While genes strongly influence whether someone develops prediabetes and type 2 diabetes, you have some control, says Jill Weisenberger, M.S., RDN, CDE, author of Prediabetes: A Complete Guide. "Even for those with a strong family history, lifestyle habits can prevent or delay the onset of type 2 diabetes. And a delay can mean less medications for fewer years and fewer complications," she says. "The prediabetes stage is the best time to reverse course," Weisenberger adds. In fact, lifestyle changes have been shown to reduce the risk of prediabetes progressing to type 2, per a 2018 study in Primary Care Diabetes.
The goal: reduce insulin resistance and preserve beta cell function (beta cells are pancreatic cells that produce insulin). Minor weight loss—just 5 to 7 percent of your body weight—can decrease your risk of developing type 2 diabetes by up to 58 percent, says the CDC, in part because a healthier weight generally means better insulin sensitivity. However, improving insulin sensitivity goes beyond the number on the scale. Here are seven ways to do just that.
You may be prepared for a lifetime of breaking down your food by numbers (calories, fat, carbs), but "that's much too simplistic and is likely to take you off course. Food quality is your best bet to improve insulin sensitivity," says Weisenberger. There's no need to be scared of carbs, including whole grains (Learn more about the benefits of complex carbohydrates). What's more, just because something is low-carb does not make it healthy. She recommends filling your plate with berries, vegetables, oats, barley, beans and lentils, which are all sources of high-fiber carbohydrates that help reduce risk of disease.
Related: The Best 7-Day Diabetes Meal Plan
Exercise helps muscles soak up glucose to be used for fuel, and it's one of the best ways to improve insulin sensitivity. That said, you don't have to jump into an intense routine to see effects. Your goal: walk 11 miles per week, or just over 1.5 miles per day, which research in Diabetelogia shows may be just as effective as an approach involving dieting, exercising and losing weight. If that amount feels like too tall an order at first, at least establish the habit by walking 10 minutes five to seven times a week and building from there, says Weisenberger.
Pictured recipe: Pork & Broccoli Thai Noodle Salad
Intermittent fasting (IF)—where you restrict your food intake to a specific window during the day—is on-trend right now. And there is some indication that IF may actually be useful if you have prediabetes. In a study published in Cell Metabolism on men with prediabetes, participants were asked to limit their food intake to a six-hour period (the IF group) or assigned to a control group that ate in a 12-hour window for five weeks. Even though they didn't lose weight, those in the IF group saw their insulin sensitivity, beta cell function and blood pressure improve, and they also saw their appetite in the evening decrease.
This diagnosis is your wake-up call to ditch the habits that you know cut into good sleep, like staring at your phone, tapping out just one last email while in bed. "Sleep is not optional, it's a necessity. Sleep deprivation is linked to obesity, heart disease and type 2 diabetes," says Weisenberger, who adds that sleep deprivation reduces insulin sensitivity even in adults without diabetes. In one study, people who had poor sleep quality were more than 2.5 times more likely to develop diabetes.
Pictured recipe: Muesli with Raspberries
Sweet, juicy red raspberries add more than flavor to your morning bowl of oatmeal or smoothie, per new research in Obesity. In a small study on adults who were overweight or obese and had prediabetes, those consuming at least one cup of red raspberries with breakfast experienced an improvement in glycemic control for two hours after the meal, which researchers attributed to improved insulin sensitivity. Raspberries are yummy and a great source of fiber, but it's important to note that this research was supported by a raspberry industry group—including plenty of other fiber-rich foods in your diet should help as well.
Daily stressors are a given, but how you deal with them is what counts. What self-care looks like—spending your lunch break in the sunshine, scheduling walking dates with friends—doesn't matter as much as doing it regularly. "Emotional stress has a way of distracting us from good habits and our health goals. It may also affect glucose metabolism in some people," says Weisenberger.
If you're already walking more throughout the day, add in strength training too. In one study where sedentary overweight or obese adults over age 50 with prediabetes performed resistance training twice a week, 34 percent of participants had normal blood sugar levels after three months. You don't have to bench heavy weights to reap the benefits, either. Start out with simple body-weight exercises (that are easily modifiable) like lunges, squats and push-ups.
Achieving an HbA1C level of 5.7 percent or a 5 percent weight loss may bring you back from the brink of diabetes, but thinking only in terms of those numbers can veer you off course. "A lot of people get off track because they focus more on the [weight loss or blood sugar] goal and ignore the process. But it's focusing on the process that helps us get to the goal and stay there," says Weisenberger. By being journey-oriented, you can build healthy habits into your life, like making time for movement that feels good to your body or figuring out how to throw together quick dinners during crazy weeks. "Your emphasis should be on habits, not weight loss," she says.