Over 41 million Americans have pre-diabetes, defined as a fasting blood sugar level over 100 mg/dl but below 126 mg/dl for diabetes; those with pre-diabetes are at high risk for cardiovascular disease and likely to develop full diabetes within 5 to 10 years if lifestyle changes are not made. The document recommends lifestyle modifications like following a diet lower in unhealthy fats and carbs, eating more vegetables, beans, whole grains, and nuts, exercising regularly, and losing weight to help control blood sugar levels and reduce risk of developing diabetes.