- A new study concludes that a majority of prediabetes cases don’t eventually develop into type 2 diabetes.
- Millions of people in the United States have prediabetes, but most of them don’t know they have the condition.
- A diet high in fiber, grains, and vegetables as well as a regular exercise routine can help reverse a prediabetes diagnosis.
Being diagnosed with “prediabetes” makes it sound like you’re just one slippery step away from developing type 2 diabetes.
That’s true in some cases but not the majority, a new study finds.
People who have prediabetes are much more likely to return to normal blood sugar levels than to develop diabetes, according to researchers from the Aging Research Center at the Karolinska Institute in Stockholm, Sweden.
Ying Shang, a PhD student and the lead study author, along with her colleagues, studied 918 participants in the Swedish National Study on Aging and Care.
All participants, who were ages 60 and older, had been diagnosed with prediabetes, meaning their blood sugar was between 100 and 125 milligrams per deciliter. (Blood sugar under 100 is considered normal, or “normoglycemia,” while blood sugar over 125 is considered diabetic.)
Researchers tracked the study group for 12 years and found that while 13 percent of the participants developed diabetes during the study period, 22 percent reverted to normoglycemia.
“During a 12‐year followup, most of older adults with prediabetes remained stable or reverted to normoglycaemia, whereas only one-third developed diabetes or died,” the researchers concluded.
The study found that having lower systolic blood pressure, no heart disease, and manageable weight was associated with reverting to normal blood sugar levels, “suggesting possible strategies for achieving normoglycaemia in older adults with prediabetes,” according to the researchers.
Physical activity also reduced the mortality rate related to prediabetes.
But more than 90 percent of people who have prediabetes aren’t aware of it, Satesh Bidaisee, DVM, MSPH, EdD, a professor of public health and preventive medicine at St. George’s University in Grenada, told Healthcare Website.
“Prediabetes invariably occurs at a young age, when people tend to be in the prime of health and pay less attention to their health,” he said.
The symptoms of prediabetes are the same as for type 2 diabetes: excessive thirst and hunger, frequent urination, fatigue, dry mouth, and weight loss.
The condition can be diagnosed via a glucose blood test that requires people to fast before being tested.
Testing for levels of hemoglobin A1c (HbA1c), which binds to glucose in the blood, is another way to check for prediabetes and diabetes. It doesn’t require fasting.
“Once patients are diagnosed with prediabetes, we can apply strategies to mitigate against progress to diabetes,” Bidaisee said. These strategies include counseling patients to adopt a healthy diet, being mindful about consuming processed sugar, and losing weight.
Jocelyn Nadua, a registered practical nurse and care coordinator at C-Care Health Services, a Toronto-based agency providing home healthcare and nursing services, told Healthcare Website that a diet high in fiber and rich in whole grains and vegetables is essential for preventing diabetes.
“A person with prediabetes has high blood sugar levels, so they should limit their sugar intake as much as possible in order to control the levels and further prevent the risk of diabetes,” she said.
“When choosing foods, consider opting for ones with a lower glycemic index (GI) of 55 or less.” (Information on how foods rank on the GI scale can be found at the websites of the American Diabetes Association and Diabetes Canada, Nadua notes.)
Reducing intake of carbohydrates — foods such as bread and pasta — is particularly effective in cutting blood sugar, said Erin Pitkethly, a pharmacist and nutritionist with the Robinsong Health Low Carb Clinic.
“Type 2 diabetes is essentially the body not properly coping with carbs,” she told Healthcare Website. “Some individuals who are consuming a very high amount of carbs will be able to reverse their prediabetes by simply cutting back to what would simply be considered a healthy diet, such as a Mediterranean diet.”
She added, “For example, someone who drinks several cans of soda daily and consumes a lot of sugar and high-carb processed foods — candy bars, cookies, potato chips — may be able to reverse their prediabetes by simply cutting these out.”
“Cutting out processed foods is key for everyone,” added Pitkethly. “Others may want to or need to adopt a slightly stricter low-carb approach, limiting their intake of starches such as potatoes, rice, and bread, and processed foods with hidden sugars, such as many yogurts and almost all granola bars.”
The findings of the Swedish study suggest that the term “prediabetes” may be somewhat misleading, according to Bidaisee.
“Pre-something means that it’s a precursor, so there’s that assumption [that the condition will lead to diabetes],” he said.
On the other hand, he notes, people diagnosed with prediabetes can’t be complacent even if they are among the 22 percent who successfully revert to normoglycemia.
“Don’t think that prediabetes reversal is a cure,” he said. “It needs to be maintained.”