Although prediabetes may not sound like anything to be overly concerned about, it does require being proactive about your health. It can have negative impacts on your overall health.
In fact, some of the symptoms of type 2 diabetes can even be present in prediabetes. And prediabetes is a big problem around the world. The prevalence of prediabetes is on the rise worldwide.
Experts have estimated that more than 470 million people will have prediabetes by the year 2030.
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What is prediabetes?
Prediabetes is an impairment in fasting plasma glucose, impaired glucose tolerance, or both of these. Essentially, it is borderline diabetes. Prediabetes is not benign because it is a risk factor for type 2 diabetes.
Prediabetes is also associated with microvascular problems. These include neuropathy, which involves changes to the nerves. Another type of microvascular problem in prediabetes is nephropathy, meaning the kidneys are affected.
Retinopathy can also occur when the eye is involved. Prediabetes can also have microvascular complications. These include stroke, coronary artery disease, and peripheral vascular disease.
Prediabetes is also linked with the following conditions:
- Periodontal disease
- Cognitive dysfunction
- High blood pressure
- Obstructive sleep apnea
- Low testosterone levels
- Fatty liver disease
- Cancer
In general, prediabetes is an abnormal physiologic state. It is a high-risk state for diabetes. In prediabetes, blood sugar levels are higher than what is healthy but lower than the threshold for diabetes. Between five and ten percent of people per year with prediabetes progress to diabetes.
The same proportion will revert back to normal blood sugar levels. Before glucose changes are even detectable, there are beta-cell dysfunction abnormalities and insulin resistance that occur.
Insulin resistance, impaired action of incretin, and insulin hypersecretion are central to the development of prediabetes. The presence of prediabetes increases the risk of developing type 2 diabetes between three and ten times.
Symptoms to look out for
Prediabetes doesn’t usually have any symptoms. One possible sign to look out for is darkened skin. This usually occurs on the neck, armpits, elbows, knees, and knuckles.
A research study looked at 130 people between the ages of 30 and 65 years old. 65 of these subjects had prediabetes, and 65 of them did not. The prediabetes diagnosis group had more gastrointestinal symptoms, including the following:
- Bloating
- Early satiety (feeling full quickly)
- Nausea
- Heartburn
- Passing gas
- Constipation
Some of the classic symptoms of type 2 diabetes to look out for to see if you’ve progressed include the following:
- Increased thirst
- Frequent urination
- Excess hunger
- Fatigue
- Blurry vision
How to naturally reverse prediabetes
Scientists now recognize prediabetes as a reversible condition. Lifestyle modification is the cornerstone of preventing progression to type 2 diabetes. In fact, lifestyle modifications have a relative risk reduction between 40 and 70 percent.
A prediabetes diet plan and prediabetes exercise plan are first-line treatments. The goal of treatment is to reach normal, healthy glucose levels. There is evidence to show that restoring normal glucose levels during prediabetes can lead to lasting remission.
Lifestyle interventions that lead to bodyweight loss can reduce the risk of progression from prediabetes to type 2 diabetes. Things that can promote reverting to normal blood sugar levels include lowering systolic blood pressure, lack of heart disease, and weight management. These can be good strategies to reach healthy blood sugar levels in patients with prediabetes.
Healthy eating
Prediabetes is on the rise, and part of this is due to the rapidly changing access to high-calorie foods. Straying away from junk food and creating healthy habits is crucial.
Dietary polyphenols may influence blood glucose and type 2 diabetes through different mechanisms. These include promoting the uptake of glucose into tissues. This then improves insulin sensitivity. Intakes of flavan-3-ols show beneficial effects on insulin resistance and other cardiometabolic risk factors.
Several studies are showing that polyphenol intake is associated with a lower risk of type 2 diabetes mellitus. Dietary polyphenols come mostly from plant-based foods. These include the following sources:
- Fruits
- Vegetables
- Whole grains
- Coffee
- Tea
- Nuts
One example of a healthy diet high in polyphenols is the DASH diet. This diet also encourages the intake of healthy fats. Another example is the Mediterranean diet.
The Mediterranean diet comprises mostly of olive oil, nuts, and red wine. These foods have been associated with improved insulin resistance and type 2 diabetes.
One study looked at 6798 participants. They found that plant-based eating is correlated to lower prediabetes risk. Researchers concluded that eating a more plant-based diet and straying away from an animal-based diet can lower insulin resistance and prediabetes risk.
Another study found that the paleo diet can also help to prevent prediabetes and type 2 diabetes.
Don’t drink sugar
Research shows that people with diabetes have a higher intake of sweetened soft drinks compared to other groups. There is evidence demonstrating that drinking 5tt6sugar sweetened beverages is significantly associated with increased odds of developing prediabetes.
Regular exercise
Prediabetes is increasing worldwide at an alarming rate. It is no coincidence that physical activity levels have decreased worldwide as well. People who have low levels of physical activity have a higher risk of prediabetes. Exercise is a cornerstone therapy for chronic diseases related to insulin resistance.
Prediabetes is linked to a few different modifiable risk factors. Physical activity is one of them. One study had 35 participants. Researchers assigned them to either high-intensity interval training or continuous moderate-intensity exercise. Both groups did their assigned type of exercise three times per week for 12 weeks.
All participants also did resistance training two times per week. Overall, subjects had a mean reduction in hemoglobin A1c by 0.5 percent. Beta-cell function improved by 28.9 percent. Insulin sensitivity went down by 34.8 percent. Overall, exercise was able to improve glycemic control in subjects with prediabetes.
Research shows that high-intensity interval training enhances fat oxidation in people with prediabetes. Several studies show that lifestyle-based treatments that involve exercise could be promising therapeutic approaches to peripheral neuropathy of prediabetes.
Extracellular vesicles are supposed to mediated type 2 diabetes and cardiovascular risk and development. Subjects in a study were told to do either interval training or continuous training for 12 supervised sessions. This happened over 13 days, for 60 minutes a day. Researchers concluded that interval exercise training decreased endothelial-derived extracellular vesicles in people with diabetes.
All in all, increasing physical activity and fitness can contribute to the remission of type 2 diabetes.
Carb control
A study compared the effects of two different diets on hemoglobin A1c and other health-related outcomes in overweight or obese adults with prediabetes. Half the participants went on a medium carb, low fat, calorie-restricted, carb counting diet consistent with the American Diabetes Association guidelines.
The other half of the participants ate a very low carb, high fat, non-calorie-restricted diet. The goal of this second diet was to induce nutritional ketosis. After three months, mean hemoglobin A1c levels were the same in the medium carb group. It was 0.6 percent lower in the low carb group.
44 percent of the low carb group discontinued one or more diabetes medications than 11 percent of the medium carb group. 31 percent discontinued sulfonylureas in the low carb group compared to 5 percent in the medium carb group.
The low carb group lost 5.5 kilograms, compared to 2.6 kilograms in the medium carb group. These results suggest that a very low carb diet can improve glycemic control in type 2 diabetes while allowing decreases in diabetes medications.
The scientific community recognizes the importance of blood sugar on overall health. The glycemic index is a valid way of classifying carbohydrate foods based on their effects on blood sugar. Evidence shows that diets low in glycemic index and glycemic load can prevent and manage diabetes and cardiovascular disease. Diets low on the glycemic index and low in glycemic load are particularly important in individuals with insulin resistance. Foods such as refined carbohydrates are high on the glycemic index.
Obesity and type 2 diabetes are associated with decreased uptake of glucose into the brain. This impairs the satiating effect of dietary carbohydrates. This is why restricting carbohydrate intake may help to maintain weight loss and improve blood sugar status.
Another study looked at 34 adults with a starting hemoglobin A1c higher than six percent. They ate either a very low carb ketogenic diet or a moderate carb low-fat diet. At 12 months, the low carb group had a 0.5 percent reduction in hemoglobin A1c. The moderate-carb group had a reduction of just 0.2 percent.
The low carb subjects also had a larger reduction in diabetes-related medication use. Six out of ten participants who took sulfonylureas or dipeptidyl peptidase-4 inhibitors in the low carb group stopped their medication. However, out of the moderate-carb group, zero out of the six participants on medications went off of them.
Weight loss
Research shows that as the body mass index decreases, so too do the following markers:
- Glucose
- Hemoglobin A1c
- Insulin levels
- HOMA-IR
- Thyroid Stimulating Hormone (called TSH for short)
People with higher body mass index or waist circumference have a higher risk of prediabetes. One study, in particular, looked at the long term impact of intentional weight loss on prediabetes. A 12-month program looked at the long-term effectiveness of an intensive weight loss lifestyle intervention on prediabetes prevention.
Participants lost an average of 3.2 kilograms on this program. They also had significantly improved glycemic control and insulin sensitivity. The researchers concluded that lifestyle intervention for 12 months effectively decreased fat deposits and improved cardiovascular risk factors in overweight and obese people with prediabetes.
In general, people with prediabetes in weight-loss interventions have a lower risk of developing diabetes compared to control groups. Weight loss actually seems to be the main factor in reducing the risk of type 2 diabetes.
Evidence shows that prediabetes and type 2 diabetes can develop parallel to weight gain. Studies show that weight loss can produce remission of type 2 diabetes. And this happens in a dose-dependent manner. This means that the more weight you lose, the more you lower your risk of developing type 2 diabetes. A weight loss of 15 kilograms can lead to type 2 diabetes’s remission in 80 percent of patients with obesity and type 2 diabetes.
Drink more water
Nutritionists tend to recommend drinking water when trying to lose weight. One study looked at overweight and obese women between 18 and 50 years old who regularly consume diet beverages. These women were then asked to continue drinking diet beverages five times per week or to substitute water for their diet beverages.
Compared to the diet beverages group, the water group had a greater weight decrease. The group that was drinking water lost 8.8 kilograms. The diet beverages group lost 7.6 kilograms. Fasting insulin went down by 1.02 millimoles per Litre in the water drinking group and by 0.72 millimoles per Litre in the diet beverages group. The study concluded that replacing diet beverages with water can lead to more weight loss and can improve insulin resistance.
Sleep pattern
There appear to be U shaped patterns when it comes to sleep and its relation to prediabetes. This means that short sleepers and long sleepers have a higher risk of diabetes. Short sleep is less than six hours. A night of normal sleep is between six and 8.5 hours. Long sleepers are those who sleep more than 8.5 hours.
Oversleeping can increase the probability of prediabetes. A sufficient amount of sleep, on the other hand, can decrease the effects of stress on prediabetes.
In particular, one study investigated the association between sleep quality and glucose metabolism among people with prediabetes. Researchers wanted to explore the potential pathways linking poor sleep to glucose intolerance. They looked at 155 subjects between the ages of 19 and 70 years of age. 62 percent of the subjects with prediabetes had a poor sleep compared to just 46 percent in the group with normal glucose levels.
Researchers concluded that prediabetes is positively associated with poor sleep. Higher C reactive protein (called CRP for short) levels might be a potential underlying mechanism of the association between prediabetes and poor sleep.
Sleep disturbances and circadian misalignment are associated with poor glycemic control in type 2 diabetes. This includes jet lag or shift work. Hemoglobin A1c is significantly higher in those reporting less than five hours of sleep per night. The same goes for those getting more than eight hours per night.
Sleep duration longer than eight hours is also associated with higher fasting glucose. Sleeping for less than six hours is associated with a higher body mass index. Overall, both short and long sleep are associated with high blood sugar measures.
Research shows that chronic insomnia and short sleep can be associated with the development of diabetes.
One study stated that sleep disturbances are commonly found in patients with diabetes. They looked at 162 patients and found that there was lower sleep efficiency in those of them with diabetes.
A different study involved 2985 participants. Compared with the reference group of six to eight hours of sleep per night, a short sleep of fewer than six hours was associated with a higher risk of prediabetes.
Increase fiber intake
Research studies show that dietary fiber has beneficial effects on prediabetes. There is evidence to show that dietary fiber decreases fasting and postprandial glucose. It also improves insulin sensitivity. Dietary fiber is even able to reduce some inflammation markers substantially, by 20 to 30 percent. Pickled and fermented foods, such as pickled vegetables and beans, could serve as a dietary source of fiber that is helpful in diabetes.
Reduce stress
Research shows that stress increases the probability of getting prediabetes.
Monitor your blood sugar with your doctor
It’s important that you keep an eye on your blood sugar levels. Work with your doctor to monitor your blood sugar. They will check it through a blood test. Prediabetes is usually high normal levels of fasting plasma glucose. This is what we call impaired fasting glucose. This is considered levels between 100 and 125 milligrams per deciLitre.
Another way to assess blood sugar is through an oral glucose tolerance test (called OGTT for short). This is the way that women are commonly diagnosed with gestational diabetes. Two hours after having a 75 gram serving of glucose, blood sugar levels are tested.
A prediabetic range of OGTT is between 140 and 199 milligrams per deciLitre. Your doctor will also test your hemoglobin A1c. This represents your blood sugar levels over the past few weeks. A high normal hemoglobin A1c suggests a prediabetic state. This is when hemoglobin A1c is 5.7 percent or higher.
Prediabetes may not be full-fledged type 2 diabetes. But it still involves higher than healthy blood glucose levels. If you have been diagnosed with prediabetes, it’s important that you monitor blood glucose levels with your doctor. Also, be sure to look out for any potential symptoms of progression to type 2 diabetes.
The good news is that prediabetes is indeed reversible. And it can be done naturally. If you eat right, exercise, and keep carb and sugar to a minimum, that is. It can also be helpful to lose some weight, drink more water, and make sure you’re getting a good night’s rest. Reduce your stress levels and increase your fiber intake too for the most benefit.
As always, it’s a good idea to speak with your health care provider if you are concerned that you have prediabetes. They will know the best course of action for your individual case and be able to create a prediabetes action plan for you.
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