Prediabetes, a condition marked by elevated blood sugar levels, impacts millions globally and is frequently considered a precursor to type 2 diabetes. If diagnosed with prediabetes, the likelihood of developing type 2 diabetes in the future increases. The good news is that prediabetes is reversible for many people through lifestyle changes and early intervention.
When we eat carbohydrates, our bodies break them down into a sugar called glucose. Glucose is used by our cells for energy, however, in prediabetes, your body either doesn’t make enough insulin (the hormone that controls blood sugar) to process that glucose or your cells become resistant to its effects. This leads to higher levels of sugar in your blood.
Prediabetes doesn’t usually cause noticeable symptoms like type 2 diabetes, so you may not even know you have it. There are certain factors, however, that can increase your risk like physical inactivity, being over 45 and/or having a family history of diabetes.
There are a few ways prediabetes can be diagnosed:
Hemoglobin A1c (HbA1c) Test
One of the most commonly used tests, the A1c provides an average of your blood sugar levels over the past two to three months. It measures the percentage of glucose attached to hemoglobin in red blood cells. An A1c level between 5.7% and 6.4% is indicative of prediabetes (normal is considered less than 5.7% and diabetes is considered >6.4%)
Fasting Plasma Glucose (FPG) Test
This test measures your blood sugar level after fasting for at least eight hours. A blood sample is taken, and if the result shows a blood sugar level between 100 and 125 milligrams per deciliter (mg/dL), it indicates prediabetes.
Oral Glucose Tolerance Test (OGTT)
This test involves fasting for at least eight hours, followed by drinking a glucose-rich beverage. Blood sugar levels are tested before and two hours after consuming the drink. If the blood sugar level is between 140 and 199 mg/dL two hours after the glucose drink, it indicates prediabetes.
In addition to these tests, your doctor may consider other risk factors, symptoms, or medical history when making a prediabetes diagnosis.
If you’ve been diagnosed with prediabetes before, the good news is that you can prevent it from advancing into diabetes by making certain changes. Things like nutrition, physical activity, stress and sleep can have a major impact on your blood sugars. By actively taking steps to improve your overall health, you can absolutely reduce the chances of developing diabetes and the complications related to it.
Adopting certain behaviors has the potential to significantly decrease your risk of developing type 2 diabetes and while everyone is different, there are several key factors that can contribute to improving your blood sugar levels:
Nutrition for Prediabetes
Balancing macronutrients during mealtimes is going to create more stability with your blood glucose. Consume a balance of carbohydrates, protein, and fat at meals and make sure to follow this principle for snacks too. If you’re unsure what macronutrients to include on your plate, here is a quick guide. You can also work with one of our registered dietitians to create a personalized nutrition plan that works best for you!
- Carbohydrates: Focus on consuming complex carbohydrates that are rich in fiber, such as whole grains, legumes, fruits, and vegetables. These carbohydrates are digested slower, helping to promote stable blood sugar. Refined carbohydrates like white bread, white rice, sugary snacks, and processed foods may cause rapid blood sugar spikes, but this doesn’t mean you can’t eat them. Make sure to pair them with protein and fiber for better balance. For example, if you want to enjoy white rice for dinner, have it with a hearty portion of vegetables or salad and chicken. If you want to have some fruit as a midday snack, pair it with nuts for better balance. Being aware of food combinations will promote stability with your blood sugar levels.
- Protein: Proteins that are lower in saturated fats like skinless poultry, seafood, legumes, tofu, and eggs are an excellent option for regulating blood sugar levels and promoting satiety. However, this doesn’t mean that you should eat more protein than carbohydrates or that you should replace carbs for protein, which is something we see people do often. Aim for a moderate and balanced intake of protein, alongside carbs, fat and fiber. The easiest way to do this is following the MyPlate method, where half of your plate is non-starchy vegetables (salad, greens, eggplant, cauliflower, etc) and the other half is divided into equal parts protein and carbohydrate.
- Fat: Fat takes longer to digest compared to carbohydrates. When consumed with carbohydrates, it slows down the rate at which glucose is released into the bloodstream, which helps to prevent rapid spikes in blood sugar levels after meals and promotes a more gradual and steady release of glucose. Fat is also more satiating than carbohydrates, meaning it can help you feel fuller for longer after a meal. Monounsaturated fats found in olive oil, avocados, and nuts, as well as polyunsaturated fats found in fatty fish like salmon, flaxseeds, and chia seeds have a variety of health benefits. Including healthy fats in your meals can help reduce hunger and cravings, preventing overeating and excessive intake of high-glycemic carbohydrates that can cause blood sugar imbalances.
Consistent Physical Activity with Prediabetes
Movement is beneficial for managing prediabetes because it helps to improve insulin sensitivity and lower blood sugar levels. Ask yourself what type of movement you enjoy and then incorporate that into your weekly routine. If you don’t like running, there’s no point in forcing yourself to do it because there’s so many other types of movement. Consider dancing, yoga, walking, boxing, martial arts or pilates. The official recommendation is at least 150 minutes of moderate-intensity aerobic activity per week, along with 30-60 minute strength training exercises 2 days a week.
Aside from spiking your blood sugar, chronic stress can have a devastating impact on your overall health. Consider implementing stress management techniques like meditation, deep breathing exercises, yoga or activities that bring you joy and relaxation.
Quality sleep plays an important role in blood sugar regulation. Similar to stress, when we don’t get enough sleep, it becomes harder for our cells to regulate blood sugar. When we’re sleep-deprived, our bodies also increase the production of stress hormones like cortisol, which can make our blood sugar levels go up. Strive for 7-9 hours of uninterrupted sleep per night. Getting blackout curtains, an eye mask and keeping your bedroom temperature between 60-67 degrees F will promote optimal sleep.
Monitor blood sugar levels regularly and maintain regular check-ups with healthcare professionals. They can provide guidance, support, and monitor progress for prediabetes.
The Role of Medication
In some cases, healthcare professionals may prescribe medication to help manage prediabetes. These medications may include metformin, which can improve insulin sensitivity and lower blood sugar levels. However, it is important to note that medication should not be considered a substitute for lifestyle changes but rather a complementary approach when appropriate.
Sustaining Lifestyle Changes
Maintaining normal blood sugar levels is not a short-term fix; it requires long-term commitment and dedication. Blood sugar levels are continuously fluctuating and you may hop back and forth between normal and prediabetes ranges in the coming months and years. It may take time to see significant improvements in blood sugar levels, but the effort invested is well worth it. Working with a registered dietitian will help you develop a plan to stay consistent with your habits. Ready to create long-term changes to improve your blood sugar? Get started with one of our registered dietitians today!
The Bottom Line
Prediabetes can provide an opportunity for individuals to take control of their health and prevent or delay the onset of type 2 diabetes. By adopting a healthy lifestyle, focusing on balanced meals, regular physical activity and stress reduction, individuals can improve their blood sugar levels and overall well-being. Regular check-ups and open communication with your healthcare providers are vital in this process. Small steps lead to big changes and while these changes might be challenging in the beginning, it will get easier over time!