“Prediabetes is a term that some healthcare professionals use to describe when your blood glucose levels are higher than normal, but not high enough for you to be diagnosed with Type 2 diabetes. Prediabetes isn’t a clinical term that is recognised by the World Health Organisation, but some healthcare professionals use it to help them explain that someone is at increased risk of Type 2 diabetes”, says Emma Elvin, Senior Clinical Advisor at Diabetes UK.
It is estimated that one in three adults in England have prediabetes. Prediabetes is a shady area because to fall into this category your blood sugar levels are somewhere between normal and diabetic. The test to identify prediabetes is known as HbA1c. This is a blood test which can be done at home and measures your average blood sugar level over the preceding 8-12 weeks.
Prediabetes predisposes individuals to type II diabetes and is a critical stage in its development. So, can it be reversed?
Is prediabetes reversible?
Type II diabetes itself is a preventable disease. In many cases, it develops because of a poor lifestyle. Therefore, as prediabetes is an indicator of impending type II diabetes, it can be reversed by making lifestyle changes.
Making changes to your diet is a good step to reducing your risk of developing diabetes. Often weight gain and obesity are directly linked to the development of the disease, which is also linked to our diet and the food choices we make. Carbohydrates are the body’s main energy source, but too many of the wrong type over a sustained period can increase the risk of diabetes.
Instead, you can make healthier choices by choosing foods which have a low glycaemic index (GI). The glycaemic index literally tells us how quickly a food increases blood sugar level; quickly, moderately or slowly. Low GI carbohydrates are absorbed slowly and have been shown to help manage blood glucose levels in individuals with type II diabetes.
Some examples of low GI foods are:
- Sweet potatoes
However, not all low GI foods are healthy such as chocolate but being sensible and basing your meals on wholegrain or low GI carbohydrates can help to regulate your blood glucose levels.
One of the main contributing factors to the increasing prevalence of diabetes is junk or fast food. Although fast food is convenient it is:
- High in calories
- Has poor nutritional value
- High in sugar, fat and salt
- Low in fibre
Research has shown that individuals who consume fast food on a regular basis are more likely to gain weight and are more at risk of poor health outcomes.
If you want to make positive changes to your diet consider:
- Reducing the total amount of fat in your diet
- Increasing the amount of fibre you eat because it is good for your digestion
- Replacing animal fats (lard and butter) with monounsaturated fats like olive, rapeseed and vegetable oils/spreads
- Reducing the number of fizzy drinks you consume. Instead, choose water or try adding fresh fruit pieces to water for added flavour
- Reducing the amount of salt you eat. A lot of salt is hidden, especially in ready-made meals, try cooking from scratch so you know exactly what you are eating
- Limiting the amount of red meat you eat each week and instead eat one or two portions of oily fish per week
- Eating at least 5 portions of fruit and vegetables every day
- Keeping your sugar intake low
- Base your meals on low GI carbohydrates like wholegrain pasta, pulses or sweet potatoes
- Snacking on fruit, nuts and seeds rather than sugary, salty and fatty alternatives
Life has been made more convenient by ready-made meals, but fast food and a fast-paced life can make it more difficult to stay on top of our health. In terms of exercise, more of us are leading sedentary lifestyles. For example, convenience and speed often mean we drive to work rather than walk so we miss out on daily exercise. For some people, the gym is not financially viable and longer working days make it seem impossible to fit exercise into our busy schedules, but physical activity is a critical element in a healthy lifestyle.
However, exercise is a great way to reduce your risk of developing type II diabetes. When we exercise, our muscles need the energy to function and their main source is glucose. So, exercise encourages the glucose in the blood to be used up by the muscles so they can complete the exercise. This process doesn’t require insulin, so exercise is also beneficial if you already have insulin sensitivity. Therefore, a single bout of exercise can improve your blood glucose levels and insulin sensitivity.
Adults should aim to complete at least 150 minutes of moderate aerobic activity per week. So, you could perform 30 minutes every day for five days and rest for two, it is important you have rest days to let your body recover. Aerobic activities include:
- Brisk walking
You should combine this with strength exercise on 2 or more days per week, too. Strength exercises should work your major muscles and you may choose weights or your own body weight using exercises like press ups, pull ups or sit ups.
As you progress you may prefer to incorporate some vigorous aerobic exercise into your programme. 75 minutes per week is advisable instead of 150 minutes of aerobic activity, but this should also be combined with strength training. Vigorous intensity aerobic activities include:
- Swimming laps
- Playing singles tennis
Additional benefits of exercise are:
- Increases good cholesterol and reduces bad cholesterol
- Better mental health
- Lower blood pressure
- Better weight control
- Strong Bones
- Better sleep
- Increased energy levels
- Stronger muscles
If prediabetes is identified early it can be reversed, preventing it from developing into type II diabetes. In the UK, up to 10% of people diagnosed as prediabetic go on to develop diabetes.
Making simple yet effective changes to your lifestyle can dramatically reduce the chance of developing the disease and can even reverse prediabetes. The two biggest factors are diet and exercise.
If you make positive changes to these two lifestyle aspects then blood glucose levels can return to normal.
Diabetes Digital Media Ltd. (2019). Prediabetes (Borderline Diabetes). Available at: https://www.diabetes.co.uk/pre-diabetes.html
National Health Service. (2014). One in Three Adults in England ‘Has Prediabetes’. Available at: https://www.nhs.uk/news/diabetes/one-in-three-adults-in-england-has-prediabetes/
Rynders, C, A et al. (2014). Effects of Exercise Intensity on Postprandial Improvement in Glucose Disposal and Insulin Sensitivity in Prediabetic Adults. The Journal of Clinical Endocrinology and Metabolism: 99(1), pp 220-228.
Tuso, P. (2014). Prediabetes and Lifestyle Modification: Time to Prevent a Preventable Disease. Perm J: 18(3), pp 88-93.