What to Do About Prediabetes

Being diagnosed with prediabetes is literally the opportunity of a lifetime. Following an appropriate program to manage prediabetes can lower the risk for type 2 diabetes. According to the Centers for Disease Control and Prevention, lifestyle changes such as weight loss and physical activity may even reverse insulin resistance, which causes prediabetes. 

A Diagnosis of Prediabetes

Having prediabetes means blood sugar levels are higher than normal, but not as high as they are in diabetes. The National Institute of Diabetes and Digestive and Kidney Diseases says a healthcare provider may let you know you have prediabetes, impaired glucose tolerance, impaired fasting glucose, or high A1C. These are the cutoffs.

All of these mean that you have prediabetes and are at higher risk for prediabetes.

Significance of Prediabetes

Prediabetes does not usually have symptoms, and 84% of those who have it are unaware, according to the Centers for Disease Control and Prevention. However, leaving prediabetes untreated can lead to diabetes months or years down the road.

Prediabetes and diabetes result from insulin resistance, which causes the body to be less responsive to a hormone called insulin, and less able to remove glucose, or sugar, from the blood properly to be used for fuel or fat storage. Instead, sugar remains in the blood, causing high blood sugar. As insulin resistance becomes more severe, prediabetes and then diabetes can develop.

If prediabetes turns into diabetes, these are some possible complications that can result from high blood sugar.

• Neuropathy in hands and feet
• Kidney disease
• Eye problems, including blindness
• Increased infections
• Amputations

However, taking care of prediabetes and blood sugar can dramatically lower the risk of these and other complications. 

Treatment for Prediabetes

The Centers for Disease Control and Prevention (CDC) note that making healthy lifestyle changes can often lower blood sugar and help prevent or delay a diagnosis of type 2 diabetes. 

Patients with prediabetes are sometimes prescribed metformin, which lowers blood sugar. Research in Diabetes Care found that only 0.7% of patients with prediabetes take metformin. It is more likely among those with higher blood sugar or body mass index (BMI) or weight. If you have prediabetes, it is important to discuss all treatment options with your doctor.

Best Diet for Prediabetes

Improving eating habits is one of the most effective ways to reverse insulin resistance. Certain foods can lower blood sugar and insulin resistance, and other foods can have the opposite effects. 

For people who are overweight or obese, losing weight can have significant results. The American Diabetes Association cites a landmark study on lifestyle changes that found a 58% lower risk reduction for diabetes over 3 years among those with a goal of losing 7 to 10% of body weight. The benefits of weight loss were sustained, as another study found a 43% reduction in diabetes diagnoses over 20 years among participants who had lost weight.

Which diet is best for prediabetes? There are many approaches to losing weight and lowering blood sugar. 

Low-Carbohydrate Diets

If prediabetes results from high blood sugar, and blood sugar increases when you eat foods with carbohydrates, does it follow that reducing carbohydrates from food can lower blood sugar? It may work. The American Diabetes Association's consensus report on nutrition published in Diabetes Spectrum acknowledges that reduced-carb diets can help with weight loss and with lowering blood sugar among people with diabetes.

A very low-carb diet may include about 21 to 70 grams of carbohydrates per day, while a reduced-carb diet may get about 30 to 40% of calories from carbohydrates, or 150 to 200 grams per day.

Healthy Diet Patterns

There are a variety of dietary patterns that are "healthier" than, say, the typical American diet, and that the American Diabetes Association states may help lower blood sugar. In general, they may include higher amounts of nutrient-dense foods, such as those high in fiber, protein, and vitamins and minerals. They may also limit less-nutritious foods, such as those high in sugar, refined starches, and unhealthy fats.

Healthy Diet Cheat Sheet

Foods to Emphasize

• Whole grains
• Vegetables
• Fruit
• Fish
• Low-fat dairy products
• Beans
• Healthy fats such as avocados, nuts, and olive oil

Foods to Limit

• Sugar-sweetened beverages and foods, such as desserts, jam, and flavored oatmeal and yogurt
• Battered, fried foods
• Refined grains, such as white bread, rice, crackers, and pasta
• Butter
• Fatty meats and processed meats

Possible Benefits

• Lower blood sugar
• Weight loss
• Lower cholesterol
• Lower blood sugar

Possible Risks

• None noted

Best Exercise for Prediabetes

The best exercise for prediabetes is almost anything that gets you moving and keeps you coming back. Physical activity can reduce insulin resistance and improve metabolism.  American Diabetes Association goes on to say that "daily moderate or high-intensity exercise is optimal" for reducing insulin resistance. 

Whether you love the great outdoors, are a gym rat, prefer to work out in privacy, or avoid all types of formal exercise, there are many ways to get active.

• Hiking, rock climbing, walking, running, and bicycling.
• Elliptical, stationary bike, treadmill.
• Aerobics, dance class, zumba, kickboxing, boot camp.
• Playing tennis, volleyball, or basketball - and training for them.
• Shoveling snow, digging dirt, raking leaves, or sweeping.

Adding in resistance or strength training can have further benefits for insulin sensitivity and weight.

More Top Tips for Preventing Diabetes

Opportunities to lower risk for diabetes occur throughout the day - and all night, too. Managing stress better, getting enough high-quality sleep, avoiding tobacco and excessive alcohol intake, and avoiding excessive sitting time can all help improve blood sugar control and help with weight loss.

These are some strategies for lowering blood sugar.

• Setting aside enough time for sleep and following a pre-bed routine to get the body and mind ready for sleep.
• Avoiding caffeine within 6 hours of bed time.
• Practicing deep breathing, progressive muscle relaxation, and other stress management techniques.
• Taking the stairs, walking around during phone calls, and setting a timer to stand up every 30 minutes while working at a computer.

Diabetes Prevention Program

One of the easiest and most effective steps you can take if you have prediabetes is to participate in a Diabetes Prevention Program (DPP). The year-long program is designed to help you lose 5 to 10% of body weight - enough to dramatically reduce the risk of developing type 2 diabetes - and to increase physical activity to goal levels.

Lark DPP offers the CDC's curriculum, but also coaches around other lifestyle behaviors that affect diabetes risk. Lark offers 24/7 unlimited coaching to help make healthy choices and turn them into habits that fit into your lifestyle. You may be eligible for Lark DPP through your health care plan or employer!