Written by Shcarry Chatmon, DO 

Edited by Megan Sloan, PA-C

Many names are used to describe irregularly high blood sugar that does not yet qualify as type 2 diabetes. Most commonly it is known as prediabetes. It is also referred to as borderline diabetes, impaired glucose tolerance, and impaired glycemia. There are many people who meet the definition of being prediabetic and do not know it. Prediabetes is a serious disease that can develop into type 2 diabetes if left unmanaged.  Sometimes there are no noticeable symptoms in people with prediabetes, and when symptoms do occur, they may take years to develop. Some of these symptoms  can include; feeling thirsty, frequent urination, blurred vision, unintentional weight loss, or feeling more tired than usual. Currently 97 million adults in the United States have prediabetes, which  is 38% of the US population. This number will continue to rise if we do not take action.   

There are specific blood tests that can easily determine if you have prediabetes, including the hemoglobin A1c test (HbA1c). This test estimates your average blood sugar levels over a two to three month period. Hemoglobin A is a protein found in red blood cells and the HbA1c test measures the percentage of hemoglobin A that has glucose (blood sugar) attached to it. The American Diabetes Association defines 5.7% to 6.5% as the range for prediabetes. Below 5.7% is considered normal and above 6.5% is considered diabetic. Your medical provider can let you know what category you fall into. It is very important to know your status because prediabetes can be reversible with healthy habits and lifestyle changes. Here are some of the most important components of a healthy lifestyle:

Eat a nutritious diet.

Choose a diet rich in fruits, vegetables, beans, legumes, seeds, and whole grains. Avoid ultra processed foods that have had their nutrients removed, or that have had excessive salt, sugar, or chemicals added. This information can be found on the nutrition label of packaged foods. Even the simple act of replacing sugar sweetened beverages with water or unsweetened drinks significantly decreases your long term risk of developing type 2 diabetes and other lifestyle-related diseases.    

Consistent physical activity.

Getting at least 150 minutes of physical activity weekly has been shown to drastically decrease the likelihood that prediabetes will progress to diabetes. This can be a brisk walk, swimming, riding a bike, yard work, group fitness classes, or anything that gets you moving and gets your heart rate elevated. Consistency is key, so find something you enjoy and can stick to long term. Though 150 minutes or more would be ideal, any amount of regular physical activity is a step in the right direction.     

Get good quality sleep. 

Adults should aim for 7-9 hours of sleep in a cool, dark, and quiet environment. It is also important to keep your sleep/wake times the same everyday, even on the weekends.  Regular sleep allows repair and restoration for our bodies and a healthy sleep routine supports good health overall. The American Diabetes Association analyzed 10 different studies that show a positive link between proper sleep habits and a decrease in diabetes risk.          

Reduce your stress levels.

Although stress is a normal part of life, it is important that we address it in healthy ways. Increased stress causes a rise in cortisol, a stress hormone that increases insulin resistance. Studies show that there is a relationship between frequent increased stress and increased rates of diabetes diagnoses.  Deep breathing, movement, meditation, connecting with nature, artistic expression, music, and community engagement have all been shown to help manage the response our bodies have to stress.   

Taking Action 

In order to reverse prediabetes, it is not necessary to change everything all at once. Changes will be more likely to last by focusing on one small area and then improving over time.. The most important first step is believing that change is possible. Create a plan by determining a specific action you would like to take. Once you know what you would like to do, decide what resources you already have, or what you might need to make it happen. Ask yourself what success looks like to you and how will you know when you have reached your goal. Imagine future challenges to your goal and what steps you might take to prevent or fix them.  There will always be times when things do not go according to plan, but if you have a plan it is much easier to get back on track and remain consistent. These activities can not only slow or completely prevent progression to type 2 diabetes, but they can also lead to more energy, increased confidence, and a better quality of life in general. Ask yourself what areas you would like to improve in and set a healthy lifestyle goal today.  

References 

1. World Health Organization. Diabetes. World Health Organization. April 5, 2023. Accessed September 5, 2024. https://www.who.int/news-room/fact-sheets/detail/diabetes 

2. Center for Disease Control. National Diabetes Statistics Report. Centers for Disease Control and Prevention. May 15, 2024. Accessed September 5, 2024. https://www.cdc.gov/diabetes/php/data-research/?CDC_AAref_Val=https%3A%2F%2Fwww.cdc.gov%2Fdiabetes%2Fdata%2Fstatistics-report%2Findex.html 

3. American Diabetes Association. What is the A1C test? Understanding A1C Test. Accessed September 5, 2024. https://diabetes.org/about-diabetes/a1c  

4. Harvard T. H. Chan School of Public Health. Sugary drinks. The Nutrition Source. August 2023. Accessed September 5, 2024. https://nutritionsource.hsph.harvard.edu/healthy-drinks/sugary-drinks/ 

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