If you have pre-diabetes, the long-term damage of diabetes, especially to your heart, blood vessels, and kidneys, may have already begun, according to the Mayo Clinic.

“Starting at age 45, we should be screening every three years for type 2 diabetes. However, some people are at risk even earlier than that,” said Dr. Amber Champion, a Mercy Medical Center endocrinologist.

About 29 million Americans have diabetes, according to the American Diabetes Association; 86 million people have pre-diabetes, which means the blood sugar level is higher than normal.

A study in the New England Journal of Medicine found something more effective than any drug in reducing diabetes risk, especially if you’re pre-diabetic.

“Losing weight can really be beneficial in preventing the onset or delaying the onset of diabetes for many years,” said Champion.

Champion says if you’re overweight, reduce your body weight by just 5 to 7 percent, exercise at least 30 minutes, five times a week, and cut back on sugary drinks. Also, try to make vegetables 50 percent of each meal and increase your fiber intake.

These lifestyle changes reduce the risk of developing type 2 diabetes by as much as 58 percent.

The Centers for Disease Control and Prevention says as many as 30 percent of those with pre-diabetes progress to diabetes within five years.