Actions to Take if You Have Prediabetes

By: Hope Warshaw, RD, CDE  |  Diabetic Living Magazine

If your health care provider tells you that you have prediabetes, consider yourself lucky. Why? Because you likely have a provider who realizes that the earlier you take action, the better shot you have at preventing type 2 diabetes or delaying its progression.

Changing the Path to Type 2

A whopping 86 million Americans have prediabetes. That’s according to the latest statistics from the U.S. Centers for Disease Control and Prevention (CDC) -- that's 37 percent of American adults over age 20 and 51 percent of adults over age 65. Research shows about 70 percent of people with prediabetes will develop type 2 diabetes over time. Despite these scary stats, only 11 percent of people who have prediabtes know it. 

Tip: 30 Healthy Low-Carb Foods to Eat

The good news is you can prevent or slow the progression of prediabetes to type 2. Numerous research studies conducted over the last 30 years show that early and aggressive management with continued vigilance over time is what prevents or delays type 2 diabetes. And the earlier you detect it and put your plan into action, the better. Here are eight ways to manage prediabetes.

1. Get Tested to Know for Sure. Do you have family -- parents or siblings -- with prediabetes or type 2 diabetes? Are you carrying extra weight around your middle? Don't get enough exercise? These are a few of the risk factors for prediabetes. A good first step to see if you are at high risk is to use the American Diabetes Association (ADA) Type 2 Diabetes Risk Test. You can take the test by visiting diabetes.org/risk. If you’re at high risk, schedule an appointment with your health care provider to get a check of your blood glucose level -- or, better yet, your A1C (an average of your blood glucose over two to three months). See the blood test results to diagnose prediabetes on the next page.

2. Max Out Your Insulin-Making Reserves. It's well known that at the center of the storm of the slow and steady onset of prediabetes is insulin resistance -- the body's inability, due to excess weight and genetic risk factors, to effectively use the insulin the body makes. Along with insulin resistance, the body also has an ever-so-slowly dwindling supply of insulin. Research shows that both insulin resistance and decreased insulin-making capacity start well before the diagnosis of prediabetes and years before the onset of type 2. It seems that some people's bodies can continue to make as much insulin as they need, while others cannot. A key to treating prediabetes is to put this insulin resistance in reverse and maximize your body's insulin sensitivity by losing weight or maintaining a healthy weight and being physically active. Studies show that just 30 minutes of daily activity, such as walking, and losing 5-7 percent of starting body weight and keeping off as many of those pounds as possible can decrease the risk of developing type 2 diabetes.

3. Trim the Pounds and Keep Them Off. Research shows that losing weight, even just 10-20 pounds, can accomplish near-miraculous health benefits: lower blood glucose (also known as blood sugar) levels, reduced blood pressure, improved cholesterol, increased energy, improved sleep quality (and decrease in sleep apnea), decreased pressure on joints, and even decreased risk of certain cancers, such as breast and colon cancer. To continue to enjoy these health benefits, it’s important to maintain as much of your weight loss as possible.

4. Be More Active. For starters, think about how you can fit more physical activity into your daily life. Can you take the stairs more often? Park farther from destinations? Get off the bus or train one stop earlier and walk the rest of the way? Even consider longer routes in your home, office, school, and other places you frequent to burn a few more calories. Make a list and try them out. Also, decrease the amount of time you sit, whether on a sofa or at a desk or table. Research is showing that minimizing sedentary behavior is good for your metabolic health: your glucose, lipids, and blood pressure.  

5. Mix and Match Resistance and Aerobic Activity. Resistance training means contracting your muscles against an opposing force by generating resistance. The goal? To make your muscles stronger and fight muscle loss from aging. The push for resistance training for people with prediabetes is to improve insulin sensitivity and, in turn, lower blood sugar levels. Couple resistance training two or three times a week with regular aerobic activity. It's ideal to get about 30 minutes of aerobic activity nearly every day. This can decrease insulin resistance, lower blood pressure, and improve cholesterol more so than resistance training alone.

6. Practice Portion Control. When it comes to tapering your calorie count, the first place to look is your food portions. To change long-term eating habits, it's best to make small changes rather than trying to adopt a rigid eating plan that will be difficult to maintain. If you're like most Americans, you likely eat too much meat, starchy foods, breads, and sweets, and on top of that you may sip too many high-calorie, low-nutrition sugary drinks. Be aware of how much you eat, and try to cut down your portions. An ounce less of meat per serving, a quarter cup less potatoes per serving, a smaller sandwich -- it adds up. And if you drink sugary beverages, swap them for zero-calorie beverages, such as water, sparkling water, tea, coffee, and diet beverages.

7. Fill Up on High-Fiber Foods. To eat enough fiber -- upwards of 25 grams a day -- eat fiber-rich whole grains, beans, legumes, fruits, and vegetables. Most Americans don't get nearly enough fiber. Think about how you can include more fiber in your diet. Increase all types of dietary fiber: fiber that offers bulk, such as wheat flour and psyllium, which improves regularity; fiber that adds a gel-like quality, such as the beta-glucan in oats and barley, which can help lower blood sugar; fiber that causes fermentation, such as legumes (beans) and underripe bananas, that contains resistant starch, which has been shown to increase insulin sensitivity.

8. Seek Support. With 86 million people with prediabetes, you are not alone. It can be overwhelming and challenging to change your lifestyle. Get support from family members, friends, coworkers, and other people who might be going through similar challenges. Do any of these people need to take the same actions you do? Perhaps you can partner up for success. Is there a group of people striving to live a healthier lifestyle at your place of worship or at work? Find programs at your local YMCA, neighborhood community centers, or online. With the passage of the Affordable Care Act (health care reform), the National Diabetes Prevention Program was set in motion under the direction of the CDC's Division of Diabetes Translation. The program's mission is to prevent the progression of prediabetes to type 2 diabetes for people at high risk by engaging them in a yearlong group program facilitated by a trained lifestyle coach. Visit cdc.gov/diabetes/prevention to see if there's a program in your area.

Don't tackle all eight actions at once. Start with one or two steps that you can easily put into action. Experience success with these goals. Then add a few more steps to what you're already accomplishing. Success breeds success.

To Diagnose Prediabetes and Type 2 Diabetes

 
Healthy
Non-Diabetes
Prediabetes
Diabetes
(type 2)*
Fasting glucose
<100
100-125
>126
Random glucose
<140
140-199
>200
A1C
(done in a lab, not
a home test)
<5.6%
5.7-6.4%
>6.5%

*Lower glucose levels are used to diagnose gestational diabetes
(during pregnancy)

Related:
Meal Plans for Diabetes
12 Healthy Ways to Lower Your Blood Sugar