Jaime Herndon is a freelance health/medical writer with over a decade of experience writing for the public.
Isabel Casimiro, MD, PhD, is board-certified in internal medicine. She is an endocrinologist at the University of Chicago and is based in Chicago, Illinois.
Prediabetes is a condition in which blood sugar levels are higher than normal, but they’re not quite high enough to be considered or diagnosed as type 2 diabetes.
The Centers for Disease Control and Prevention (CDC) estimates that about 96 million American adults live with prediabetes. This is more than 1 in 3. Of these people living with prediabetes, more than 80% don’t know they have it.
Prediabetes increases your risk of type 2 diabetes, which has serious health consequences. Being aware of the condition and taking steps to address it through lifestyle changes like diet modification, regular exercise, weight loss, and quitting smoking can make a difference and reduce the likelihood of developing diabetes.
This article will review ways in which you can help to reverse prediabetes and reduce the risk of developing type 2 diabetes.
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Diet is a significant factor in prediabetes and the risk for type 2 diabetes. Making small changes to your diet can have a big effect.
Fiber is a carbohydrate found in fruits and vegetables, whole grains, and legumes. It helps you regulate your bowels, but it also helps control blood sugar, lowers cholesterol and triglycerides, and helps with weight management because it makes you feel full.
Adding more foods like beans, lentils, apples, pears, baby carrots, almonds, and vegetables like broccoli and spinach are easy ways to get fiber into your diet. Make choices like brown rice over white rice and whole wheat pasta instead of white pasta.
Low-glycemic index (GI) diets are helpful for blood sugar control and weight loss in people with prediabetes. These diets focus on foods that don’t raise your blood sugar swiftly. They include foods like green vegetables, fruits, lentils, raw carrots, and bananas.
Many restaurants serve larger portions than necessary, and people tend to eat more when larger portions are on the plate. In a world of supersized meals and getting more for our money, portion sizes have become inflated and unrealistic, leading to overeating and weight problems.
Accurate and appropriate portion sizes can help you recalibrate your eating habits and help with weight management. The CDC has a guide to help you figure out the appropriate portions.
Though you may be watching what you eat, watching what you drink is just as important. Drinking sugar-sweetened drinks like soda has been associated with a higher occurrence of insulin resistance (prevents cells from taking up glucose from the blood to use as energy) and a higher risk of developing prediabetes. This does not include diet soda.
Drinking more than three servings of a sugar-sweetened drink per day or an average of six servings per week was associated with a 46% higher risk of developing prediabetes.
Diet soda or reduced sugar juice are better options. Even better is swapping those drinks for water. Water can also help you feel full, which helps with weight management.
Intermittent fasting (IF) may be an option for some people with prediabetes. In IF, you only eat at a specific time. You fast for a certain number of hours or eat only one meal several days a week.
IF has been found to be an effective tool for losing weight, lowering fasting glucose and insulin levels, and lowering insulin resistance. More research needs to be done on IF and prediabetes. Discuss it with your healthcare provider to see if it’s an option for you.
This video has been medically reviewed by Suzanne Fisher, RD, LDN
Being overweight or having obesity is a risk factor for prediabetes, and regular physical activity can help with weight management. Losing even 5% to 7% of your body weight can reduce your risk of developing type 2 diabetes.
Before you start an exercise program, ask your healthcare provider if it is safe for you to do so. Even brisk walking, several times a week for 30 minutes, five times a week helps.
Not only does exercise help with weight management, but it also helps the body more effectively use insulin (a hormone that controls glucose in your bloodstream).
Cigarette smoking contributes to type 2 diabetes. The CDC estimates that people who smoke are about 30% to 40% more likely to develop type 2 diabetes than those who do not smoke.
Smoking can cause inflammation, which interferes with the effectiveness of insulin in the body. Cigarette smoke also damages cells, called oxidative damage, which is associated with a higher risk of developing diabetes.
Quitting smoking can help improve your health, and also reduces your risk of associated conditions like heart disease. Talk with a healthcare provider about plans to quit smoking and local resources you may be able to use.
Getting enough sleep is important for overall health. Poor sleep habits are associated with insulin resistance and prediabetes.
Even without documented risk factors like sleep apnea, not getting enough sleep, not having a regular sleep schedule, and frequently interrupted sleep can all have an impact on health and prediabetes risk.
Sleep apnea, in which a person has episodes of stopped breathing during sleep, has been found to increase the risk of developing prediabetes and diabetes. This is because sleep apnea reduces the amount of oxygen in the body, negatively affecting glucose levels and insulin resistance.
If you have sleep apnea, talk with a healthcare provider about treating it and how to best manage it.
Treating conditions associated with diabetes and prediabetes is important in managing your health risks.
High cholesterol is associated with prediabetes, and many of the lifestyle changes to reverse prediabetes can also help to treat high cholesterol. High cholesterol can cause heart problems and heart attacks.
Talk with a healthcare provider about whether medication is necessary. Sometimes diet and exercise alone aren’t enough.
High blood pressure (hypertension) is often associated with diabetes. It’s also associated with many risk factors for prediabetes: obesity, a sedentary lifestyle, and poor diet. High blood pressure can put you at risk for heart attack and stroke (a blockage of blood flow to the brain or bleeding in the brain).
It’s important to see a healthcare provider to ensure your blood pressure is in the normal range and treat high blood pressure if necessary.
People with polycystic ovary syndrome (PCOS) are often insulin resistant, which increases the risk of type 2 diabetes. Treating PCOS with medications, weight management, and increased physical activity can help reduce the risk of prediabetes and type 2 diabetes.
Sometimes medication may be necessary. The American Diabetes Association and the Endocrine Society recommend Glucophage (metformin) for prediabetes, especially for those who have obesity, are over age 60, or had gestational diabetes (high blood sugar during pregnancy).
However, many healthcare providers feel otherwise. This is because about two-thirds of people with diabetes will not develop diabetes, and introducing medication will be unnecessary for many of these people.
For those at high risk of developing diabetes, metformin may be useful, especially if measures like dietary modification, exercise, and other lifestyle changes are not effective.
Stress can increase blood sugar levels and makes it harder to regulate blood sugar. Stress can also trigger overeating and reaching for comfort foods that usually aren’t the most healthy.
Things you can do to help manage stress include:
Prediabetes is when your blood sugar is high but not yet high enough to be clinically diagnosed as diabetes. That means there is still time to reverse this trend by making lifestyle changes, taking medication if necessary, and caring for other health conditions.
Things like changing your diet, becoming physically active, quitting smoking, and managing stress can make a difference in helping to get your blood glucose levels under control.
If you have prediabetes and coexisting conditions, talk with a healthcare provider about how they may affect your blood glucose levels. Let them know what kinds of lifestyle changes you are planning to make (diet, exercise, stress management).
Making lifestyle changes can be overwhelming, so don’t be afraid to ask them if any local resources might be helpful. Support groups or exercise groups can provide encouragement.
Many people with prediabetes have no symptoms, and it’s only until early signs of diabetes occur that people get a diabetes diagnosis. This is why it’s important to talk with a healthcare provider if you have risk factors for prediabetes. You can take steps to reduce your risk of developing the condition.
You can eat fruit, but in moderation. It’s also a good idea to eat fruits that have a low glycemic index, like apples, cherries, bananas, grapes, and blueberries. Talk with a healthcare provider or speak with a nutritionist who specializes in diabetes if you’re worried about your nutrition or would like to learn more about healthy meal plans.
Supplements are not regulated by the Food and Drug Administration (FDA), so it’s important to speak with a healthcare provider before taking any supplements to help lower blood sugar. They also have the potential to interact with medications, so keep that in mind.
According to the American Diabetes Association, supplements that may impact blood sugar include:
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