I Have Prediabetes: Now What?

If you are reading this, you (or a loved one) has probably been told by a doctor that you have abnormally high sugar levels, or prediabetes. This means your blood test results for sugars were above normal but below the range for actual diabetes. Prediabetes is extremely common; 35% of people in the USA are considered prediabetic.

What is Diabetes?

Diabetes is a disease caused by your body losing the ability to properly digest and use sugars and starches in food, thus leading to high sugar levels in your blood. It may help to think of diabetes as a modern lifestyle disease, mostly caused by our gains in weight, lack of physical activity and changes in diet.

Why is Prediabetes So Important?

Prediabetes concerns us doctors because it means you run an extremely high risk of developing diabetes in the next few years. The good news: you have great control over whether or not you develop full diabetes.

You should think of prediabetes as an early warning sign that whatever you’ve been doing to your body isn’t too healthy. Most likely, you fall into one or more of these three risks:

1. Body mass index (BMI) over 25 (Don’t know your BMI? Use this BMI calculator.)
2. Lack of enough exercise (Not sure how much is enough? Read this.)
3. Non-ideal food choices and portions (For food tips, Read here.)

How Great is My Risk for Progressing to Type 2 Diabetes?

Studies show that prediabetic people run a 25% risk of developing diabetes within three years, most developing diabetes within 10 years. The greatest risk factor? Being overweight or obese. Having a BMI under 23 is ideal; a BMI of 25 increases your lifetime risk for diabetes by 600%. A BMI of 30 increases your risk by 4,000% — that’s 40 times the risk! Find out more about your risk for diabetes and heart disease with this online risk calculator.

How Can I Prevent Diabetes?

You could lower your risk by more than half following the steps outlined below! The Diabetes Prevention Program (DPP) proved that lifestyle changes worked better than pills. Lifestyle changes lowered a prediabetic person’s risk for developing full diabetes by 58% over three years–much better than the 31% improvement with a daily pill.

• 1. Lose weight. Weight gain and obesity are the main causes of type 2 diabetes–therefore, weight loss should be the #1 lifestyle change for prediabetics. If you are prediabetic, your goal should be to lose 5-10 percent of your body weight.
• 2. Exercise. Exercise may not directly cause much weight loss, but your muscles absorb sugar from the blood much better after exercising. This is why exercising is crucial to help control blood sugar levels, for both prediabetics and diabetics. How much is enough? Doctors usually recommend 150 minutes a week of moderate exercise, but any amount is better than nothing. Recent research shows that shorter, more intense workouts can also help (Click here for more about high intensity interval training).
• 3. Eat right. Healthy food choices also are crucial to controlling your sugars. However, diabetes/prediabetes isn’t so much a sugar problem; it’s a starch and carbohydrates problem. You shouldn’t just be thinking, “I need to cut down on sweets.” No, your main culprits are all the starches you consume, pastas, breads, rice and potatoes. A few quick tips:
  • Brown is better than white: White breads and flours have lost all the nutritious fibers that help regulate your bowels as well as your sugar spikes after a meal. If you love carbs, try to switch to whole wheat pastas, breads and rice.
  • Portion control: Total calories are also important. You are most likely consuming more than you realize.
  • Cut back on soda, beer and juice: These drinks are empty calories, full of processed sugars, which stress out your liver and pancreas. These unhealthy carbs, especially in sodas, are a major cause of obesity and diabetes in both children and adults.

Can Medicine Help Me?

One prescription medicine in particular, called metformin, can help a prediabetic avert full diabetes. In the DPP study, metformin reduced prediabetic patients’ risks by 31%. That’s pretty good but not nearly as good as lifestyle changes! However, metformin may be helpful if you are very overweight (BMI over 35), if you are under 45 years old, or if you are a woman with a history of high sugar levels during pregnancy. Consult your doctor to determine your best plan for action.

When Should I Get My Blood Glucose Retested?

A prediabetic patient should get his/her blood glucose tested once a year. One other test, the HbA1c, measures your glucose levels over the previous three months and is often helpful as a second test. People with diabetes usually get the HbA1c test every three months.

In Summary

Don’t get discouraged by a prediabetes diagnosis. You have control over your next steps! Even if you already have diabetes, you could maybe forego that second or third medicine (especially insulin injections) if you make the listed lifestyle changes–especially losing 5-10% of your weight.

What Resources Can Help Me?

In addition to following the links included here, there is a wealth of information from the American Diabetes Association.