What to do to stop prediabetes from becoming diabetes.

By Winnie Yu
WebMD Feature

Reviewed by Laura J. Martin, MD

 

If you’ve just learned you have prediabetes, you’re not alone. According to the American Diabetes Association, there are 79 million people in the U.S. who have elevated blood sugars, but who don’t yet qualify for a diagnosis of diabetes. About 11% of people with prediabetes go on to develop type 2 diabetes within three years.

The same factors that cause prediabetes also cause diabetes. That includes lifestyle (diet and physical activity) and any risk you inherited from your family. Prediabetes can be diagnosed based on various blood tests, including the fasting blood glucose test, the oral glucose tolerance test, and the A1C glycated hemoglobin blood test. The results of those tests, in someone with prediabetes, are out of the healthy range but fall short of the diabetes range.

As scary as a prediabetes diagnosis might be, it’s best to treat this news as a wake-up call. “It’s an opportunity to initiate lifestyle changes or treatments, and potentially retard progression to diabetes or even prevent diabetes,” says Gregg Gerety, MD, chief of endocrinology at St. Peter’s Hospital in Albany, N.Y. “We know this not only through supposition but from clinical research.”
Tackling prediabetes with lifestyle changes is often the best way to start. Here’s what experts recommend you do to stop the progression to diabetes:

1. Become More Active

Regular physical activity is critical to reducing your risk for developing diabetes. But if it's been a while since you exercised, start by building more activity into your routine by taking the stairs or doing some stretching during TV commercials, says Patti Geil, MS, RD, CDE, author of What Do I Eat Now?
Let your doctor know that you're planning to start adding more activity to your day -- your doctor should be one of your biggest fans.
“Physical activity is an essential part of the treatment plan for prediabetes because it lowers blood glucose levels and decreases body fat,” Geil says. Ideally, you should exercise at least 30 minutes a day, five days a week.
Can’t commit to a regular workout? Want to squeeze in more activity? Consider wearing a pedometer and tracking your steps. “Walking 10,000 steps a day is the equivalent of walking about five miles,” Geil says.

2. Lose Some Weight.

You don't have to whittle yourself down to your ideal weight. Losing relatively small amounts of weight can make a difference.
The Diabetes Prevention Trial found that people who had prediabetes who did 30 minutes a day of moderate exercise and lost 5% to 7% of their body weight were able to cut their odds of getting diabetes by 58%. For someone who weighs 200 pounds, that means losing just 10-14 pounds.

3. See Your Doctor More Often

People with prediabetes need more than an annual check-up. They should see their doctors every three to six months, Gerety says. “Regular check-ups affirm and encourage patients to go in that direction and provide some barometers for success,” he says.
Patients who are doing well can get positive reinforcement from their doctors, while those who are not can get back on track. “Patients like some tangible evidence of success or failure,” Gerety says.

4. Eat a Healthy Diet

Break it down into simple steps:

• Load up on fruits and vegetables, especially the less-starchy kinds such as spinach, broccoli, carrots, and green beans. 
• Build more high-fiber foods into your day. 
• Choose whole grain foods instead of processed grains -- for example, brown rice instead of white rice.

Also, swap out high-calorie foods. “Drink skim milk rather than whole milk, diet soda rather than regular soda,” Geil says. “Choose lower-fat versions of cheese, yogurt, and salad dressings.”
And be smart about your snacks. Rather than nosh on high-fat, high-calorie chips and desserts, try eating fresh fruit, whole-wheat crackers with peanut butter or low-fat cheese, Geil says.
Your doctor or a registered dietitian should be able to give you advice specific to your needs.

5. Get Support and Get Informed

Losing weight, eating a healthy diet, and exercising regularly isn’t easy. But it's a lot easier if you have people helping you out, holding you accountable, and cheering you on, says Ronald T. Ackermann, MD, MPH, an associate professor of medicine at Indiana University School of Medicine.
Consider joining a group where you can pursue a healthier lifestyle in the company of others with similar goals.
A certified diabetes educator may also help you learn about what you need to do to prevent your prediabetes from becoming diabetes. You can find one at the American Association of Diabetes Educators at www.diabeteseducator.org.

6. Make Sleep a Priority

Not getting enough zzzzzs on a regular basis doesn’t just make you tired and grumpy. It also increases stress hormones in your body, which causes the body to store fat and make it hard for you to lose weight, says Theresa Garnero, APRN, BC-ADM, MSN, CDE, author of Your First Year With Diabetes (American Diabetes Association). It also interferes with your body’s ability to use insulin effectively, and may be a risk factor for prediabetes and type 2 diabetes.
To help establish good sleep habits, go to bed and wake up at the same time every day. Wind down before you turn out the lights. Use the bedroom for sleep and sex only. Minimize caffeine after lunch if you have trouble sleeping.

7. Upgrade Your Outlook

Having the right mindset can help you tackle prediabetes. That means nixing blame and making a commitment to the best choices for your health, Garnero says.
Accept that you won’t do things perfectly every day, but pledge to do your best most of the time.
“Make a conscious choice to be consistent with everyday activities that are in the best interest of your health,” Garnero says. “Tell yourself, ‘I’m going to give it my best. I’m going to make small changes over time.