In the United States today, approximately 96 million adults have prediabetes — and up to 70 percent of those who have elevated blood sugar will go on to develop type 2 diabetes, according to an American Diabetes Association expert panel. That’s in addition to more than 37 million who already have the chronic disease.
Naturally, then, it might feel daunting to try to get high blood sugar under control. But fortunately experts say a number of simple (read: straightforward, not necessarily all easy, but doable) steps can bring glucose levels back into a healthy range. You also have plenty of reasons beyond diabetes prevention to do just that.
People with prediabetes have a higher risk of suffering from a heart attack or stroke in the future — along with other heart disease issues — “even without full-blown diabetes,” says Zhenqi Liu, M.D., James M. Moss professor of diabetes at the University of Virginia School of Medicine.
Here are steps you can take to reduce your risk and lower your blood sugar.
1. Know your numbers
To start, you need to know where you stand. The vast majority with prediabetes — more than 80 percent — don’t know they have it, according to the Centers for Disease Control and Prevention.
The U.S. Preventive Services Task Force recommends people ages 35 to 70 who are overweight or obese get screened for prediabetes and diabetes. The American Diabetes Association (ADA) recommends screening for all people 45 and up and testing blood sugar earlier in those at higher risk for diabetes. You can assess your individual risk using an online tool provided by the ADA, answering questions about risk factors ranging from age and immediate family history of diabetes to activity level and race.
What’s considered a healthy blood sugar number depends on the test. For example, with a fasting blood sugar test, anything below 100 milligrams per deciliter is considered healthy. A glucose level of 100 to 125 mg/dL is considered prediabetes and 126 mg/dL or higher is diabetes. Another test, hemoglobin A1C, measures a person’s average blood sugar over two to three months as a percentage. A result of 5.7 to 6.4 percent is considered prediabetes and 6.5 percent or higher is diabetes. For more about testing, see Your Prediabetes Questions Answered.
Many with diabetes who rely on insulin to help with blood sugar control use continuous glucose monitors — wearable devices that provide ongoing data on blood sugar — to track their levels. While some people who don’t have diabetes use the technology as well to keep tabs on their blood sugar, there is currently no strong data on the effectiveness of this strategy for people with prediabetes.
If you’ve been diagnosed with prediabetes or diabetes, talk to your doctor about how to best monitor your blood sugar as you make lifestyle changes.
2. Don’t complicate exercise
Lifestyle changes needn’t be overly involved or difficult to be effective — like with incorporating regular physical activity.
“You have to exercise 150 minutes a week,” says Elbert Huang, M.D., general internist and director of the Center for Chronic Disease Research and Policy at the University of Chicago. That needs to be at least a brisk walk, he notes, but it doesn’t have to be more strenuous than that.
Experts say the key is to pick a routine you’re likely to stick with, rather than one with onerous requirements you’re not likely to follow. It could be any form of exercise, said Minna Woo, M.D., a clinician scientist and endocrinologist at Toronto General Hospital, and director of the Banting and Best Diabetes Centre. You don’t need a gym membership, she adds.
To optimize the benefits, consider taking that walk after you eat. Research suggests exercising 30 minutes after a meal may be optimal to help with blood glucose control.