Updated on March 19, 2024.
Approximately 98 million adults in the United States have prediabetes, according to the Centers for Disease Control and Prevention (CDC), and more than 8 in 10 of them don't know it.
Having prediabetes means your blood sugar levels are higher than normal, but not quite high enough to be considered type 2 diabetes. Without taking action to lower those blood sugar levels, many people with prediabetes will eventually go on to develop type 2 diabetes.
Understanding diabetes
Ordinarily, blood sugar is your body’s main source of energy. It comes from the food you eat and it's used by your body's cells to perform the various tasks you need to stay alive. Insulin is a hormone the body makes to help move that blood sugar into your body’s cells to use as energy. But when type 2 diabetes develops, the cells in your body aren't able to use insulin as effectively to manage blood sugar. This is called insulin resistance. When you have insulin resistance, your body can’t keep your blood sugar levels balanced.
Doctors and researchers don't fully understand all of the factors that cause type 2 diabetes, but genetics, lifestyle, and health issues (such as being overweight or obese) all seem to play a role.
While having prediabetes may not in itself be dangerous, it does need to be taken seriously. Once type 2 diabetes develops, it takes a great deal of effort to keep it under control. Without proper management, diabetes can lead to a range of health problems including nerve damage, kidney disease, and loss of vision. It also increases your risk for heart attack and stroke.
Luckily, having prediabetes doesn’t mean that type 2 diabetes is inevitable. Read on for expert advise on how to reverse your diabetes risk and keep your health on track from Jessica Crandall, RDN, CDE, a registered dietitian and owner of Vital RD in Denver, Colorado, and Ashley Guild, MD, an internal medicine specialist in Hermitage, Tennessee.
Take a look at your diet
“Nutrition is an investment in your long-term health,” says Crandall, “not only for your energy levels today but for preventing disease in the future.”
If you’ve been diagnosed with prediabetes, it's a good idea to take stock of your pantry and fridge. Start by removing things that contain unhealthy added sugars, such as flavored yogurt, sweetened cereals, and sugary drinks. “All those added sugars increase the risk for additional weight gain, and that is related to diabetes,” says Crandall.
Replace them with foods that can help reverse diabetes, like fruits and vegetables, high-fiber whole grains, lean protein, and non-fat dairy. Also, when you make snacks, look to include foods that are high in fiber and that include some protein. That might be whole grain crackers and cottage cheese or string cheese and low-sodium deli meat. The combination of fiber and protein helps slow down sugar absorption in the body for better blood sugar control.
When it comes to carbohydrates (carbs), watch how much you eat, as eating too much can cause your blood sugar levels to spike.
“Carbohydrates give us energy, but I always say it’s like the three bears,” says Crandall. “You don’t want too little and you don’t want too much.” How much is the right amount? “It depends on weight and activity, but most women are at around 30 to 45 grams of carbs per meal and 45 to 60 grams per meal for men.”
One handy way to help keep track of carb intake? “Half of your plate should be covered with vegetables,” says Crandall. “Then a quarter of your plate can be protein and a quarter can be carbohydrates.” Healthy carbohydrate foods might include brown rice, whole-grain pasta, or a starchy vegetable like a sweet potato.
Keep track of your weight
Exercising and maintaining a healthy weight are critical to reversing your risk for type 2 diabetes. In fact, according to Dr. Guild, losing just 5 to 10 percent of your body weight can help slow or stop the progression of the disease. Exercise also helps increase your body’s sensitivity to insulin, making you better able to regulate your blood sugar.
If you do need to shed some pounds, Crandall suggests finding small ways to work in activity throughout the day, such as taking a 10-minute walk after lunch or dinner. “Those additional minutes of activity add up,” she says.
Check your blood sugar levels—and write it down
Checking your blood sugar levels can help you identify which foods tend to drive it up, says Guild. Keeping blood sugar steady is one important step when it comes to managing prediabetes.
“It might be helpful in the beginning to keep a food diary and record the foods you eat and your corresponding blood sugar levels,” says Guild. To do so you’ll need to get a glucose meter. (These small devices can be found at most pharmacies, and many health plans cover them for free.)
Guild suggests checking your numbers in the morning before eating breakfast, two hours after each meal, and right before bedtime.
Cut back on alcohol and stop smoking
While enjoying a drink every now and then isn’t off limits, it is a good idea to cut back if you drink alcohol on a regular basis. Not only can alcohol contribute to weight gain and increase the risk of diabetes, it also makes blood sugar harder to control. Stick to no more than one drink per day if you’re a woman, two per day if you’re a man.
As for smoking, we know that it's bad for anyone, but especially so for those with prediabetes. According to the CDC, smokers are 30 to 40 percent more likely to develop type 2 diabetes. Smoking also contributes to insulin resistance.
Keep stress in check
The daily demands of living can increase anyone’s stress levels, at least temporarily. But living in a state of high anxiety most of the time encourages the production of certain hormones in the body that increase blood sugar levels. People who are chronically stressed are also less likely to eat healthy, exercise, and get enough rest, all of which can also increase the risk of diabetes.
If you’re tense most of the time, learning how to relax and calm down can go far in helping to reverse your diabetes risk. Meditation, breathing exercises, yoga, and other forms physical activity can all help.
Talk to a diabetes educator
When you have prediabetes or high blood sugar levels, it's important to stay in close contact with a healthcare provider (HCP). It may also be beneficial to work with a certified diabetes educator (CDE) to learn more about your risk for diabetes and how to lower it. (Check with your health coverage to see if your plan will cover visits with a CDE.) A diabetes educator can help you better understand the lifestyle changes you need to make to reverse your risk as well as help you to develop easy-to-follow self-management plans.
“I always tell my clients, you can be in the driver’s seat and prevent the progression of the disease, or you can choose to be the passenger and let the disease take over,” Crandall says. “It’s really up to you, from nutrition, exercise, behavior, and working with your team of healthcare professionals.”
