People with prediabetes have high blood sugar levels that put them at a higher risk of Type 2 diabetes. It’s a serious condition that can cause heart disease, vision loss, kidney disease and amputations.
It’s important to know that prediabetes can be reversed through diet and exercise. Lifestyle changes can also lower your risk of getting Type 2 diabetes by 40-70%.
Exercise
Despite the rise of medications such as metformin, gliptins, and acarbose, lifestyle modification including exercise continues to be the primary way to delay or reverse the progression of prediabetes to diabetes. In addition to improving glucose tolerance, physical activity also improves lipid metabolism and increases overall strength.
Aerobic exercise such as brisk walking, jogging, swimming, cycling or aerobics helps reduce blood sugar in the short term and improves insulin sensitivity in the long term. Ideally, these types of exercises should be done three to five times a week for at least 150 minutes per week.
Studies have shown that resistance training, or weight lifting, increases muscle mass and helps your cells become more sensitive to insulin. Adding in some flexibility and balance exercises, like yoga, Pilates or tai chi, will help you stay healthy and reduce the risk of falls or injury.
In one study, researchers randomly assigned 31 sedentary adults with prediabetes to either an hour of aerobic exercise or an hour of resistance training for two weeks. The results? After the workout, their blood sugar levels were significantly lower when they took a glucose tolerance test.
However, it’s important to note that not all studies have produced similar results. Some have exhibited high rates of random sequence generation bias, which can be caused by the difficulty in blinding participants and experimenters to the type of exercise they are receiving.
If you are new to exercise, it’s best to start slowly and gradually increase your activity level over time. This will reduce your risk of injuries and keep you motivated. It’s also important to find activities that you enjoy, so you’ll be more likely to stick with your exercise routine in the long run.
Diet
The most effective ways to lower your blood sugar level and prevent the progression of prediabetes are diet and exercise. But changing your eating habits may not be easy. Luckily, there are plenty of tools and resources available to help you improve your health.
Tara Seymour, an advanced practice clinical dietitian and diabetes educator at Johns Hopkins, says the first thing to do is start by dropping sugary items from your diet. This may mean reducing the amount of soda, juice and energy drinks you drink, as well as avoiding packaged baked goods and pancake mixes that contain a lot of sugar.
Adding more protein-rich foods to your meals can also help. This is because proteins slow down the rate at which carbohydrates enter your bloodstream, so they won’t spike your blood sugar. A few examples of protein-rich foods include nuts and seeds, (or natural nut butters), plain yogurt, cottage cheese and hard-boiled eggs.
In addition, you should drink lots of water. This will help you stay hydrated and improve your urine’s color, which should be pale yellow. It’s also helpful to cut out sugary drinks like 100% fruit juice, soda, sweetened coffee or tea, energy drinks and mixed alcohol cocktails.
Studies show that increasing the amount of calories you burn through physical activity can significantly improve your glycemic control and body weight. It’s important to focus on cardiovascular exercise, such as brisk walking or swimming, and also incorporate strength training. Strength training, or resistance exercises, like using dumbbells or bodyweight exercises, helps you build muscle and improves insulin sensitivity. Flexibility and balance exercises, such as yoga, Pilates or tai chi, can also enhance your overall health and well-being.
Weight Loss
Prediabetes isn’t a permanent condition, but gaining excess weight can accelerate the transition to Type 2 diabetes. The good news is that losing weight by improving diet and increasing physical activity, if needed, can reverse pre-diabetes.
The best way to lose excess weight is through a healthy eating plan that includes nutrient-dense, whole foods. Choose foods low in sugar and fat, and avoid empty calories like soda and other junk food. Eating frequent, small meals throughout the day is another strategy to help regulate blood sugar.
Exercise is good for everyone, but it’s especially important if you have prediabetes. Exercise helps you burn more calories, and it also reduces your insulin resistance so you can use the sugar you eat more effectively.
A recent study found that people who lost 7% of their body weight and walked 150 minutes a week had a 58% lower risk of developing Type 2 diabetes than those who gained weight and stayed the same. In addition to exercise, the study found that lifestyle interventions can reverse pre-diabetes by including goal setting, personalized diets with calorie recommendations, meal replacement and quarterly check-ups.
Sleep is also important for reducing your diabetes risk. Getting enough quality sleep can improve your insulin sensitivity and help keep your blood sugar stable.
It’s important to know that there are some factors you can’t control, such as your genetics. However, most prediabetes can be reversed by changing your diet and exercise habits. To learn more about how you can reverse prediabetes, listen to Dr. Avadhanula on the latest episode of the Health Essentials Podcast. New episodes are posted every Wednesday. You can subscribe on Apple Podcasts or Google Play.
Quit Smoking
Many smokers don’t realize that cigarette smoking significantly raises their risk of developing type 2 diabetes. Smokers have 30 – 40% more chance of getting the disease compared to nonsmokers. This is because smoking reduces insulin sensitivity and secretion while impairing the functioning of beta cells.
Moreover, smoking also contributes to poor sleep quality which can affect blood sugar regulation. Getting the right amount of sleep, avoiding alcohol and caffeine late in the day, following regular sleep schedules, and staying away from electronic devices just before bedtime can all help regulate blood sugar levels during the night.
Studies show that people who quit smoking often experience improvements in their health, including an increase in their glycemic control. The risk of progression to type 2 diabetes decreases after a person stops smoking, even though in the first few years after quitting smoking there is usually an initial increase in the risk because of weight gain and worsening glycemic control.
In the long run, however, the risk of progression to diabetes decreases as weight loss occurs. In a study by Pani et al[22], the authors found that each pound of excess weight gained increased the risk of progression from prediabetes to diabetes by 2%.
You may find it easier to stick with your plan to stop smoking when you get some support from friends and family, or even from a professional counselor. You can try cold turkey, use nicotine gum, patches or inhalers, or ask your doctor about medications to help you quit. The money you save from not buying cigarettes will be an excellent incentive as well—at around $10,000 a year for the average smoker, that’s a lot of change you can put toward your other healthy goals!
Medication
Some people with prediabetes need medication to help their blood sugar levels get back to normal. A health care provider might recommend the drug metformin (Glumetza) for adults who don’t improve their blood sugar levels with changes to their diet and exercise alone. They might also recommend medications to control cholesterol and high blood pressure, which are common risk factors for diabetes.
Regular, moderate-intensity exercise helps increase the use of glucose in the body and improve muscle insulin sensitivity. In a study, 31 sedentary older adults with prediabetes who took part in a two-week exercise program did better on a glucose tolerance test than those who didn’t. They also saw improvements in their muscle insulin sensitivity.
Studies have shown that losing weight, eating a healthy diet and getting plenty of exercise can reverse prediabetes or prevent it from progressing to type 2 diabetes. It can also reduce the risk of developing other serious conditions, such as heart disease and stroke, by 40-70%.
People with prediabetes should be screened for type 2 diabetes at least once every three to five years, or more often if they are at increased risk. These include those who are overweight, people who have a family history of type 2 diabetes or of African-American or Hispanic descent, and those who have a condition such as polycystic ovary syndrome (PCOS).
Reversing prediabetes requires making many lifestyle changes at once. It’s important to seek the guidance of a doctor or registered dietitian, who can help you plan healthy eating patterns and find support groups. Some community organizations offer programs to help you make healthy lifestyle changes, like the National Diabetes Prevention Program.
