How to reverse or prevent prediabetes

Prediabetes is a condition that often shows up quietly over time, without obvious symptoms. If left unchecked, it can lead to type 2 diabetes and other serious health issues.

An estimated 98 million Americans have prediabetes, but most don’t realize it — and that’s part of the problem. How do you treat a condition you don’t even know you have?

Fortunately, there’s a lot you can do to prevent or even reverse prediabetes. It starts with understanding the condition, knowing your health risks and discovering the steps you can take to improve them.

Recognizing the risks of prediabetes

Prediabetes means your blood sugar (also called glucose) levels are higher than normal, but not high enough to be considered type 2 diabetes.

It often begins when your body doesn’t use insulin properly — a condition known as insulin resistance.

Insulin is a hormone made by your pancreas. It helps control the amount of sugar in your blood. When your cells stop responding to insulin the way they should, sugar builds up. This can lead to prediabetes — and if it gets worse, diabetes. Over time, high blood sugar can also cause serious health problems like heart disease, nerve damage and kidney problems.

The risk for prediabetes increases with age, and it goes up if there is a history of diabetes in your family. People of Asian, Hispanic, Native American and African American descent are at higher risk, as are mothers who had gestational diabetes or birthed a baby weighing more than nine pounds.

While you may not be able to affect those risk factors, you can control others by making changes to your lifestyle.

Warning signs and symptoms of prediabetes

People with prediabetes may notice things like persistent fatigue, a need to nap after meals, frequent hunger and cravings for sugar. They may find themselves gaining weight or struggling to lose it, even with effort.

Other symptoms of insulin resistance and prediabetes include:

• elevated readings for cholesterol, triglycerides or blood pressure
• general aches and pains
• sleep issues
• brain fog
• mood changes, such as feeling depressed or anxious

Symptoms can be subtle on their own but collectively signal an underlying issue that deserves attention. Early intervention offers a chance to make lifestyle changes that may help prevent further problems.

How prediabetes is diagnosed

Prediabetes is typically diagnosed with simple blood tests that measure your blood sugar levels. The definitive test is the hemoglobin A1C test, which shows your average blood sugar over the past three months. The fasting blood sugar test, which checks your levels after not eating overnight, is a common part of an annual physical exam.

These tests are quick and often done in a doctor’s office or clinic. If results show your A1C falls between 5.7% and 6.4%, and/or your fasting blood sugar is between 100 and 125 mg/dL, you may be diagnosed with prediabetes.

What you can do to treat prediabetes

Many people find they can reverse prediabetes by adopting a healthy lifestyle. Changes to how you move, eat, manage stress and sleep can all help — and it doesn’t all have to happen at once. Small steps over time can lead to powerful results.

Lifestyle changes

Lifestyle medicine is the gold standard for treating prediabetes. It focuses on daily habits that support your body’s natural healing, including:

• physical activity
• food & nutrition
• stress management
• sleep
• environment

Physical activity

Moving your body can help slow the progression from prediabetes to diabetes. Some studies list exercise as the primary way to delay or reverse the disease. A good starting point can be choosing ways to increase your daily step count:

• Take the stairs.
• Park farther away from your destination.
• Stand at your workstation.
• Set reminders to routinely get up and move.

Cardio and strength training exercises can help with prediabetes by optimizing blood glucose levels. Stay safe by discussing your exercise routine with your health provider. Start slowly, wear good shoes and drink plenty of water.

Diet

It can be helpful to think of this change as developing a lifestyle versus going on a diet. There can be many pitfalls to dieting. In fact, losing and gaining weight, also known as yo-yo dieting, can increase insulin resistance.

A Mediterranean diet can help lower your risk of diabetes. Focus on whole plant foods, including colorful fruits, vegetables, whole grains and beans, to maintain steady energy and moods. Reduce your intake of added sugars and refined grains, such as white flour, and pay attention to how food affects your overall well-being.

Stress management

Chronic modern stress — from money worries, deadlines or relationships — can raise stress hormones like cortisol, which increases blood sugar. “Toughing it out” might seem okay, but it can harm your long-term health.

Stress management helps your body and brain to deal more effectively with the tough things in life. Even short breaks to relax can make a difference. Mindfulness practices, such as those taught in diabetes prevention classes, can help improve blood sugar levels, much like the benefits you get from eating healthy foods and exercising.

Sleep

Poor sleep, including interruptions caused by snoring or sleep apnea, can raise stress hormones and blood sugar levels, which increases your risk of prediabetes and diabetes. Even if you don’t feel tired during the day, disrupted sleep still stresses your body.

Good sleep habits can make a big difference. Try to:

• Stick to a regular sleep schedule.
• Create a calming bedtime routine.
• Keep your room dark, cool and quiet.
• Aim for 7-8 hours of quality sleep each night.

Environmental factors

Exposure to harmful substances — some visible, some hidden — can affect your body over time. Chemicals called endocrine disruptors (EDCs), found in everyday products, can interfere with hormones and are linked to diabetes.

You can’t avoid EDCs altogether, but small changes help. Try to:

• Use less plastic.
• Avoid microwaving food in plastic.
• Wash fresh foods well.
• Check product labels for language about EDCs.

Reversing prediabetes to prevent type 2 diabetes

Prediabetes is a serious condition because it increases the risk of type 2 diabetes, heart disease and stroke. Many people with prediabetes develop type 2 diabetes within 5 to 10 years — but lifestyle changes can significantly slow or even reverse symptoms.

Developing long-term habits

Long-term changes can feel overwhelming, but starting small makes them manageable. Just like with exercise, slow and steady progress leads to lasting results. Over time, these small steps — like healthier eating, exercise and stress management — can significantly lower your risk of developing prediabetes or help reverse the condition if you already have it.

When to see a doctor

See your doctor for an annual physical even if you are feeling fine, especially if you’re concerned about prediabetes. Talk about your risk factors and any symptoms you may be experiencing, even if they’re mild. Ask to be tested for prediabetes and learn about lifestyle changes that can reduce your risk for it.

Learning about prediabetes

Diabetes prevention education programs have proven highly effective in helping people improve their health and reduce their risk of developing diabetes. In the Preventing Diabetes classes led by integrative nutritionists from the Penny George Institute for Health and Healing, participants get a 360-degree look at their lifestyle and help with an action plan for diabetes prevention. They learn about diabetes test values, identify barriers to wellness and set goals to overcome them. Morning, afternoon and early evening classes are available.