Can I Reverse Prediabetes?

Diabetes doesn’t have to be your destiny

Adam Rosenbluth, M.D.,

AARP

Comments

Published August 26, 2024

gif of a man trying to eat bread and other high-carbohydrate foods while a doctor holds him back to reverse prediabetes

James Yates

My blood test said I have prediabetes. Now what?

I’m glad you asked this question because these days, prediabetes affects around 1 in 3 people. If you have this condition, it means your blood sugar levels are higher than normal but not high enough for you to be considered diabetic. Diabetes is a chronic disease where the body doesn’t make enough insulin or doesn’t use it properly, which causes blood sugar to rise.

The good news is that by making moderate lifestyle changes, you can prevent your numbers from rising. You may even be able to lower them. Diabetes doesn’t have to be your destiny.

Let’s begin by looking at your test results. One of the best ways your doctor can tell if you’re currently at risk of becoming diabetic in the future is by checking your blood with something called an A1C test, also known as hemoglobin A1C. This simple test gives your doctor a measurement of your average blood glucose (blood sugar) level over the past 90 days.

The higher the number, the higher your risk of developing type 2 diabetes. For instance, most people within a normal range will get a reading somewhere between 5.0 and 5.6. But once that number hits 5.7 and until it reaches 6.4, we consider you prediabetic. If your A1C number is 6.5 or higher, then you’re considered diabetic.

The first thing I tell my patients is, “Listen, don’t get upset. It’s wonderful that we have the ability to tell whether or not you’re at risk for diabetes in the future. These numbers are often reversible. You can lower them by changing your diet and exercising regularly.”

When I say changing your diet, you may think I’m talking about simply cutting out candy. But it goes beyond gummy bears, candy bars or even ice cream.

For most of us, our A1C numbers rise because we’re consuming too many simple carbohydrates, such as pasta, bread, sugary breakfast cereals and processed foods. Instead of these foods, consider following a Mediterranean diet which emphasizes whole grains, fish and vegetables.

In terms of exercise, you don’t have to join a gym or run a marathon. Just get moving. A modest amount of exercise for 15 minutes, three to five days a week, is a good way to begin — and walking is a great choice. If you’re overweight, the combination of exercise and altering your diet can help you drop pounds and lower your chance of developing diabetes. If you smoke, quitting will help as well. The more cigarettes you smoke, the higher your risk of getting type 2 diabetes.

If someone is thinking, I’m prediabetic, not diabetic, so I don’t really have to worry about it, that’s not entirely true. When a person spends a lot of time in that prediabetic window, and their numbers are gradually going up, they are putting their cardiac health in danger.

More from Dr. Adam

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What if I Don’t Want to Get Weighed at the Doctor’s Office?

Do You Really Need That Multivitamin?

High blood sugar levels can damage or inflame blood vessels, which increases the risk of heart attack, stroke, kidney disease, vision loss, peripheral vascular disease and heart failure. Those who have prolonged high blood sugar levels also have a higher risk of osteoarthritis. After adjusting for other possible factors, if someone has prediabetes, they’re 25 percent more likely to have a heart attack sometime down the road.

Let’s say you’ve worked on eating better and increasing your exercise routine, but maybe not enough, or it just hasn’t worked. Rather than wait for more serious issues to develop, your doctor might recommend medication. Metformin is the usual choice. It’s the No. 1 drug recommended by the American Diabetes Association for lowering blood glucose levels, and evidence shows that people who take this drug may reduce their risk of developing cancer, heart disease and even dementia. Metformin is also associated with weight loss in some people.

Most importantly, don’t be discouraged by your A1C score. It’s certainly not inevitable that you’ll get diabetes. Now that you know where you stand, you can change direction and move toward lowering your blood sugar level — and that’s a sweet spot.

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