Seeing the diagnosis can be scary: prediabetes – but it doesn’t have to be inevitable.

Diabetes doesn’t have to be inevitable. While 1 of 3 U.S. adults have a diagnosis of prediabetes (a blood sugar level that’s higher than normal but not high enough to be termed diabetes), not all develop full-blown diabetes.  That’s the goal – to prevent or delay it;  diabetes comes with a host of issues (retina or nerve problems and heart risks, among others).

The key to turning around prediabetes? Lifestyle. Lifestyle. Lifestyle. The good news? A landmark study of prediabetes reversal found lifestyle improvement did better than medicine to reverse prediabetes. A review of the research just confirmed that again.

One physician who knows that well is Sam Dagogo-Jack, MD, DSC, MBA, a professor of medicine and chief of endocrinology, diabetes and metabolism at the University of Tennessee Health Science Center, Memphis.   He was a principal investigator at one of the 27 centers set up around the U.S. from 1996-2001 for the long-running Diabetes Prevention Program (DPP) and continues to study the evidence about reversing prediabetes. A follow up study came after the original study, called the DPP Outcomes Study.

The Landmark Study: Evidence

The DPP study looked at whether following the prescribed lifestyle improvement program or taking metformin, a medicine to treat high blood sugar levels in those with diabetes, would delay or prevent type 2 diabetes, and how it compared to simply taking placebo (pill without medicine).

After three years, those in the lifestyle change group lowered their chances of getting type 2 diabetes by about 58%

More than 3,200 were enrolled, and 45% were from minority groups (African American, Alaska Native, American Indian, Asian American, Hispanic/Latino or Pacific Islander) at high risk of diabetes. After three years, those in the lifestyle change group lowered their chances of getting type 2 diabetes by about 58% compared to those who took placebo. Those over age 60 reduced their risk even more, by 71 %.

Those who took metformin lowered their chances by 31% compared to those who took placebo.

As Dr. Dagogo-Jack said: “The ratios are roughly 2 to 1,” in favor of lifestyle over medicine.

As the study continued, about 5% of those changing their lifestyle got diabetes each year, but 11% of those on placebo did.

In a review known as a meta-analysis published earlier this year, Dagogo-Jack and his colleagues again concluded that lifestyle improvement beats out medicine to reverse prediabetes.

Prediabetes Action Plan

“The first line approach is a serious attempt to modify lifestyle,” Dagogo-Jack says. “That’s not an opinion. It’s evidence.”

What lifestyle improvements?

• Weight loss, if needed. Losing just 5 to 7% of starting weight makes a difference. (If you’re overweight at 150 pounds, a 5% loss is just 7.5 pounds. At 200 pounds, it’s 10 pounds.)
• Exercise, 30 minutes 5 times a week. “We target 8,000 to 10,000 steps a day,” Dagogo-Jack said. Walking is fine.
• Reduce your intake of saturated fat, carbohydrates and fried and fatty foods.
• Eat more vegetables, more fiber.

Instead of the do-it-yourself approach, you can sign up for an in-person or online diabetes prevention program at the CDC site, which took up the DPP protocol.  The program is one year, meeting weekly the first six months, then once or twice a month for the last six months. It’s free or has a fee, depending on the location.

Know Your Risk, Know Your Numbers

The American Diabetes Association offers a 60-second diabetes risk test.  (You can have the results emailed or view them right away.)

A test known as A1C measures your blood glucose levels, averaging it over the past 2-3 months and expressing it as a percentage. Under 5.7% is normal; 5.7 to under 6.5% is prediabetes, and 6.5% and higher is diabetes.

Collect Some Information, Motivation

Cleveland Clinic has this explainer, and also these 9 tips to prevent prediabetes from progressing. Your healthcare provider may offer motivation and support, as well.

Have Diabetes and need help to pay for insulin treatments? Check out the resources Fact Sheet from the American Diabetes Association.  

Your turn

Have you turned around prediabetes? Go on, brag a little! Share your story in the comments!

Kathleen Doheny is a Los Angeles-based independent journalist, specializing in health, behavior, fitness and lifestyle stories. Besides writing for Senior Planet, she reports for WebMD, Medscape, Psycom.net,  Practical Pain Management, and other sites.  She is a mom, mother-in-law and proud and happy Mimi who likes to hike, jog and shop.

Doheny photo: Shaun Newton

This article offered by Senior Planet and Older Adults Technology Services is for informational purposes only and is not intended to substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding any medical condition. If you think you may have a medical emergency call 911 immediately.

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