Pre-diabetes is also known as borderline diabetes. It is a condition where the sugar in the blood is higher than normal but not high enough to be diagnosed as type 2 diabetes. The Centers for Disease Control and Prevention (CDC), reported that 88 million adults or more than 1 in 3 adults in the United States have pre-diabetes. The International Diabetes Federation estimated that, by the year 2035, pre-diabetes prevalence is likely to increase to 471 million globally (1). A blood test diagnosis of prediabetes is having an A1C of 5.7% to 6.4%, or a fasting blood sugar level of 100 mg/dl to 125 mg/dl, or an oral glucose tolerance test level of 140 mg/dl to 199 mg/dl. A second test sometime is needed to confirm the diagnosis.
Risk factors for developing pre-diabetes
Prediabetes is associated with health risks such as type 2 diabetes, heart disease, and stroke. Modifying risk factors include;
If you are physically inactive for less than 3 times each week
High blood pressure
Overconsumption of alcohol
Non-modifying risk factors include
If you are 45 years or older, have a parent, brother, or sister with diabetes
Having gestational diabetes (diabetes during pregnancy) or giving birth to a baby that weighs more than 9 pounds
If you are African American/Black, Hispanic/Latino American, American Indian, Pacific Islander, or Asian American
Exercise and weight loss
The Diabetes Prevent Program by the CDC has shown that participants who lost 5 to 7% of their body weight (10-14 pounds for someone who weighs 200 pounds) and exercise for 150 minutes weekly can reduce the risk of developing type 2 diabetes by 58% (those who are 60 years and older showed a 71% reduction) (3).
As you can see, exercise plays a vital role in reducing the risk of pre-diabetes and reversing its diagnosis. American College of Sports Medicine recommends moderate to vigorous activity for at least 22 to 35 minutes daily to promote weight loss (4). Working major muscles such as legs, arms, hips, back, abdomen, chest, and shoulder for at least 2 to 3 days per week is also associated with weight loss. However, keeping your weight in the normal range is the key to prevent pre-diabetes. The general rule of thumb is that you need to burn about 3500 calories per day to lose 1 pound.
Eating healthy is another major lifestyle change that can permanently reverse prediabetes. Eating healthy for life include making healthy food choices such as increasing fiber intake to greater than or equal to 15 grams per 1000 kcal or aim for at least 21-25 grams of fiber per day if you are a female and 30 to 38 grams if you are a male. High fiber foods include vegetables, fruits, beans whole grain, and whole wheat foods.
Reducing the intake of total fat in your diet to less than 30% with 10% or less of the total being saturated fat (animal food sources like red meat, poultry skin, full-fat dairy products, palm oil, and coconut oil. Eliminate trans-fat or partially hydrogenated which is found in some foods like baked goods, microwave popcorn, frozen pizza and stick margarine. Also, eliminating sugar sweetened beverages.
You can also follow the MyPlate Plan as a guide to learn about portion control, choosing the right food and beverages with less saturated fat, sodium, and added sugar (5). You can also connect with a Registered Dietitian or a Certified Diabetes Care & Education Specialist who can provide an individualized treatment plan to suit your lifestyle, food preferences, culture, tradition, and nutritional needs and goals (6)
In some cases, the health care provider may need to prescribe Metformin, especially if there are other underlying diseases such as PCOS, high cholesterol, obesity, and high blood pressure. Metformin has helped to improve those with a higher than normal body weight and reduce cholesterol (7).
While there are no clear evidence for pre-diabetes symptoms, individuals can limit their risk by eating healthy, reach or reduce weight, and exercising regularly. If you meet 2 or more of the risk factors above you can take the risks test (8). If you score more than 5, talk to your doctor for additional testing to confirm the diagnosis.