Treatment Overview
If you have been diagnosed with
prediabetes, you will play a key role in your
treatment and have an opportunity to reverse the condition or delay the
progression to
type 2 diabetes. Losing weight, eating a healthy diet,
and getting regular exercise are very effective in preventing or delaying the
onset of diabetes as well as lowering your risks for other complications, such
as
coronary artery disease or
stroke. These measures may sound simple, but they are
very important for your overall health and for preventing diabetes.
In some cases, your health professional may prescribe medicine in
addition to diet and exercise. But recent research has shown promising results
in preventing diabetes through diet and exercise alone. One large study done in
the U.S. (Diabetes Prevention Program) showed that making these lifestyle
changes was more effective at lowering the risk of getting type 2 diabetes than
taking medicine:7
- Those who lost a modest amount of weight (5% to
10% of total body weight) and exercised lowered their risk by
58%.
- Those who took medicine lowered their risk by 31%.
Monitor your weight
Most people with prediabetes
are overweight—body mass index, BMI, of 25 or greater. If you have a
BMI of 25 or higher, losing just 5% to 10% of your body weight may help you
prevent or delay type 2 diabetes.13 A healthy weight
helps your body use
insulin properly. One recent study showed that losing
weight improves
insulin resistance in people with prediabetes. The
degree of improvement is related to the amount of weight lost.14 For more information on determining your BMI, see:
Eat a balanced diet
If you have prediabetes, you
may be able to prevent or delay the disease by doing all of the
following:
- Limit the amount of fat you eat. Eat foods
low in
saturated fat and high in
soluble fiber
- Eat less
calories.
- Spread
carbohydrate throughout the day and limit sweets to
avoid sudden peaks in blood sugar. Of the three major nutrients (carbohydrate,
protein, and fat), carbohydrate has the greatest effect on blood sugar.
Talk to your health professional about
developing a plan for healthy eating.
One
large study found that men who ate a diet high in vegetables, fish, poultry,
and whole grains had a lower risk for getting type 2 diabetes compared with men
who ate a diet high in red meat, processed meat, high-fat dairy foods, refined
grains, and sweets.15
Planning meals to
manage prediabetes often means looking at food in a new way. There are several
easy ways to adapt your diet. A registered dietitian can help you build a meal
plan that fits your lifestyle. For more information on one type of meal
planning, see:
Diabetes: Using a plate format for
eating.
Exercise regularly
Experts advise doing either of
these things for
exercise:16
- Do
moderate activity for at least 30 minutes a day, 5
days a week or more. Moderate activity is equal to a brisk walk, cycling about
10 to 12 miles per hour (mph), sailing, or shooting baskets. You notice your
heart beating faster with this kind of activity.
- Do
vigorous activity for at least 20 minutes a day, 3
days a week or more. Vigorous activity is equal to jogging, cycling at least 12
mph, cross-country skiing, or playing a basketball game. You breathe rapidly
and your heart beats much faster with this kind of activity.
Being active in several chunks of 10 minutes or more
throughout the day can count towards the above recommendations. You can choose
to do one or both types of activity. Talk to your doctor before you start a
fitness program.
Exercise helps control your blood sugar by using
glucose for energy during and after activity. Exercise helps your body respond
better to insulin and lowers your risk of getting diabetes. It also helps you
maintain a healthy weight; lower
high cholesterol; raise
high-density lipoprotein (HDL), or "good,"
cholesterol; and lower
high blood pressure. These benefits also help prevent
heart and blood vessel (cardiovascular) disease. You may lower your risk of
getting diabetes even more by exercising for longer periods of time during each
exercise session.
Exercise can consist of moderate walking or more
vigorous activities such as jogging, running, bicycling, or playing tennis.
Research has also shown that other activities, such as gardening or snow
shoveling may be beneficial.17 Work with your health
professional to plan a safe exercise program.
Take medicine if needed
In some cases a health
professional may prescribe an oral medicine—most commonly
metformin—to help improve
metabolism in
insulin-resistant patients. This may be appropriate in
people with
polycystic ovary syndrome. If your doctor has
prescribed medicine for prediabetes, be sure to take it as directed.
Stop smoking
If you smoke cigarettes, talk with a
health professional about ways to quit. Smoking may play a role in the
development of type 2 diabetes, and it contributes to early development of
diabetes complications.18 For more information on how
to quit, see the topic
Quitting Tobacco Use.
Monitor blood pressure and cholesterol levels
If
you have prediabetes you are more likely to get cardiovascular disease than
someone with normal blood glucose levels.2 Your health
professional may take your blood pressure and test your blood periodically to
check your
cholesterol levels. By lowering your cholesterol to
the recommended levels and keeping your blood pressure
under 140/90 millimeters of mercury (mm Hg), you may reduce your risk of heart
and large blood vessel disease.
By eating a healthy diet and
getting regular exercise, you may be able to keep your blood pressure and
cholesterol levels within the recommended ranges. People who have
high-density lipoprotein (HDL) cholesterol levels of
35 milligrams per deciliter (mg/dL) or less or
triglyceride levels of 250 mg/dL or more are at higher
risk for getting type 2 diabetes.5