According to the Centers for Disease Control and Prevention (CDC), over 84 million people have prediabetes, and 9 out of 10 of them don’t know it. What’s more, many people with prediabetes will eventually go on to develop type 2 diabetes within five years.
Prediabetes is a condition in which your blood sugar levels are higher than normal, but not high enough to be considered type 2 diabetes. When a person has type 2, once known as adult-onset diabetes, their body may be able to produce some insulin on its own, but the cells aren’t able to use it effectively enough to manage the amount of glucose, or sugar, in the blood—also called insulin resistance. Doctors and researchers can’t say for sure what causes type 2 diabetes, but genetics, lifestyle and health issues such as being overweight all seem to play a role.
While prediabetes may not sound off any alarms, it does need to be taken seriously. Once type 2 diabetes develops, it takes a great deal of effort to keep it under control, and without proper management, it can lead to a host of health problems including nerve damage, kidney disease and loss of vision. It also increases your risk for heart attack and stroke.
Luckily, having prediabetes doesn’t mean that type 2 diabetes is inevitable. We talked with Jessica Crandall, RDN, CDE, Wellness Center Director of Denver Wellness and Nutrition in Colorado, and Ashley Guild, MD, of the Tristar Medical Group in Hermitage, Tennessee, for ways to reverse your risk and get your health back on track.
1. Take inventory of your diet.
“Nutrition is an investment in your health long-term,” says Crandall, “not only for your energy levels today, but for preventing disease in the future.”
If you’ve been diagnosed with prediabetes, take stock of your pantry and fridge and remove things that contain unhealthy added sugars, such as flavored yogurt, sweetened cereals and sugary drinks. “All those added sugars increase the risk for additional weight gain, and that correlates with diabetes,” says Crandall.
Replace them with nutrient-dense foods such as fruits and vegetables, high-fiber whole grains, lean protein and non-fat dairy. Also, prepare snacks that combine high-fiber carbs and protein, such as whole grain crackers and cottage cheese or string cheese and low-sodium deli meat. This helps slow down sugar absorption for better blood sugar control.
When it comes to carbs, watch how much you eat, as eating too much can cause your blood sugar to spike. “Carbohydrates give us energy, but I always say it’s like the three bears,” says Crandall. “You don’t want too little and you don’t want too much.” How much is the right amount? “It depends on weight and activity, but most women are at around 30 to 45 grams of carbs per meal and 45-60 grams per meal for men.”
One handy way to help keep track of carb intake? “Half of your plate should be covered with vegetables,” says Crandall. “Then a quarter of your plate can be protein and a quarter can be carbohydrates.”
2. Keep an eye on the scale.
Exercising and maintaining a healthy weight are critical to reversing your risk for type 2 diabetes.In fact, according to Dr. Guild, losing just 5 to 10 percent of your body weight can help slow or stop the progression of the disease. Exercise also helps increase your body’s sensitivity to insulin, making you better able to regulate your blood sugar.
If you do need to shed some pounds, Crandall suggests finding small ways to work in activity throughout the day, such as taking a 10-minute walk after lunch or dinner. “Those additional minutes of activity add up,” she says.
3. Check your blood sugar and write it down.
Checking your blood sugar regularly isn’t absolutely necessary, says Guild, but doing so could help you identify which foods tend to drive it up. Keeping blood sugar steady is one important piece of the puzzle when it comes to managing prediabetes.
“It might be helpful in the beginning to keep a food diary and record the foods you eat and your corresponding blood sugars,” says Guild. To do so you’ll need to get a glucose meter, then follow these steps from the American Diabetes Association to be sure your readings are accurate.
Guild suggests checking your numbers in the morning before eating breakfast, two hours after each meal and right before bedtime.
4. Cut back on alcohol and steer clear of smoking.
While a glass of wine every now and then isn’t off limits, it is a good idea to cut back if you imbibe on a regular basis. Not only can alcohol contribute to weight gain and increase the risk of diabetes, it also makes blood sugar harder to control. Stick to no more than one drink per day if you’re a woman, two per day if you’re a man.
As for smoking, we know that it’s bad news for anyone, but especially so for those with prediabetes. According to the CDC, smokers are 30 to 40 percent more likely to develop type 2 diabetes, and lighting up also contributes to insulin resistance.
5. Keep stress in check.
The daily demands of living can drive up anyone’s stress levels, at least temporarily. But living in a state of high anxiety most of the time encourages the production of “fight or flight” hormones that increase glucose levels. People who are chronically stressed are also less likely to eat healthy, exercise and get enough rest.
If you’re tense most of the time, find ways to relax and calm down for the sake of your health. Meditation, breathing exercises, yoga and other forms physical activity can all help.
6. Talk to a diabetes educator.
In addition to your primary care physician, working with a certified diabetes educator (CDE)—check to make sure your insurance covers one—is a great way to be proactive about diabetes prevention. Your diabetes educator can help you better understand the lifestyle changes you need to make to reverse your risk, as well as help you to develop easy-to-follow self-management plans.
“I always tell my clients, you can be in the driver’s seat and prevent the progression of the disease, or you can choose to be the passenger and let the disease take over,” Crandall says. “It’s really up to you, from nutrition, exercise, behavior and working with your team of healthcare professionals.”
Sourcing: CDC, American Diabetes Association