Posted by 
A diagnosis of prediabetes can be a wake-up call, especially if you didn’t know you were at risk. But that wake-up call doesn’t need to be cause for alarm.
Having prediabetes—blood sugar or A1c levels that are elevated but not up to diabetes level—means you have a higher risk of developing Type 2 diabetes. Your blood sugar level shows the concentration of glucose in your bloodstream at the exact moment you do a fingerstick; the A1c test measures your average blood sugar levels over the past three months.
Here’s how the numbers break down:
- Normal: fasting blood sugar level lower than 100 mg/dL; A1c below 5.7%
- Prediabetes: fasting blood sugar level between 100 and 125 mg/dL; A1c between 5.7% and 6.4%
- Diabetes: fasting blood sugar level of 126 mg/dL or above; A1c of 6.5% or above
The closer these numbers are to diabetes level, the greater your risk of developing diabetes.
With the right support and lifestyle habits, however, you can stop the disease in its tracks. And there are a lot of compelling reasons to do so.
“Having Type 2 diabetes can affect nearly all the systems in your body,” says Amy Folker, NP, a nurse practitioner at Rush Oak Park Hospital. Type 2 diabetes can lead to kidney disease, heart disease, stroke, blindness and neuropathy (numbness, tingling or pain)—among other conditions.
https://www.youtube.com/embed/r8HfoqvPcis?color=whiteCredit: Rush University Medical Center
To help people with prediabetes avoid these risks, Folker heads up a program called Project Lifestyle Change. As of June 2021, the free 12-month education and support program has helped more than 700 people with prediabetes make the lifestyle changes necessary to avoid the onset of Type 2 diabetes. And it’s based on principles anyone can live by to keep their blood sugar levels under control.
1. Eat well
“Building healthy eating habits is fundamental to avoiding diabetes,” Folker says. So Project Lifestyle Change helps participants understand how to select proteins, carbohydrates and healthy fats.
- There are two types of carbohydrates: simple and complex. Simple carbohydrates, like French fries and white bread, aren’t good for blood sugar levels. Complex carbohydrates like whole grains are better choices. Because simple carbohydrates are so easy to digest, they can easily spike blood sugar. Complex carbohydrates are digested slower, so there’s less chance of your blood sugar spiking.
- There are lean and not-so-lean proteins. Proteins don’t raise blood sugar levels the way carbohydrates can. Still, lean proteins like chicken breast, pork loin and beans are healthier for your heart because they’re lower in saturated fats. Your heart can be directly affected by diabetes.
- Unhealthy fats are saturated or trans fats, like you find in butter or most fried foods. Saturated fats and trans fats can increase cholesterol, which can then increase the likelihood of heart disease or stroke. Diabetes can further increase the risk of developing these conditions. Healthy fats are monounsaturated fats, found in olive oil, fish and nuts, and polyunsaturated fats (omega-3 and omega-3 fatty acids), found in seafood.
Avoiding sugar-sweetened beverages and eating lean proteins, healthy fats, whole grains, fruits and vegetables is optimal for keeping blood sugar levels in check. Whether it’s their fiber, vitamins A and C, potassium or a range of antioxidants, fruits and vegetables help to reduce inflammation and cell damage that could lead to Type 2 diabetes.
2. Get moving
For exercise, Folker suggests 150 minutes per week, which is the official recommendation. But that exercise can be anything from vigorous running to leisurely walking: It’s your choice. The more strenuous the exercise, the greater the cardiovascular benefits (just don’t overdo it).
Even if you aren’t able to do 150 minutes, any physical activity—even just walking around your house for a half hour or so, walking your dog or doing housework—can help keep your blood sugar levels at normal levels. Exercise lowers glucose in the bloodstream. It also lessens your body’s resistance to insulin, which can help prevent diabetes.
If you aren’t already exercising regularly but want to be more active, it’s helpful to set realistic goals at first. Too much, too soon can lead to injury or burnout. Start slowly, and gradually increase both the amount of time and the intensity. And if you’ve never exercised before, talk to your doctor before starting any type of exercise.
Once you’re exercising, it’s important to stay hydrated, so drink plenty of water. If you do opt for the occasional sports drink, choose sugar-free varieties, but generally speaking, it’s best to stick to water.
It’s also important to accept that regular exercise might not be easy at first. “That’s OK,” says Folker. “If you ease in and stay consistent, exercise will be extremely helpful in preventing diabetes. It can be fun, too.”
One way to make it fun is to find activities that don’t feel like exercise—for instance, skating, dancing, riding a bike or gardening. If you’re able to be active without it feeling like a chore, you’re more likely to stick with it.
3. Sleep well
Healthy sleep habits are extremely important for your overall health, and especially for prediabetics. Sleeping less than six hours per night can put you at elevated risk for developing diabetes, since higher blood sugar levels are more frequent in those who get less sleep.
Consistency is the key to establishing healthy sleep habits. For starters, try going to bed and waking up at the same time each day. The more regular your sleep routine is, the better.
Being ready for bed each night might also mean limiting your intake of caffeine, nicotine or alcohol in the evenings. And if you need to nap, make sure to keep it short, if possible. Long daytime naps can keep you from getting a full night’s sleep, and that deep, uninterrupted sleep is what your body needs to rejuvenate.
It’s also crucial to use your bedroom only for sleeping. Watching TV, doing work or scrolling on your phone in the dark can disrupt your sleep schedule and your ability to be ready for rest. If you have a TV in your bedroom, try removing it. And store your phone away from the bed where you can’t reach for it in the middle of the night—if you can’t put it in another room, try stashing it in a drawer or closet so you won’t be tempted. A dark, quiet comfortable bedroom where you only go to sleep is best for supporting healthy sleep.
4. Seek support
Taking action against prediabetes means setting personal goals and making lifestyle changes, but you don’t have to go it alone.
Family and friends can provide support and positive reinforcement. Here are some ways you can get them involved:
- Ask someone to be an exercise buddy to stay motivated and accountable,
- Encourage your family members to go out for ice cream occasionally, as a treat, but not keep pints of mint chocolate chip in the freezer
- Invite family or friends to cook meals together—that way, healthy eating habits could make for healthy socializing, too
- Either try new healthy recipes, or create lighter versions of your favorite meals by swapping out ingredients, like using zucchini noodles or spaghetti squash instead of pasta; making an egg white omelet instead of using whole eggs; or replacing oil with applesauce in your baked goods.
5. Play the long game
It’s all about you being in control of your health.
“It’s not that they’re just coming and taking the medicine that the doctor prescribes for a condition,” Folker says of patients in Project Lifestyle Change. “It’s not a quick fix. They’re problem solving and changing things to improve their health. Prediabetes is an opportunity to make positive, lasting lifestyle changes.”
If you have prediabetes or feel you’re at risk for it, now is the time to act, before it develops into Type 2 diabetes. Whether it’s finding your favorite healthy meals, your favorite way to exercise or your healthy sleep rhythm, you can take charge and, in doing so, change your course.
And if it doesn’t happen all at once, that’s OK. As you turn those lifestyle changes into sustained healthy habits, in time prediabetes can go from something to worry about to simply being part of your health history.
Nick Cannariato, Rush University Medical Center