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:
Using a plate format.
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 hoops. 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