Having prediabetes means your blood sugar, or glucose, levels are higher than they should be. It puts you at a higher risk of type 2 diabetes as well as complications like heart attack and stroke. But a prediabetes diagnosis also gives you the opportunity to avoid developing diabetes.
With a combination of lifestyle changes, you can stop and even reverse prediabetes.
There’s no single diet recommendation for prediabetes. But some basic strategies to focus on to help lower your blood sugar include:
- Reduce added sugar: Sugar is naturally found in many foods, including fruits and vegetables, but natural sugar doesn’t spike your glucose the way added sugar does. These sugars are found in foods like packaged cookies, cereal, and candy.
- Reduce refined carbs: Your body turns all carbohydrates into sugar, but not at the same speed. Whole and complex carbs turn into sugar more slowly than refined carbs, so they won’t raise your blood sugar levels as much. Eat more carbs from nonstarchy vegetables and whole grains (like brown rice, beans, and oats), and fewer carbs from simple or refined sources, like white pasta, white bread, and snack crackers.
- Add lean proteins and healthy fats: When it’s time to add protein to your plate, choose lean options like fish, chicken, eggs, and low-fat yogurt instead of processed meats. Opt for fats from foods like avocados, nuts, seeds, and oily fish, while limiting saturated and trans fats.
- Swap water in for sugar-sweetened beverages: People who regularly drink soda and juice are more likely to have prediabetes or diabetes than people who don’t. Drinking more water keeps you hydrated without the excess sugar or calories. If you miss the flavor, try adding fruit to your water.
Getting regular physical activity increases insulin sensitivity, or how well your body uses a hormone called insulin to absorb glucose and turn it into energy. High insulin sensitivity helps your body maintain healthy blood sugar levels and lowers your risk of type 2 diabetes.
The standard recommendation is to get a minimum of 30 minutes of exercise five days a week, or 150 minutes per week in total. Consider these tips to get more movement in every day:
- Walk your dog around your neighborhood after dinner.
- Turn on a video workout to do at home.
- Set up a mini treadmill or walking pad so you can log steps while you watch TV or answer emails.
- Walk while you’re talking on the phone to coworkers, family, or friends.
- Do yard work like raking leaves or digging a garden.
- Ask your kids to join you for a dance party in the living room.
- Play pickleball, basketball, or another sport with a friend.
Losing even a small amount of excess body weight can positively impact blood sugar levels, helping your body use insulin better to maintain a more stable blood sugar level.
If your doctor approves weight loss as a healthy strategy for you, determine a goal. You can calculate how much 5-7% of your current body weight is—that’s the minimum amount of weight loss experts recommend to see changes in blood sugar levels.
Sleep plays a big part in how well your body regulates hormones. That includes insulin: Poor sleep has been shown in studies to decrease insulin sensitivity by as much as 30% after just four or five nights in a row. Poor sleep includes not getting enough sleep, waking up often during the night, and sleeping on an irregular schedule.
Obstructive sleep apnea—a sleep disorder that causes frequent night wakings, among other symptoms—is a known risk for type 2 diabetes. You may be just as likely to develop type 2 diabetes if you have sleep apnea as you are with a family history of diabetes.
If you have a hard time getting good rest, talk to your doctor about ways to improve your sleep.
A high level of stress, especially over time, can affect the way your body metabolizes glucose. This can make it difficult for your body to maintain a stable blood sugar level and eventually lower your insulin sensitivity.
To better manage your stress, try practicing approaches such as:
- Deep, intentional breathing
- Mindfulness or meditation
- Yoga or Tai Chi
- Guided imagery or visualization
- Progressive muscle relaxation
Smoking is a risk factor for prediabetes—and avoiding smoke is an important step to take when you’re trying to reverse your diagnosis. Most experts recommend a combination of mental health therapy or counseling and nicotine replacement products as the best way to quit smoking. Try these tactics:
- Decide how you want to quit—little by little, or all at once.
- Talk to a counselor or mental health professional about your history of smoking and get help identifying which methods may work for you.
- Ask your healthcare provider about nicotine replacement products like over-the-counter or prescription patches, gum, or nasal sprays.
- Be prepared for temporary withdrawal effects like irritability and anxiety. Talk to your doctor about tips for managing withdrawal.
In some cases, your healthcare provider may recommend that you also take a prescription medication to help regulate your glucose levels.
A common medication for prediabetes is metformin. Metformin helps lower the amount of glucose in your blood in several ways, including decreasing the amount of glucose your liver makes and increasing your insulin sensitivity. Studies suggest metformin may lower the risk of type 2 diabetes by about 31%.
Discuss Medications That May Increase Your Risk
Some medications can change how you metabolize glucose, leading to increased blood sugar levels and an increased risk of prediabetes and diabetes. Reach out to your doctor if you’d like to discuss alternatives to medications such as:
- Corticosteroids
- Antipsychotic medication
- Statins
- Beta blockers
For people with prediabetes, doctors usually recommend having blood work done at least every one to two years to check your glucose levels and your A1C, an average of your blood glucose levels over two to three months.
However, you should contact your healthcare provider sooner if you have any of the following symptoms that could be signs of type 2 diabetes:
- Frequent urination
- Excess hunger or thirst
- Fatigue
- Blurry vision
- Unintended weight loss
- Numbness or tingling in your hands or feet
- Slow-healing cuts, sores, or bruises
Lifestyle changes can help you reverse prediabetes and avoid a type 2 diabetes diagnosis.
Try to cut down on refined sugar and carbs, get at least 150 minutes of exercise each week, and try to lose at least 5% of your body weight if you have extra weight to lose. You can support your efforts with good sleep, stress management, and avoiding smoking.
You can also talk to your doctor about whether they recommend medication such as metformin to go along with lifestyle approaches.
