How to cope with pre-diabetes

The Right Diet for Prediabetes

How to cope with pre-diabetes

A prediabetes diagnosis can be alarming. This condition is marked by abnormally high blood sugar (glucose) most often due to insulin resistance. This is a condition in which the body doesn’t use insulin properly. It’s often a precursor to type 2 diabetes.

According to the Mayo Clinic, people with prediabetes are at an increased risk of developing type 2 diabetes. With prediabetes, you may also be at risk of developing cardiovascular disease.

However, a prediabetes diagnosis doesn’t mean you’ll definitely get type 2 diabetes. The key is early intervention — to get your blood sugar the prediabetes range. Your diet is important, and you need to know the right kind of foods to eat.

How diet relates to prediabetes

There are many factors that increase your risk for prediabetes. Genetics can play a role, especially if diabetes runs in your family. However, other factors play a larger role in the development of disease. Inactivity and having overweight are other potential risk factors.

In prediabetes, sugar from food begins to build up in your bloodstream because insulin can’t easily move it into your cells.

People think of carbohydrate as the culprit that causes prediabetes, but the amount and type of carbohydrates consumed in a meal is what influences blood sugar. A diet filled with refined and processed carbohydrates that digest quickly can cause higher spikes in blood sugar.

For most people with prediabetes, the body has a difficult time lowering blood sugar levels after meals. Avoiding blood sugar spikes by watching your carbohydrate intake can help.

When you eat more calories than your body needs, they get stored as fat. This can cause you to gain weight. Body fat, especially around the belly, is linked to insulin resistance. This explains why many people with prediabetes also have overweight.

You can’t control all risk factors for prediabetes, but some can be mitigated. Lifestyle changes can help you maintain balanced blood sugar levels and stay within a healthy weight range.

Watch carbs with the glycemic index

The glycemic index (GI) is a tool you can use to determine how a particular food could affect your blood sugar.

Foods that are high on the GI will raise your blood sugar faster. Foods ranked lower on the scale have less effect on your blood sugar spike. Foods with high fiber are low on the GI. Foods that are processed, refined, and void of fiber and nutrients register high on the GI.

Refined carbohydrates rank high on the GI. These are grain products that digest quickly in your stomach. Examples are white bread, russet potatoes, and white rice, along with soda and juice. Limit these foods whenever possible if you have prediabetes.

Foods that rank medium on the GI are fine to eat. Examples include whole-wheat bread and brown rice. Still, they aren’t as good as foods that rank low on the GI.

Foods that are low on the GI are best for your blood sugar. Incorporate the following items in your diet:

  • steel-cut oats (not instant oatmeal)
  • stone-ground whole wheat bread
  • nonstarchy vegetables, such as carrots and field greens
  • beans
  • sweet potatoes
  • corn
  • pasta (preferably whole wheat)

Food and nutrition labels don’t reveal the GI of a given item. Instead make note of the fiber content listed on the label to help determine a food’s GI ranking.

Remember to limit saturated fat intake to reduce the risk of developing high cholesterol and heart disease, along with prediabetes.

Eating mixed meals is a great way to lower a food’s given GI. For example, if you plan to eat white rice, add vegetables and chicken to slow down the digestion of the grain and minimize spikes.

Portion control

Good portion control can keep your diet on the low GI. This means you limit the amount of food you eat. Often, portions in the United States are much larger than intended serving sizes. A bagel serving size is usually about one-half, yet many people eat the whole bagel.

Food labels can help you determine how much you’re eating. The label will list calories, fat, carbohydrates, and other nutrition information for a particular serving.

If you eat more than the serving listed, it’s important to understand how that’ll affect the nutritional value. A food may have 20 grams of carbohydrate and 150 calories per serving. But if you have two servings, you’ve consumed 40 grams of carbohydrate and 300 calories.

Eliminating carbohydrates altogether isn’t necessary. Recent research has shown that a lower carb diet (less than 40 percent carbs) is associated with the same mortality risk increase as a high carbohydrate diet (greater than 70 percent carbs).

The study noted minimal risk observed when consuming 50 to 55 percent carbohydrates in a day. On a 1600-calorie diet, this would equal 200 grams of carbohydrates daily. Spreading intake out evenly throughout the day is best.

This is in line with the National Institutes of Health and the Mayo Clinic’s recommendation of 45 to 65 percent of calories coming from carbohydrates daily. Individual carbohydrate needs will vary a person’s stature and activity level.

Speaking to a dietitian about specific needs is recommended.

One of the best methods to manage portions is to practice mindful eating. Eat when you’re hungry. Stop when you’re full. Sit, and eat slowly. Focus on the food and flavors.

Eating more fiber-rich foods

Fiber offers several benefits. It helps you feel fuller, longer. Fiber adds bulk to your diet, making bowel movements easier to pass.

Eating fiber-rich foods can make you less ly to overeat. They also help you avoid the “crash” that can come from eating a high sugar food. These types of foods will often give you a big boost of energy, but make you feel tired shortly after.

Examples of high-fiber foods include:

  • beans and legumes
  • fruits and vegetables that have an edible skin
  • whole grain breads
  • whole grains, such as quinoa or barley
  • whole grain cereals
  • whole wheat pasta

Cut out sugary drinks

A single, 12-ounce can of soda can contain 45 grams of carbohydrates. That number is the recommended carbohydrate serving for a meal for women with diabetes.

Sugary sodas only offer empty calories that translate to quick-digesting carbohydrates. Water is a better choice to quench your thirst.

Drink alcohol in moderation

Moderation is a healthy rule to live by in most instances. Drinking alcohol is no exception. Many alcoholic beverages are dehydrating. Some cocktails may contain high sugar levels that can spike your blood sugar.

According to the Dietary Guidelines for Americans, women should only have one drink per day, while men should limit themselves to no more than two drinks per day.

Drink servings relate back to portion control. The following are the measurements for an average single drink:

  • 1 bottle of beer (12 fluid ounces)
  • 1 glass of wine (5 fluid ounces)
  • 1 shot of distilled spirits, such as gin, vodka, or whiskey (1.5 fluid ounces)

Keep your drink as simple as possible. Avoid adding sugary juices or liqueurs. Keep a glass of water nearby that you can sip on to prevent dehydration.

Eat lean meats

Meat doesn’t contain carbohydrates, but it can be a significant source of saturated fat in your diet. Eating a lot of fatty meat can lead to high cholesterol levels.

If you have prediabetes, a diet low in saturated fat and trans fat can help reduce your risk of heart disease. It’s recommended that you avoid cuts of meat with visible fat or skin.

Choose protein sources such as the following:

  • chicken without skin
  • egg substitute or egg whites
  • beans and legumes
  • soybean products, such as tofu and tempeh
  • fish, such as cod, flounder, haddock, halibut, tuna, or trout
  • lean beef cuts, such as flank steak, ground round, tenderloin, and roast with fat trimmed
  • shellfish, such as crab, lobster, shrimp, or scallops
  • turkey without skin
  • low fat Greek yogurt

Very lean cuts of meat have about 0 to 1 gram of fat and 35 calories per ounce. High-fat meat choices, such as spareribs, can have more than 7 grams of fat and 100 calories per ounce.

Drinking plenty of water

Water is an important part of any healthy diet. Drink enough water each day to keep you from becoming dehydrated. If you have prediabetes, water is a healthier alternative than sugary sodas, juices, and energy drinks.

The amount of water you should drink every day depends on your body size, activity level, and the climate you live in.

You can determine if you’re drinking enough water by monitoring the volume of urine when you go. Also make note of the color. Your urine should be pale yellow.

Exercise is a part of any healthy lifestyle. It’s especially important for those with prediabetes.

A lack of physical activity has been linked to increased insulin resistance, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Exercise causes muscles to use glucose for energy, and makes the cells work more effectively with insulin.

The NIDDK recommends exercising 5 days a week for at least 30 minutes. Exercise doesn’t have to be strenuous or overly complicated. Walking, dancing, riding a bicycle, taking an exercise class, or finding another activity you enjoy are all examples of physical activity.

The Centers for Disease Control and Prevention (CDC) estimate that 84 million U.S. adults have prediabetes. Perhaps even more concerning is that 90 percent don’t know they have the condition.

Early medical intervention is important in order to catch the condition before it turns into type 2 diabetes. If you’ve been diagnosed with prediabetes, you and your doctor can develop a diet plan that will help.


After a Prediabetes Diagnosis: How to Prevent Diabetes

How to cope with pre-diabetes

From the WebMD Archives

Getting diagnosed with prediabetes is a serious wake-up call, but it doesn't have to mean you will definitely get diabetes. There is still time to turn things around.

“It’s an opportunity to initiate lifestyle changes or treatments, and potentially retard progression to diabetes or even prevent diabetes,” says Gregg Gerety, MD, chief of endocrinology at St. Peter’s Hospital in Albany, N.Y.

Making these seven changes in your daily habits is a good way to start.

Becoming more active is one of the best things you can do to make diabetes less ly.

If it's been a while since you exercised, start by building more activity into your routine by taking the stairs or doing some stretching during TV commercials, says Patti Geil, MS, RD, author of What Do I Eat Now?

“Physical activity is an essential part of the treatment plan for prediabetes, because it lowers blood glucose levels and decreases body fat,” Geil says.

Ideally, you should exercise at least 30 minutes a day, five days a week. Let your doctor know about your exercise plans and ask if you have any limitations.

If you're overweight, you might not have to lose as much as you think to make a difference.

In one study, people who had prediabetes and lost 5% to 7% of their body weight (just 10-14 pounds in someone who weights 200 pounds) cut their chances of getting diabetes by 58%.

See your doctor every three to six months, Gerety says.

If you're doing well, you can get positive reinforcement from your doctor. If it's not going so well, your doctor can help you get back on track.

“Patients some tangible evidence of success or failure,” Gerety says.

  • Load up on vegetables, especially the less-starchy kinds such as spinach and other leafy greens, broccoli, carrots, and green beans. Aim for at least three servings a day.
  • Add more high-fiber foods into your day.
  • Enjoy fruits in moderation – 1 to 3 servings per day.
  • Choose whole-grain foods instead of processed grains — for example, brown rice instead of white rice.

Also, swap out high-calorie foods. “Drink skim milk rather than whole milk, diet soda rather than regular soda,” Geil says. “Choose lower-fat versions of cheese, yogurt, and salad dressings.”

Instead of snacking on high-fat, high-calorie chips and desserts, choose fresh fruit, or whole wheat crackers with peanut butter or low-fat cheese, Geil says.

Not getting enough sleep regularly makes losing weight harder, says Theresa Garnero, author of Your First Year With Diabetes.

A sleep shortfall also makes it harder for your body to use insulin effectively and may make type 2 diabetes more ly.

Set good sleep habits. Go to bed and wake up at the same time every day. Relax before you turn out the lights. Don't watch TV or use your computer or smartphone when you're trying to fall asleep. Avoid caffeine after lunch if you have trouble sleeping.

Losing weight, eating a healthy diet, and exercising regularly is easier if you have people helping you out, holding you accountable, and cheering you on, says Ronald T. Ackermann, MD, MPH, an associate professor of medicine at Indiana University School of Medicine.

Consider joining a group where you can pursue a healthier lifestyle in the company of others with similar goals.

A certified diabetes educator may also help you learn about what you need to do to prevent your prediabetes from becoming diabetes. You can find one through the American Association of Diabetes Educators.

Having the right mind-set can help.

Accept that you won’t do things perfectly every day, but pledge to do your best most of the time.

“Make a conscious choice to be consistent with everyday activities that are in the best interest of your health,” Garnero says. “Tell yourself, ‘I’m going to give it my best. I’m going to make small changes over time.’”

Those changes will add up.


Ronald T. Ackermann, MD, MPH, associate professor of medicine, Indiana University School of Medicine.

Theresa Garnero, APRN, BC-ADM, MSN, CDE, author, Your First Year With Diabetes, American Diabetes Association.

Patti Geil, MS, RD, CDE, author, What Do I Eat Now?, American Diabetes Association.

Gregg Gerety, MD, chief of endocrinology, St. Peter’s Hospital, Albany, N.Y.

American Diabetes Association: “Prediabetes” and “Prediabetes FAQs.”

National Diabetes Information Clearinghouse: “Diabetes Prevention Program.”

© 2016 WebMD, LLC. All rights reserved.


The Surprising Truth About Prediabetes

How to cope with pre-diabetes

You can have prediabetes for years but have no clear symptoms, so it often goes undetected until serious health problems show up. That’s why it’s important to talk to your doctor about getting your blood sugar tested if you have any of the risk factors for prediabetes, which include:

  • Being overweight
  • Being 45 years or older
  • Having a parent, brother, or sister with type 2 diabetes
  • Being physically active less than 3 times a week
  • Ever having gestational diabetes (diabetes during pregnancy) or giving birth to a baby who weighed more than 9 pounds

Race and ethnicity are also a factor: African Americans, Hispanic/Latino Americans, American Indians, Pacific Islanders, and some Asian Americans are at higher risk.

Ready to find out your risk? Take the 1-minute prediabetes risk test and be sure to share the results with your doctor.

Diabetes Is Harder to Live with Than Prediabetes

Though people with prediabetes are already at a higher risk of heart disease and stroke, they don’t yet have to manage the serious health problems that come with diabetes.

Diabetes affects every major organ in the body.

People with diabetes often develop major complications, such as kidney failure, blindness, and nerve damage (nerve damage can lead to amputation of a toe, foot, or leg).

Some studies suggest that diabetes doubles the risk of depression, and that risk increases as more diabetes-related health problems develop. All can sharply reduce quality of life.

Prediabetes = Preventdiabetes

Think of prediabetes as a fork in the road: Ignore it, and your risk for type 2 diabetes goes up. Lose a modest amount of weight and get regular physical activity, and your risk goes down.

Modest weight loss means 5% to 7% of body weight, just 10 to 14 pounds for a 200-pound person. Regular physical activity means getting at least 150 minutes a week of brisk walking or similar activity.

That’s just 30 minutes a day, five days a week.

The CDC-led National Diabetes Prevention Program (National DPP) has been proven to help people make the lifestyle changes needed to prevent or delay type 2 diabetes. Through the program, participants:

  • Work with a trained coach to make lasting lifestyle changes.
  • Discover how to eat healthy and add more physical activity into their day.
  • Find out how to manage stress, stay motivated, and solve problems that can slow progress.

If you’re told you have prediabetes, ask your doctor or nurse if there is a National DPP lifestyle change program offered in your community. The best time to prevent type 2 diabetes is now.

Many people don’t realize that type 1 and type 2 are different kinds of diabetes.

  • About 90%-95% of people with diabetes have type 2; about 5% have type 1.
  • Type 1 is thought to be caused by an immune reaction and can’t yet be prevented; type 2 can be prevented or delayed through lifestyle changes.
  • Type 1 often starts quickly and has severe symptoms; type 2 is gradual and develops over many years.
  • Type 1 occurs most often in children, teens, and young adults; type 2 occurs most often in older people (though increasingly children, teens, and young adults are developing it).
  • People with type 1 must use insulin every day to survive.
  • Prediabetes can develop into type 2 diabetes, but not type 1.

Learn more about different diabetes types and treatments.

Recipe for prevention: healthy eating and physical activity.


5 Steps to Stop Prediabetes

How to cope with pre-diabetes

From the WebMD Archives

Have you or a family member just received a prediabetes diagnosis? This is a serious wake-up call, but it doesn't have to mean diabetes will develop. You can take steps to turn things around.

It's an opportunity to start lifestyle changes or treatments, and slow or even prevent diabetes, says Gregg Gerety, MD, chief of endocrinology at St. Peter's Hospital in Albany, NY. These changes to familiar, daily habits are a good way to start.

Move more. Hands down, exercise is one of the best things you can do to make diabetes less ly. “Physical activity is an essential part of the treatment plan for prediabetes because it lowers blood glucose levels and decreases body fat,” says Patti B. Geil, a registered dietitian and co-author of What Do I Eat Now? A Step-by-Step Guide to Eating Right With Type 2 Diabetes.

If you haven't exercised in a while, start by building more activity into your day. Take the stairs or do steps in place during TV commercials. Ideally, you should exercise at least 30 minutes a day, 5 days a week. Let your doctor know about your exercise plans. and ask if you should consider any special factors or limitations.

Lose weight. If you're overweight, you might not have to lose as much as you think to make a difference. In one recent study, people who had prediabetes and lost 5% to 7% of their body weight (just 10 to 14 pounds for someone who weighs 200 pounds) trimmed their chances of developing diabetes more than half.

Check in more often. A good rule of thumb is to see your doctor every 3 to 6 months, Gerety says. The payoff is twofold: If you're doing well, you get positive reinforcement from your doctor. And if the condition is not going so well, your doctor can help you get on track.

Step up to better nutrition. Geil suggests several ways you can improve your diet. Load up on vegetables, especially the less starchy kinds such as spinach, broccoli, carrots, and green beans.

Aim for at least three servings a day. Add more high-fiber foods to your meals. Enjoy fruit in moderation, about one to three servings per day. And choose whole grains over processed grains.

For example, eat brown rice instead of white rice.

Also, swap high-calorie foods. “Drink skim milk rather than whole milk, diet soda rather than regular soda,” Geil says. “Choose lower-fat versions of cheese, yogurt, and salad dressings.”

Occasional snacks are fine too, but trade the high-fat, high-calorie chips and desserts for fresh fruit, or whole wheat crackers with peanut butter or low-fat cheese, Geil says.

Make sleep a priority. Plenty of quality shut-eye is essential for many reasons, but not getting enough sleep on a regular basis plays havoc with your health — and your weight.

Too little sleep makes losing weight harder, says Theresa Garnero, a diabetes nurse educator and author of Your First Year With Diabetes: What to Do, Month by Month.

A sleep shortfall also makes it harder for your body to use insulin effectively and may make diabetes more ly.

Create some good sleep habits and stick with them. Go to bed and wake up at the same time every day. Relax before you turn out the lights. Don't watch TV or use your tech devices when you're trying to fall asleep.

The right mind-set and support can help you make a change. Here's how to get started.

Choose and commit. Accept that you won't do things perfectly every day, but pledge to do your best most of the time. “Make a conscious choice to be consistent with everyday activities that are in the best interest of your health,” Garnero says. “Tell yourself, 'I'm going to give it my best. I'm going to make small changes over time.'”

Get support. Losing weight, eating healthy meals, and exercising regularly are easier if you have people who hold you accountable, says Ronald T. Ackermann, MD, MPH. Join a group to be in the company of others with similar goals.


Ronald T. Ackermann, MD, MPH, director, Center for Community Health, Institute for Public Health and Medicine, Northwestern Feinberg School of Medicine.

Gregg Gerety, MD, chief of endocrinology, St. Peter's Hospital, Albany, NY.

Patti B. Geil, RD, co-author, What Do I Eat Now? A Step-by-Step Guide to Eating Right With Type 2 Diabetes.

Theresa Garnero, diabetes nurse educator; author, Your First Year With Diabetes: What to Do, Month by Month.

© 2015 WebMD, LLC. All rights reserved.


What Is Prediabetes—And 6 Steps to Help You Manage It

How to cope with pre-diabetes

What is prediabetes? This condition is characterized by elevated blood sugar that is still below the type 2 diabetes range. “Some people hear 'prediabetes' and they think 'pre-problem,' but that's not the case,” says Jill Weisenberger, M.S., R.D.N., author of Prediabetes: A Complete Guide (buy it on amazon for $9.99).

Not sure if you're at risk? Take this quiz to help answer Do I Have Prediabetes?

Having the disorder, she says, means that you already have insulin resistance. Insulin is the hormone that ferries the sugar from your blood (aka blood glucose) into the rest of the body, so when you're resistant to this hormone, blood sugar rises. At the prediabetes stage, your body can counter the problem by pumping out more insulin.

But this diagnosis also means that the special cells in your pancreas (called beta cells) that make insulin have started to burn out. So eventually, insulin production declines and blood sugar levels creep up.

“You have the same issues with prediabetes as with type 2, the difference is just the degree,” Weisenberger adds.

Because the condition usually has no outward symptoms, your doctor will give you a blood test to confirm whether or not you have it.

For More: Prediabetes Symptoms—and How to Know If You're at Risk

Make Plants the Star of Your Plate

Filling up on veggies, fruits, grains, beans and plant-based oils may help improve the steadiness of post-meal blood sugar levels, compared to eating a more meat-centric diet, Danish researchers found.

But they note that effective veg-forward eating can still include moderate amounts of lean animal products, chicken.

In fact, this kind of vegetarian-ish diet may lower the risk of developing prediabetes in the first place.

Do It: Get recipes at our vegetarian diet center.

Pick the Right Fats

People with prediabetes who ate 50 grams a day of monounsaturated fats (MUFAs, found in nuts and oils) saw better insulin sensitivity after 12 weeks versus those who consumed just 20 to 30 grams of these fats, according to a study conducted at the Mayo Clinic. Worth noting: Half of the MUFAs came from olive oil (2½ Tbsp. daily). This oil is known for its anti-inflammatory properties—important because inflammation is linked to insulin resistance. Check out our Olive Oil Buyer's Guide for more.

Snag More Zzzs

Getting less than 5 hours of sleep a night increased the risk of progressing from prediabetes to type 2 diabetes by 68%, compared to getting 7 hours, according to a study published in Diabetic Medicine.

Inadequate rest increases levels of cortisol, a stress hormone that can release stored sugar into your blood for energy. Cortisol also temporarily increases insulin resistance so your body has extra sugar to fuel your groggy self—not great for your health if it happens frequently.

Food can also make a difference with this, check out Healthy Recipes for Sleep-Enhancing Foods.

Muscle Up

In a study published in PLOS ONE, after strength training for 30 minutes, twice a week for three months, 30% of people with prediabetes returned to healthy blood sugar levels. Muscle tissue absorbs sugar your bloodstream to burn for energy. So more muscle equals bigger impact.

Fun Fact: Weightlifting May Be Better for Your Heart Than Cardio

Scale Back

“If someone is overweight—and not everyone with prediabetes is—making diet and exercise changes to drop some pounds can be key,” says Weisenberger. “We know that when people lose as little as 5% of their body weight, their insulin sensitivity improves.” Our 7-day Prediabetes Diet Plan is a great way to kick off healthy lifestyle changes to prevent diabetes—without sacrificing flavor

Read More: 7 Simple Ways to Reverse Prediabetes

Say “So long” to Soda

A year after getting diagnosed with prediabetes, 34% of people who continued to drink sugar-sweetened beverages (soda, juice or otherwise) developed type 2 diabetes, while only 8% of those who gave them up did, according to Japanese researchers.

Don't tackle all six actions at once. Start with one or two steps that you can easily put into action. Experience success with these goals. Then add a few more steps to what you're already accomplishing. Success breeds success.

Find Your Blood Sugar Balance | Diabetic Living January/February 2020


Prediabetes: Diagnosis, risk factors, and natural remedies

How to cope with pre-diabetes

When a person has prediabetes, their blood glucose levels are consistently high but not yet high enough to develop into type 2 diabetes.

Prediabetes is a widespread condition in the United States. Around 33.9 percent of people over 18 years of age and nearly 50 percent of people aged 65 years and older have prediabetes, according to the Centers for Disease Control and Prevention (CDC).

Getting enough exercise, eating a wholesome diet, and maintaining a healthful weight can reverse prediabetes and prevent the development of type 2 diabetes.

In this article, we look at prediabetes, ways to test for it, and how to reverse the condition.

Prediabetes is when someone has consistently high blood sugar levels that have not yet reached the stage of type 2 diabetes.

When a person has prediabetes, their body cannot use insulin effectively. Insulin is the hormone responsible for transporting sugar from the bloodstream to the cells to use for energy.

Sometimes, the inability to use insulin correctly results in the cells not getting enough sugar. As a consequence, too much sugar remains in the bloodstream.

High blood sugar levels can cause serious health complications, especially damage to the blood vessels, heart, and kidney.

According to the CDC, more than 84 million adults in the U.S. have prediabetes, but many do not know they have the condition, as it is completely symptomless.

By the time most people experience symptoms, the condition has usually progressed to type 2 diabetes.

The American Diabetes Association (ADA) suggest that people should consider blood screening tests for diabetes when they are 45 years old.

However, glucose testing should begin earlier for people who have risk factors for diabetes, such as being overweight or having a family history of diabetes.

Several blood sugar tests can confirm a diagnosis of prediabetes. Doctors repeat tests two or three times before confirming a diagnosis.

Glycated hemoglobin test

Healthcare professionals call the glycated hemoglobin test the A1C test. They use it to check an individual’s average levels of blood sugar over the previous 3 months.

An A1C blood test score of between 5.7 and 6.4 percent means an individual is ly to have prediabetes.

Some conditions, such as pregnancy, can impact on a person’s blood sugar levels and may interfere with A1C results.

In addition, results for some people may show inaccuracies in A1C testing. These include results from individuals of certain ethnicities with a genetic sickle cell trait, including people of African, Mediterranean, or Southeast Asian descent.

These inaccuracies can lead to a misdiagnosis of the disease or poor management of blood sugar.

Fasting blood glucose test

The fasting blood glucose test (GT) measures sugar levels at the time of the measurement. Doctors consider a result of 100—125 milligrams per deciliter (mg/dl) to be a sign of prediabetes.

Those people taking the GT cannot eat or drink for at least 8 hours before giving a blood sample. Many arrange the test for early morning, as most people will already have fasted overnight.

Oral glucose tolerance test

Share on PinterestAn OGTT can help diagnose prediabetes.

The oral glucose tolerance test (OGTT) also requires 8 hours of fasting. Typically, blood sugar levels will then be checked before and 2 hours after drinking a glucose drink.

Other protocols include testing blood sugar levels every 30–60 minutes after consuming the glucose drink.

Doctors consider a 2-hour value of 140–199 mg/dl to be a sign of impaired glucose tolerance. Prediabetes produces this effect on the blood.

Doctors often use the OGTT to help diagnose people who should not undergo the A1C test, such as women who may have gestational diabetes or those with blood conditions.

Prediabetes testing in children

According to the ADA, in 2012, the number of adolescents aged 12–19 years with prediabetes had increased from 9 percent of this age group to 23 percent.

The ADA recommend annual diabetes screenings for children who are overweight or have a combination of risk factors for prediabetes. Typically, medical professionals will interpret the test results for children in the same way as those for adults.

The risk factors for prediabetes and diabetes in children include:

  • Being overweight: Children who are obese or have high levels of fat around the midriff have a higher risk of prediabetes than children who are not.
  • Age: Most diagnoses of type 2 diabetes in children occur during their early teens.
  • Family: Children who have family members with type 2 diabetes or a mother who had gestational diabetes are more ly to struggle with blood sugar control.
  • Race or ethnicity: Children of African American, Native American, and Hispanic descent are more ly to develop type 2 diabetes in comparison to other races and ethnicities.

Once a doctor diagnoses prediabetes, people must undergo regular testing. This provides a better understanding of blood sugar changes and the progression of the condition.

Keeping an eye on blood sugar levels over time also helps a person monitor the impact of any changes they make to their lifestyle or diet. It is possible to reverse prediabetes with the correct lifestyle measures.

People with prediabetes should have blood glucose tests at least once a year or more often, depending on their risk factors.

Many factors can contribute to the development of prediabetes.

Increasingly, research has identified links between family history and prediabetes. However, a sedentary lifestyle and excess belly fat are among the most common and influential causes of prediabetes and type 2 diabetes.

Risk factors for prediabetes and type 2 diabetes include:

Being overweight or obese: The increased presence of fatty tissue reduces the sensitivity of the cells to glucose.

  • Age: Prediabetes can develop at any age, but health experts believe the risk rises after 45 years of age. This may be due to inactivity, poor diet, and a loss of muscle mass, which typically declines with age.
  • Diet: Regularly consuming excess carbohydrates, especially sweetened foods or drinks, can impair insulin sensitivity over time. Diets that are high in red or processed meats also have links to the development of prediabetes.
  • Sleep patterns: According to this 2018 study, people with obstructive sleep apnea have an increased risk of developing prediabetes.
  • Family history: Having an immediate relative with type 2 diabetes significantly increases the risk of someone developing the condition.
  • Stress: Research from 2018 into males in the workplace found that people who experience long-term stress may face a higher than normal risk of diabetes. During periods of stress, the body releases the hormone cortisol into the bloodstream, raising blood glucose levels.
  • Gestational diabetes: Women who give birth to infants weighing 9 pounds or more may have a higher risk of prediabetes. Those who develop gestational diabetes during pregnancy and their children are also at a higher risk of developing the condition.
  • Polycystic ovary syndrome (PCOS): Women with PCOS are more susceptible to insulin resistance, which can lead to prediabetes or type 2 diabetes. Women with type 1 diabetes have a higher risk of PCOS than women who do not have the condition.
  • Ethnicity: The risk of developing prediabetes tends to be higher for African Americans, Native Americans, Hispanics, Pacific Islanders, and Asian Americans. The reason remains unclear.
  • Metabolic syndrome: A combination of the impact of obesity, high blood pressure, high levels of triglycerides, or “bad” fats, and low levels of high-density lipoprotein, HDL or “good” fats, can increase insulin resistance over time. Metabolic syndrome is the presence of three or more conditions that influence a person’s metabolism.

Exercise and diet can help an individual reverse prediabetes, although not every recommendation works for all people.

Some people use herbs and supplements to manage their diet. However, the National Institute of Diabetes and Digestive and Kidney Disorders (NIDDK) advise that no research supports the use of specific spices, herbs, vitamins, and minerals to treat diabetes.

Turmeric, which is a brightly-colored spice, might have some effects on diabetes progression. Learn more about turmeric and diabetes here.

Lifestyle changes

Share on PinterestIncreasing physical activity levels might help prevent or reverse prediabetes.

Healthful lifestyle changes can reduce the chances of developing type 2 diabetes. These changes include:

  • Losing weight: Losing roughly 7 percent of total body weight, particularly reducing belly fat, may reduce the risk of developing type 2 diabetes by 58 percent.
  • Undertaking moderate, consistent activity: People with diabetes should attempt 150 minutes of moderate exercise per week. Even if people are not feeling ready for an intensive workout, going for a walk or gardening can make a difference.
  • Increasing muscle mass: Muscle burns calories at a higher rate than fat, so increasing muscle mass can contribute to achieving a healthy weight. This, in turn, may help to stabilize blood glucose levels.
  • Increasing flexibility: Stretching is a form of exercise. Being flexible can also help reduce the impact of injuries and improve recovery, resulting in a more reliable exercise regimen.
  • Reducing stress: As stress might be a risk factor for prediabetes, managing stress levels can help prevent the condition.
  • Having a healthful diet: Diets that are high in fiber, lean proteins, and complex carbohydrates but low in simple sugars, help keep blood glucose levels stable.
  • Sticking to a strict meal schedule: Eating smaller meals regularly throughout the day helps prevent spikes and dips in blood glucose levels. Be sure to eat at similar times each day and avoid snacking excessively between meals.
  • Stopping smoking: Nicotine is a stimulant that raises blood glucose levels. Smoking can cause insulin resistance and is a risk factor for diabetes.
  • Avoiding excess sugars: Foods and drinks with added sugars can cause extreme changes in blood glucose and contribute to weight gain.
  • Sticking to moderate coffee intake: Caffeine is another stimulant that increases blood glucose levels. However, some studies have linked coffee to increasing insulin sensitivity.
  • Getting enough sleep: One 2015 study suggests that people who have low sleep quality also face a higher risk of prediabetes.

People with prediabetes risk factors or high blood glucose levels may need to monitor their levels at home and take medication to reduce blood glucose.

A doctor may prescribe some people with prediabetes medications, such as metformin, to manage their symptoms.

Signs that prediabetes has progressed to type 2 diabetes include:

  • increased or unrelenting thirst
  • fatigue or feeling weak
  • feeling faint or dizzy
  • blurred vision

Anyone who experiences these symptoms may want to see their doctor for a medical opinion.

People who have a diagnosis of prediabetes should not be alarmed. Instead, they can use this as an opportunity to focus on diet and an exercise regimen to potentially reverse the progression of the disease.

  • Diabetes
  • Type 2
  • Pediatrics / Children's Health


5 Ways to Prevent Prediabetes from Becoming Diabetes

How to cope with pre-diabetes

The Prediabetes Explosion: More than 86 million American adults—approximately one-third of those over age 18 and half of those over 65—have prediabetes, and most of them don’t even know it. If you have prediabetes, it means your blood sugar levels are consistently higher than normal, but not yet high enough to be diagnosed as diabetes.

Prediabetes puts you at higher-than-normal risk of developing type 2 diabetes, heart disease, and stroke. According to U.S. Centers for Disease Control, up to 30% of overweight men and women with prediabetes will develop type 2 diabetes within five years of diagnosis.

You don’t have to be one of them! Here are five steps you can take to reduce your diabetes risk.

RELATED: Beating Prediabetes on a Budget

1. Get Tested

Not everyone with prediabetes will develop type 2 diabetes, but everyone with prediabetes is at higher-than-normal risk.

So talk to your healthcare provider about determining your own risk and getting a simple blood test for diabetes screening.

If necessary, find out what steps you should take right now to avoid or delay the development of type 2 diabetes and related medical conditions.

2. Change Your Diet

If you have prediabetes, you can reduce your risk of developing more serious conditions by eating better and losing any excess weight. Eating better means choosing more healthful foods (e.g.

, lean meats or protein substitutes, fresh veggies, high-fiber starches, healthful fats); eating a wide variety of these foods to balance your meals and be sure you’re getting all the nutrients you need; and sticking to small portion sizes.

It also means eating regularly scheduled meals and snacks to avoid extreme blood sugar highs and lows throughout the day.

RELATED: 5 Flour Options Good for Diabetics and Baking

3. Reduce Toxic Stress Levels

Researchers have found that while short-term psychological stress can actually be good for you, chronic stress suppresses your immune system and could increase your risk of developing type 2 diabetes by altering your insulin needs.

In some people, chronic stress may also trigger a cascade of hormonal events that increase appetite.

While it’s not always possible to eliminate your source of stress, coping techniques, such as yoga, meditation, reading and writing poetry, counseling, or exercise, can help reduce overbearing pressure before it makes you sick.

4. Get Moving

When you’re at risk of developing diabetes, too much TV time or other time spent in sedentary activities increases your risk even more.

Regular exercise can help you manage your weight, reduce high blood pressure and blood fats, sleep better, improve your mood, and boost your energy levels, all of which can also help alleviate stress.

The ADA recommends 30 minutes of moderate-to-vigorous aerobic exercise, such as brisk walking, stair climbing or jogging, at least 5 days a week, and strength training, such as calisthenics or weight training, at least twice a week.

RELATED: Managing My Prediabetes With Kale and Ice Cream

5. Take Your Meds

In many cases, lifestyle changes such as improved diet, stress reduction, increased physical activity, and weight management will help you control your blood sugar and prevent prediabetes from turning into diabetes.

But if you are obese, under 60 years old, or have a history of gestational diabetes, your healthcare provider may recommend oral medication, such as metformin, as the first best step toward managing your condition.

If you feel you would benefit from medication, ask your doctor if you are a candidate.

This article originally appeared on


Taking Steps to Reverse Prediabetes

How to cope with pre-diabetes

This is the third in a three-part series about prediabetes, and in previous blogs we looked at what it is and how to live with it. Here we focus on how you can reverse it.  

Can you reverse a pre-diabetes diagnosis? In short, the answer is yes. Perhaps you’ve been prediabetic for a while now, managing the illness pretty well and making improvements in the kitchen and with exercise. If so, you are on the right path and in time you may reverse your prediabetes condition.

The key is consistency and adopting these new habits permanently into your new lifestyle.

Exercise and eat healthy to reverse prediabetes

As with anyone simply trying to lose weight, you can temporarily change behaviors and achieve success. But the key is keeping with your new healthier habits for the long term.

Staying physically active and eating a healthy, balanced diet every day is the prescription. Most doctors would agree that their patients can improve their own health by making tweaks to their everyday choices.

According to the Mayo Clinic, without lifestyle changes, people with pre-diabetes are very ly to progress to type 2 diabetes. And if you already are prediabetic, it may have started long-term damage to your heart, blood vessels and kidneys. While prediabetes may not seem life-threatening or even a big deal, more serious consequences can follow (as a type 2 diabetic) such as:

If you recall from our first blog in this series, people with prediabetes don't process sugar (glucose) properly.

Their fasting plasma glucose levels are above a normal range of 100 mg, but not quite the minimum level of 126 mg associated with full-blown diabetes. (See the chart.) Most of the glucose in your body comes from the food you eat.

When our food is digested, sugar enters the bloodstream. With pre-diabetes, however, sugars accumulate in the bloodstream instead of fueling the cells.

This can be avoided or corrected if you:

  • Eat healthy foods. Choose foods low in fat and calories and high in fiber. Focus on fruits, vegetables and whole grains. Strive for variety to help you achieve your goals without compromising taste or nutrition.
  • Be more active. Aim for 30 to 60 minutes of moderate physical activity most days of the week. Walking is the best exercise since it’s free and low-impact.
  • Lose excess weight. If you're overweight, losing just 5 to 10 percent of your body weight — only 10 to 20 pounds if you weigh 200 pounds — can reduce the risk of developing type 2 diabetes. Stay motivated by remembering the benefits of losing weight, such as a healthier heart, more energy and improved self-esteem. You are rewarding your body and not punishing it.
  • Stop smoking. If you don’t smoke, don’t ever start. If you do, quit. UPMC Pinnacle offers a smoking cessation program that can support your efforts.
  • Discuss your symptoms with your doctor. Sometimes your doctor will prescribe a medicine called Metformin. In trials, this has been shown to reduce the risk of diabetes by 30 percent. It decreases your appetite and also helps with weight reduction. It also decreases the glucose production from your liver.

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