Prediabetes is a concerning signal indicating an increased risk of developing type 2 diabetes. If left unmanaged, prediabetes can lead to long-term complications, including damage to the heart and blood vessels. But is it possible to reverse prediabetes through lifestyle changes such as diet and exercise?
Type 2 diabetes, in particular, has become a significant health challenge in the 21st century. It is projected that by 2025, approximately 380 million people worldwide will be diagnosed with diabetes. Given that diabetes is a risk factor for various other diseases and chronic conditions like cardiovascular disease, renal disease, stroke, and blindness, effective management and treatment are crucial.
Before individuals progress to type 2 diabetes, many are considered to be in a precursor stage called prediabetes. This condition occurs when people have higher than normal blood sugar levels, although not high enough to be diagnosed as type 2 diabetes. Nonetheless, prediabetes is a significant risk factor for developing type 2 diabetes.
Examining the statistics of people with prediabetes highlights the scale of the problem: over one in three individuals in the U.S. and the U.K. have been diagnosed with prediabetes.
Considering prediabetes as an early warning sign for type 2 diabetes, one might wonder if there is anything individuals can do to change their trajectory. Can substantial lifestyle modifications reverse this condition?
These questions were explored in our May podcast titled “In Conversation: Can diet and exercise help reverse prediabetes?” The discussion featured Dr. Hilary Guite, Dr. Thomas Barber (associate clinical professor at Warwick Medical School and consultant endocrinologist at University Hospitals Coventry and Warwickshire), and Angela Chao (Managing Editor at Healthline Media and Medical News Today). Angela shared her personal experience of reversing her prediabetes diagnosis and the lifestyle changes she made to sustain it.
Angela’s case was atypical, as her blood sugar readings did not initially raise concerns among medical professionals. She did not fit the typical profile of someone with prediabetes or at risk of developing diabetes, as she was slim, young, and active. However, she led a rather sedentary lifestyle at the time.
“My readings were so low on the spectrum, I don’t even think my primary doctor at the time even had a conversation about this with me, other than just giving me the range and the diagnosis,” she explained.
However, after changes were made to the threshold for prediabetes diagnosis, some physicians and Angela’s doctor friends became concerned.
Measuring prediabetes typically involved fasting glucose readings or a standard glucose tolerance test, according to Dr. Barber. The latter test required ingesting a sugary drink and measuring blood sugar levels over the next two hours.
The definition of prediabetes is an evolving one, varying from country to country.
“Different societies and esteemed groups have different definitions. And I think the first point to make really is that whether we’re talking about diabetes or prediabetes is that we’re talking about a continuum,” Dr. Barber explained.
In the U.K. and the U.S., there are differences in the units of measurement and the thresholds used to diagnose prediabetes.
“It is a bit confusing because, as you say, there are different units. But essentially, in the U.K., we use millimoles per liter for glucose, and in the U.S., it’s milligrams per deciliter. Millimoles per mole is what we tend to use clinically now and have done for some years,” Dr. Barber clarified.
Furthermore, the use of hemoglobin A1C adds to the confusion, as it has two separate units of measurement, namely percentage and millimoles per mole.
Dr. Barber emphasized that glucose is not a discrete measure but a continuous variable.