What is prediabetes?
Prediabetes is a condition in which blood glucose (sugar) or A1C levels are higher than normal but not high enough to be diagnosed as diabetes. The CDC reports 86 million American adults have prediabetes – that’s more than 1 out of 3. Those with prediabetes have an increased risk of developing type 2 diabetes, heart disease, and stroke. They also have increased risk for kidney damage.
Unfortunately, since there are typically no signs or symptoms, nine out of ten people with prediabetes don’t know they have it. The American Diabetes Association recommends testing to detect prediabetes and type 2 diabetes for adults who are overweight or obese and have one or more of the following risk factors:
- African American, Hispanic/Latino, American Indian, Asian American, or Pacific Islander
- Have a parent, brother, or sister with diabetes.
- Being physically inactive
- Have high blood pressure or take medication for high blood pressure
- Have a history of cardiovascular disease
- Have low HDL cholesterol and/or high triglycerides
- Are a woman who had diabetes during pregnancy (gestational diabetes)
- Age 45 years or older
Despite these alarming statistics and broad risk factors, research indicates that individuals can cut their risk of getting type 2 diabetes by more than half through lifestyle modifications.
3 Tips to Prevent Diabetes
Several research studies suggest that lifestyle measures are the best way to dodge the diabetes bullet. One of the most significant was The Diabetes Prevention Program (DPP), a major clinical research study, that found lifestyle modifications reduced the risk of developing type 2 diabetes by 58% over a 3 year period, while the drug metformin reduced risk by 31% overall.
With just a few lifestyle adjustments, prediabetes can be reversible for some individuals, returning their blood glucose levels back to normal. Since there is no cure for diabetes, however, prevention is crucial. The following three tips can help prevent or delay the onset of type 2 diabetes.
Tip 1: Healthy Eating. The Joslin Diabetes Center, a Harvard Medical School affiliate, recommends a personalized approach to diabetes management as opposed to a “one size fits all.” Joslin developed the following basic guidelines for general guidance, however they encourage consulting with a Registered Dietitian for an individualized plan:
- Carbohydrate: About 40 percent of calories should come from carbohydrates, including at least 20-35 grams of fiber. With the best sources coming from fresh vegetables, fruits, beans and whole-grain foods. Minimize the amount of pasta, white bread, white potatoes, and sugary cereals.
- Protein: 20-30 percent of calories from protein (unless you have kidney disease). The best sources include fish, skinless chicken or turkey, nonfat or low-fat dairy products, and legumes (beans and peas).
- Fat: 30-35 percent of calories from fat (mostly mono- and polyunsaturated fats). Best sources include olive oil, avocado, nuts, seeds and fatty fish like salmon.
Tip 2: Exercise. Physical activity is an important component to any healthy lifestyle, but those with prediabetes can especially benefit. Not only does exercise help lower blood sugar levels, but it aids in weight loss which is another helpful factor in reducing your risk of developing diabetes.
For the greatest benefit, aim for 60-90 minutes of moderate-intensity physical activity on most days of the week. If you are unable to start there, try to walk briskly for at least 30 minutes a day, 5 days a week. Again, if that is too challenging to start, just try to be more active throughout the day, such as parking further from the store entrance or taking the stairs.
Tip 3: Weight Loss. If you are overweight, losing 5-10% of your total weight is beneficial for improving insulin sensitivity and regulating glucose control. If you are 200 pounds, for example, then your goal is to lose 10-20 pounds. The Joslin Diabetes Center recommends achieving this goal by losing just one pound every one to two weeks through a reduction of 250 to 500 calories per day.
Additional Resources and Information
You can take an online quiz to find out if you are at risk for prediabetes on the CDC website (http://www.cdc.gov/widgets/prediabetes/html5/iframe.html).
Joslin Diabetes Center: Joslin.org
American Diabetes Association: Diabetes.org
You can also email me personally at StephanieBrustRD@gmail.com if you have any questions.
American Diabetes Association. (2012, 03 24). All About Prediabetes. Retrieved 03 22, 2015, from American Diabetes Association: professional.diabetes.org/content/PML/All_About_Prediabetes_24dee6ff-cbf0-4a55-80b7-9d5d29de0bd7/All_About_prediabetes.pdf
American Diabetes Association. (2014). Diagnosis and Classification of Diabetes Mellitus. Diabetes Care , 37, Supplement 1.
Division of Diabetes Translation. (2015, 03 15). Prediabetes: Am I at risk? Retrieved 03 22, 2015, from Centers for Disease Control and Prevention: http://www.cdc.gov/diabetes/prevention/prediabetes.htm
Joslin Diabetes Center. (2011, 08 22). Clinical Nutrition Guideline For Overweight and Obese Adults with Type 2 Diabetes, Prediabetes Or Those at High Risk For Developing Type 2 Diabetes. Retrieved 03 22, 2015, from Joslin Diabetes Center: www.joslin.org/bin_from_cms/Nutrition_Guidelines-8.22.11(1).pdf