Test Your Knowledge

A panel of physicians and diabetes experts from the Centers for Disease Control and Prevention (CDC) and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) concluded that treatment for prediabetes is crucial for several reasons. These reasons include:

• Damage to vital organs and systems in the body from high glucose (blood sugar) levels can begin in the prediabetes stage.
  
  
• Having glucose levels in the prediabetic range places a person at a 50 percent higher risk for having a heart attack or stroke.

• With modest lifestyle changes, the development of type 2 diabetes can be delayed or prevented.
  
  
• Lifestyle changes can return elevated glucose levels to the normal range.

The U.S. Department of Health and Human Services (HHS) conducted a large prevention study of prediabetic people at high risk for diabetes. In the Diabetes Prevention Program, lifestyle changes reduced the development of type 2 diabetes by 58 percent over three years. Based on this study, HHS recommended the following changes in lifestyle:

• Weight loss. Modest weight loss in overweight individuals has been shown to prevent or delay type 2 diabetes. The recommended goal is 5 to 10 percent of the person’s body weight. Reduced weight may also decrease other risks such as high blood pressure and unhealthy levels of cholesterol.
  
  
• Physical activity. Even modest exercise or other physical activity decreases the risk of getting type 2 diabetes. Sedentary lifestyles do not help prediabetic patients. Modest physical activity of 30 minutes per day is recommended for reducing risk. It can be activity as simple as walking and can be split into several sessions per day. The total amount of exercise recommended is a minimum of 150 minutes per week.

Exercise improves cardiovascular function and circulation and can improve blood pressure and cholesterol levels. Recent research indicates that regular exercise may even stop prediabetic neuropathy.

The Diabetes Prevention Program also examined antidiabetic agents including metformin, a biguanide, were also examined in the Diabetes Prevention Program. These drugs sensitize the body to the actions of insulin. The chance of preventing type 2 diabetes with medication varied according to the age and weight of the individual and the type of medication. Metformin reduced the risk of developing type 2 diabetes by 31 percent over a three–year period. The study concluded that drug therapy, though effective, appeared to be less beneficial than the 58 percent reduction through lifestyle changes for the prevention of type 2 diabetes.

Making improvements in weight and physical activity is the best way to prevent prediabetes from progressing to type 2 diabetes. Other lifestyle changes that may be included in a treatment plan for prediabetes are:

• Eat a good diet that is low in fats and sweets, and high in fiber
  
  
• Stop smoking
  
  
• Avoid excessive use of alcohol
  
  
• Treat high blood pressure and unhealthy cholesterol levels

Modest consumption of alcohol can decrease an individual’s risk of diabetes, according to the Harvard School of Public Health, but heavier consumption is harmful.

As with type 2 diabetes, a physician must recommend any changes and prescribe a plan of treatment specific to the patient. Once the plan is in place, it is important the individual closely follow the treatment to maximize the chances for a healthy life without diabetes.