How to turn around a diagnosis of prediabetes
What is pre-diabetes and how common is it?
You may not have heard of pre-diabetes, so what exactly is it? When your blood glucose levels rise above certain limits, your pancreas makes extra insulin to get body cells to absorb more glucose. For a time, this extra insulin helps blood-glucose levels remain normal. But insulin overproduction can’t last. Blood glucose begins to increase, with excess glucose remaining in your blood instead of entering cells. Continued raised levels will result in a blood test showing you have pre-diabetes. It may take several years, but without lifestyle changes or treatment, type 2 diabetes then develops.
Mild symptoms like often feeling thirsty and tired, needing to urinate more frequently, and cuts that take a long time to heal may be overlooked as signs of pre- or type 2 diabetes. In the UK, pre-diabetes currently affects one person in 12.
A pre-diabetes diagnosis is a warning that type 2 diabetes is ahead. If you do not alter your lifestyle, your risk of type 2 diabetes will increase. Not everyone with pre-diabetes goes on to develop full-blown type 2 diabetes, but over three to five years around 25% of people will.
Being diagnosed with pre-diabetes means that your body is not dealing with glucose very well. However, many people can reverse this diagnosis – or even established Type 2 diabetes – with lifestyle changes.
My top 5 ways to beat pre-diabetes
There are five main lifestyle factors that can be addressed to reduce the risk of developing prediabetes, or from stopping prediabetes becoming type 2 diabetes:
1. Losing weight and regular exercise
One of the main risk factors for pre-diabetes is being overweight. However, relatively small changes can make a big difference. Research shows that for those at high risk of developing type 2 diabetes, losing 5% of your body weight can reduce this risk by as much as 58%. With lifestyle changes and support from health professionals, the chance of prediabetes developing into type 2 diabetes can be reduced or delayed by 50%.
Insulin cannot work properly if you are not regularly active, and exercise is crucial for reducing the risk of pre-diabetes and type 2 diabetes. Regular physical activity helps the body use insulin more effectively, which prevents the build-up of glucose in the blood. Additionally, exercise can help with weight management.
Taking 30 minutes of moderate, regular activity, such as brisk walking, five days a week, reduces your diabetes risk considerably. With little or no regular exercise, 25% of pre-diabetes cases later become type 2 diabetes. One in 10 adults now risks developing type 2 diabetes by the year 2030, but walking for 15 minutes after meals could prevent this.
2. Getting enough sleep
Overwhelming evidence shows that getting fewer than six hours’ sleep a night makes it four and a half times more likely that you’ll have high blood glucose levels, increasing your risk of pre- and type 2 diabetes. High blood glucose during the night can lead to difficulty sleeping, causing headaches, increased thirst and needing to urinate, which can interfere with falling asleep.7 If you already have pre- or type 2 diabetes, poor sleep will worsen the condition, meaning insulin doesn’t work as well as it should, resulting in raised blood glucose levels and a continuation of the cycle.
3. Quit smoking
Smoking is a proven independent risk factor for prediabetes, increasing the likelihood that type 2 diabetes will eventually follow.8 Nicotine raises blood glucose levels, thickening the blood and increasing the risk of heart disease, stroke and circulatory problems, issues which are also associated with type 2 diabetes. This means that people who smoke are 30-40% more likely to develop pre- and type 2 than those who don’t smoke. Elevated blood glucose levels are more difficult to control when nicotine is present. Quite simply, the more cigarettes and vapes you smoke, the greater your risk of pre- and type 2 diabetes.
4. Reduce high cholesterol
Reducing your cholesterol level is also a key change you can make for better health, and with the right advice and support, you can reduce harmful blood fats. Research shows that consuming too much dietary sugar can lower levels of HDL (good) cholesterol and raise the amount of LDL (bad) cholesterol and triglyceride blood fats.
It is possible to lower high cholesterol by making healthier food choices to reduce your saturated fat intake and by quitting smoking. Choose foods that are low in saturated fats and trans-fats – these are found in commercial baked goods like biscuits, cakes and pies, and fried foods, such as French fries, doughnuts and fried chicken. Choose lean meats, fat-free or low-fat milk, yogurt and cheese, wholegrains, fruits and vegetables, and foods that are low in salt, with no added sugar. Foods that are high in fibre help reduce cholesterol levels and do not cause a sharp rise in blood glucose.
5. Reduce high blood pressure
High blood pressure is a very common health problem. The heart is forced to work much harder to circulate blood around the body when blood pressure is high. If the blood also contains excess glucose (with pre- or type 2 diabetes), this makes the blood sticky and thick, making it even more difficult to circulate and increasing the strain on the heart further.
A high sugar intake raises blood glucose levels and thus blood insulin levels, triggering your sympathetic nervous system to increase blood pressure and heart rate. This means reducing your sugar consumption is an effective way to reduce your blood pressure and therefore your risk of a range of health issues, including pre- and type 2 diabetes. Cutting out salt and taking regular exercise can also lower high blood pressure. Lowering systolic blood pressure by 5mmHg – achievable with medication and lifestyle changes – can reduce the risk of type 2 diabetes by as much as 16%.
Top tip: Tackling these lifestyle factors will improve your overall health, the most important elements being to reduce sugar, fat and salt in your diet. Healthy eating and regular exercise will ultimately lead to weight loss and reduced blood glucose, blood pressure and blood cholesterol levels. If you smoke, quitting will result in reduced blood cholesterol, blood glucose, and blood pressure levels. If you feel you might be at risk of pre- or type 2 diabetes, visit your GP for help and support.
Why is it important to avoid becoming diabetic?
Reducing your risk of developing pre- and type 2 diabetes may be something you have never considered, especially if you feel fit and healthy right now. However, don’t be fooled into thinking that the ‘pre’ gives you plenty of time to consider possible lifestyle changes or that pre-diabetes doesn’t pose a significant threat to your health. You can have prediabetes for years without experiencing any symptoms, which means you won’t know there is anything wrong until you’ve been tested or are affected by serious health problems.
Risk reduction is important because diabetes brings with it a number of serious secondary health conditions. Delayed diagnosis allows elevated blood glucose levels to damage body cells and structures. This cell damage can ultimately cause sight problems, impaired kidney function, heart and blood vessel disease, stroke and nerve damage. The great news, though, is that prediabetes, and potentially even type 2 diabetes, is reversible.
Take Control of Your Prediabetes and Type 2 Diabetes: Prevent, manage and reverse your condition by Dr Val Wilson is available now (£16.99, Bloomsbury)
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