Worried about Prediabetes? Three Simple Steps to Reverse It

Have you ever had the feeling you’re headed in the wrong direction, but you can’t find an exit ramp, and you don’t see a good way to turn around?  If you feel that way about prediabetes, I hear you.  Sometimes people with prediabetes feel like they’ve missed the exit, and it’s too late.  But, the truth is that reversing prediabetes is within your reach.  You just need to know how to shift gears.

Prevalence of prediabetes

More than one-third of Americans have prediabetes, and about 84% of the people who have it don’t even know they have it.  That’s a total of 88 million people walking around with prediabetes right now, with more than 73 million of those people unaware of their condition.  That’s why it’s really important to get your annual check-up, including bloodwork.  The sooner you know you have prediabetes, the sooner you can take steps to reverse it.

Who’s at risk for prediabetes?

The more of these risk factors you have, the more likely you are to develop prediabetes:

  • Having a parent or sibling with type 2 diabetes

  • Being 45 years old or older

  • Getting physical activity less than 3 times a week

  • Being overweight

  • For women, having polycystic ovarian syndrome, gestational diabetes in pregnancy, or delivering a baby who weighed more than 9 pounds

What is prediabetes?

When my sister and I were kids, we would sometimes argue in the backseat of our yellow Oldsmobile Cutlass Supreme.  (Those were the days!)  My mom would say, “If you kids don’t stop that fussing I will turn this car around!”  Prediabetes is your body’s way of giving you the same warning,  “If you kids don’t stop this…!”  Prediabetes is like a warning from your body telling you to turn this car around!  When you have prediabetes, your body is basically saying, “Hey!  I can’t live like this.  Something’s gotta give here, and fast.”

During prediabetes, your body is probably making plenty of insulin, maybe even more than a typical person would make.  But…your cells are insulin resistant, so the insulin isn’t able to do its job, and the sugar in your bloodstream has a hard time crossing the border from your bloodstream into your cells.  So, your blood sugar level rises.  If you have prediabetes, your blood sugars are higher than normal, but not high enough to diagnose you with active or “real” diabetes. 

These are the ranges for blood glucose per the American Diabetes Association:

Prediabetes glucose levels and A1c ranges

Fasting Blood Sugar

  • Normal: less than 100

  • Prediabetes: 101-125

  • Diabetes 126 or higher

Oral Glucose Tolerance Test

  • Normal: less than 140

  • Prediabetes: 140-199

  • Diabetes: 200 or higher

Hemoglobin A1c

  • Normal: 5.6 or less

  • Prediabetes: 5.7 to 6.4

  • Diabetes: 6.5 or higher

Signs and symptoms of prediabetes

Are you ready for this?  There are usually no signs and symptoms of prediabetes.  Our bodies are resilient; we can adapt to a lot before we start to break down.  Chances are you will not have many indications that you have prediabetes based on the way that you feel.  You might feel a little tired or run down, but most likely you would not have any of the classic symptoms of diabetes such as extreme thirst, blurry vision, or headaches.  Prediabetes is a “silent” condition.

Treatment of prediabetes

The three proven ways to reverse prediabetes are weight loss, increased exercise, and changing to a vegan (plant-based) diet.

The National Diabetes Prevention Program is designed to help people with prediabetes reverse their condition.  The program has two goals for its participants:

  • Lose 5-7% of their body weight (for a 200-pound person, this would be 10-14 pounds)

  • Get at least 150 minutes of physical activity per day (30 minutes, 5 days per week, or a similar schedule)

Research has shown that people who achieve those two goals have roughly a 50% percent chance of reversing their prediabetes.  Among people with prediabetes who don’t make any changes to their diet or physical activity, one-third will have full-blown type 2 diabetes after 4 years, and two-thirds will still be in the prediabetic range.

Medications for reversing prediabetes

In addition to diet and exercise, some physicians choose to put their prediabetic patients on medications to help with prediabetes.  Metformin is the most commonly prescribed medication for prediabetes.  Metformin works by preventing your liver from releasing extra sugar into your bloodstream.

Diet for reversing prediabetes

So…will you have to eat twigs and berries to reverse prediabetes?  No.  The diet for prediabetes is the same as a healthy diet for most people:  lots of high-fiber fruit and vegetables and whole grains, smaller portions of lean meats, and heart-healthy fats.  As always, avoid fast food, fried food, sweets, and pre-packaged snacks most of the time. 

If you’re really ready to change your habits, a plant-based (vegan) diet can do wonders for type 2 diabetes and pre-diabetes, but that’s not mandatory.  I’m not a vegan, but I acknowledge its benefits for people with diabetes, and I want to make sure you’re aware of them.  You can find a free diabetes-friendly meal plan here (it does include meat because that’s what most of my clients want.)

Changing your eating habits is easier said than done, I know.  So, I like to help my clients make the easiest possible changes they can first, and then build on those successes.  What’s the “low hanging fruit” for you when it comes to changing your diet?  Can you cut back from 3 soft drinks a day to 2?  Can you change from fried to grilled chicken?  There might be lots of tiny little changes you can make.  Just start with one change, and keep doing it until it’s permanent, and then add another one. 

Before you know it you’ll have turned this car around all by yourself.  My mom will be so proud!

Julie Cunningham is a Registered Dietitian and Certified Diabetes Care & Education Specialist. She believes food is the foundation of good health, and that our culture of obsession about body size is damaging to health, happiness, and productivity in far too many people. When not talking or writing about food and health, she can be found in the the mountains of western NC, where she lives with her family and four legged friends.

Julie Cunningham

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