asked questions
Is taking Mounjaro cheating?
Not at all. Mounjaro is a tool that can make lifestyle changes more achievable. Many people find that reduced appetite helps them stick to healthier eating patterns they struggled with before.
The key is using the medication as support while building long-term habits. Our approach focuses on developing the skills you’ll need, whether you continue taking Mounjaro long-term or eventually stop.
How long would I need to take it?
This varies for everyone. The SURMOUNT-1 study followed people for three years, and the diabetes prevention benefits were maintained throughout.
However, when people stopped taking the medication, some began to regain weight and showed signs of increased blood sugar.
Some people may use Mounjaro for 1-2 years to achieve significant weight loss and then maintain their results through lifestyle changes.
Others may benefit from longer-term use. This decision should be made with your healthcare provider based on your individual response and circumstances.
What happens to my prediabetes while on Mounjaro?
Most people notice an improvement in their blood sugar levels quite quickly. In clinical trials, 95% of people with prediabetes who took tirzepatide had normal blood sugar levels by the end of the study.
You’ll want to have regular blood tests (every 3-6 months) to monitor your HbA1c levels.
Many people find their levels return to the normal range within 6-12 months of starting treatment.
Can I prevent diabetes without medication?
Yes, absolutely. Lifestyle interventions, including a balanced diet, regular physical activity, and sustained weight loss, can reduce the risk of type 2 diabetes by approximately 50%.
The NHS Diabetes Prevention Programme offers free support for this approach.
However, if you’ve struggled to lose weight or maintain weight loss through lifestyle changes alone, Mounjaro can provide the additional support needed to achieve the kind of weight loss that significantly reduces diabetes risk.
What if I have other health conditions?
Prediabetes often occurs alongside other conditions like high blood pressure, sleep apnoea, or PCOS.
Mounjaro can often be safely used with these conditions and may even help improve them through weight loss.
However, you’ll need an individual medical assessment. Some medications and health conditions require special monitoring or dose adjustments.
Take home message
Prediabetes is your opportunity to prevent type 2 diabetes before it develops. While lifestyle changes remain the foundation of prevention, Mounjaro can provide additional support for people who need significant weight loss.
The research showing 94% reduction in diabetes risk demonstrates the potential benefit; however, it’s essential to note that this was achieved alongside lifestyle changes, not in place of them.
The medication works best when combined with building healthier habits.
If you’re considering Mounjaro for prediabetes, focus on providers who offer comprehensive support rather than just medication, like Second Nature.
The goal isn’t just to prevent diabetes in the short term, but to build the habits and achieve the weight loss that will protect your health for years to come.
Remember that catching prediabetes early gives you a huge advantage. With the right combination of lifestyle changes and, if needed, medical support, most people can return their blood sugar levels to normal and significantly reduce their future diabetes risk.
Second Nature's Mounjaro programme
Second Nature provides Mounjaro as part of our Mounjaro weight-loss programme
Why choose Second Nature over other medication providers, assuming you’re eligible?
Because peace of mind matters.
We’ve had the privilege of working with the NHS for over eight years, helping people across the UK take meaningful steps toward a healthier, happier life.
Our programmes are designed to meet people where they are, whether that means support with weight loss through compassionate one-to-one health coaching, or access to the latest weight-loss medications (like Mounjaro) delivered alongside expert care from a multidisciplinary team of doctors, psychologists, dietitians, and personal trainers.
At the heart of everything we do is a simple belief: real, lasting change comes from building better habits, not relying on quick fixes. We’re here to support that change every step of the way.
With over a decade of experience, thousands of lives changed, and a long-standing record of delivering programmes used by the NHS, we believe we're the UK’s most trusted weight-loss programme.
We hope to offer you something invaluable: peace of mind, and the support you need to take that first step.
