Prediabetes Treatments: Everything You Need To Know

Hey, Science Enthusiasts! Have you ever found yourself pondering the reality behind prediabetes? Is it a legitimate concern or just another buzzword? And if so, are there even any prediabetes treatments available?

Prediabetes isn't a myth - it's the real deal, a common condition that's worth paying attention to. It's the middle ground between normal blood sugar levels and full-blown diabetes. If it's left unchecked, it could lead to diabetes, bringing along a host of health issues like heart disease, stroke, and more. The respite? It's a pivotal phase where your actions can prevent diabetes from taking over. Prediabetes is reversible, and we've got the scoop on how to make it happen. We're here to discuss how you can navigate this disease like a pro. From available tests to prediabetes treatments, we'll try to cover it all!

Highlights

• Prediabetes is the middle ground between normal blood sugar and diabetes, and requiring attention

• Symptoms include thirst, fatigue, and blurry vision; tests like HbA1c and fasting plasma glucose aid detection

• Factors like eating, stress, hydration, medications, exercise, alcohol, smoking, and recent diet choices affect test outcomes

• Lifestyle changes, including diet, exercise, fasting, rhythm regulation, stress management, and weight control, are vital for prediabetes treatment

• Collaborative healthcare, staying connected with professionals, and considering medications provide a comprehensive approach to prediabetes treatments

How do you know you're prediabetic?

First things first, how do you know if you're prediabetic? Well it often comes without any signs. You could have it for years and not have any symptoms. For some people though, they make experience a few of the following symptoms:

1. Unquenchable Thirst

You'll experience a persistent, all-day thirst due to the body trying to eliminate excess blood sugar.

2. Constant Fatigue

You may feel drained even after a good night's rest, as the body struggles to use blood sugar effectively.

3. Blurry Vision

Your vision may start blurring as high glucose levels can cause diabetes-related retinopathy.

4. Frequent Urination

Excess sugar gets eliminated through urine, leading to more bathroom trips, especially at night.

5. Slow Wound Healing

Wounds don't heal as fast due to stiffened blood vessels and slowed immune cells impairing the body's natural healing processes.

6. Unexplained Weight Changes

Irregular blood sugar handling causes weight loss or gain from mixed-up hunger signals from our leptin and ghrelin (hunger hormones).

7. Tingling or Numbness

Elevated blood sugar levels damage your nerve fibers, resulting in tingling or numbness in hands and feet.

8. Darkened Skin Patches

Insulin resistance leads to Acanthosis Nigricans, causing darker and thicker skin patches in certain areas.

Although these symptoms rarely show up, catching them on time can be a huge life saver.(1)

Tests to Detect Prediabetes

For those who don't experience symptoms, you can easily detect prediabetes with simple diagnostics tests. The diagnostic tests are blood tests to measure your blood sugar level, which is necessary to diagnose prediabetes and diabetes. These are:

1. HbA1c

The HbA1c test, or glycated hemoglobin test, is a blood test that provides an average of your blood sugar levels over the past two to three months. Hemoglobin is a protein in red blood cells that binds to glucose, and the HbA1c test measures the percentage of hemoglobin that has sugar molecules attached to it.Here's a breakdown of what the results mean:

The HbA1c test is valuable because it provides a more stable and reliable indicator than daily blood sugar tests, which can fluctuate. It helps you understand how well you've managed your blood sugar over an extended period.

According to the American Diabetes Association, an A1c between 5.5% to 6% means a 25% chance of developing diabetes in 5 years. If it's 6 to 6.4%, that chance jumps to 50%. (2)

2. Fasting plasma glucose test

Think of this blood test as a snapshot of your sugar levels after a night of fasting. When you fast, your body produces extra insulin to handle the glucose. But in prediabetes and diabetes, this system doesn't work smoothly, leaving your sugar elevated.

Check the results:

1. Normal: Below 100 mg/dL

2. Prediabetes: 100 to 125 mg/dL

3. Diabetes: 126 mg/dL or more

3. Random plasma glucose test

The random plasma glucose test is a spontaneous check on your blood sugar with no fasting required. It gives you a glimpse of your glucose levels anytime during the day, helping you keep tabs on prediabetes and lowering your risk.

If your random glucose is 200 mg/dL or above, it could signal diabetes. This test isn't the go-to for screening prediabetes or diabetes. Your doctor might recommend another test for a more accurate diagnosis you can count on.

4. Oral glucose tolerance test

The Oral Glucose Tolerance Test (OGTT) is like a sugar challenge for your body. First, you take a blood test after an 8-hour fast. Then, you drink a sugary liquid, and they recheck your blood sugar after two hours. Here's what your results mean:

1. Normal: Fasting sugar should be below 100 mg/dL, and after two hours, it should stay below 140 mg/dL.

2. Prediabetes: Fasting sugar is below 100 mg/dL (normal), but after two hours, it's between 140 to 199 mg/dL.

3. Diabetes: Fasting sugar is 126 mg/dL or higher, and it hits 200 mg/dL or more after two hours.

4. This test provides a detailed look at how your body deals with glucose, helping doctors and health coaches understand your situation better

When to do Prediabetes Diagnostic tests?

When you have symptoms, obviously! Nope. It's not just then.

According to the experts at the American Diabetes Association, they recommend that screening for prediabetes and diabetes should begin at the age of 35 irrespective of sex. (3) But, if you are overweight, you most likely have additional risk factors for prediabetes or type 2 diabetes. And if you have gestational diabetes, then you should consider getting your blood work done before the age of 35 too.

Some of the other risk factors of prediabetes include:

1. High Blood Pressure

Elevated blood pressure increases the risk of prediabetes.

2. Excess Weight

Having a body mass index (BMI) of 35kg/m² or being classified as obese is a risk factor.

3. Family History

A family history of type 2 diabetes can contribute to the likelihood of developing prediabetes.

4. Symptoms

Experiencing symptoms such as blurry vision, frequent urination, constant thirst, hunger, fatigue, and tingling or numbness in the feet or hands can indicate a risk.

5. Ethnic Background

Individuals from certain ethnic backgrounds, including African, American Indian, Asian, Hispanic/Latino, or Pacific Islander, have an increased predisposition to prediabetes.

If any of this sounds like you, it is crucial to be tested quickly.

What Influences Prediabetes Test Outcomes?

Your blood glucose level changes throughout the day due to several factors. Everything from your eating habits to medications can alter the results of these tests and here's how:

1. Eating Habits

Your blood sugar levels can be like a rollercoaster based on what and when you eat. Too much or too little food can shake things up because your body turns carbs into glucose. Also, the type of food matters. Foods high in fiber and protein help slow down the process, providing a more stable blood sugar response. So, it's not just about the quantity but also the quality of it!

2. Stress Levels

Stress triggers the release of hormones like cortisol and adrenaline, which can cause your liver to release more glucose into your bloodstream. This can lead to elevated blood sugar levels, influencing the accuracy of diagnostic tests.

3. Hydration

Dehydration can concentrate the blood, leading to higher blood sugar readings. Proper hydration is essential for accurate test results, as it helps maintain a balanced blood composition.

4. Medications

Some medications, especially those affecting insulin sensitivity or glucose metabolism, can influence blood sugar levels. It's crucial to consider the potential impact of medications on diagnostic tests.

5. Exercise Routine

Physical activity is known to lower blood sugar levels as the muscles use glucose for energy. Changes in your exercise routine, especially around the time of the test, can affect blood sugar readings.

6. Alcohol Adventures

Alcohol can interfere with the liver's ability to regulate blood sugar. It may initially cause a drop in blood sugar levels, but later, it can lead to an increase. This fluctuation can impact the reliability of diagnostic tests.

7. Smoking Stints

Smoking can stimulate the release of stress hormones, contributing to higher blood sugar levels. It can also affect insulin sensitivity, potentially influencing test results.

8. Sweet Treats

Consuming sugary foods directly raises blood sugar levels. This can result in a temporary spike in blood glucose, affecting the accuracy of diagnostic tests. It's essential to consider recent dietary choices when interpreting test results. (4) Consuming sugary foods directly raises blood sugar levels. This can result in a temporary spike in blood glucose, affecting the accuracy of diagnostic tests. It's essential to consider recent dietary choices when interpreting test results.

Prediabetes Treatments - What Can You Do?

The real question is, can you really dodge diabetes? Absolutely yes! With healthy lifestyle choices and medicine, you can treat prediabetes and even prevent diabetes.

But here's the crucial part: beginning a healthy lifestyle early can dramatically reduce your risk of developing diabetes. In fact, a study by the National Institute of Diabetes and Digestive and Kidney Diseases underscores this, revealing a staggering 58 percent decrease in type 2 diabetes risk with healthy lifestyle changes. So, the key takeaway? The sooner you start, the better your chances. (5)

Let's sum up some science-backed lifestyle choices to combat prediabetes and optimize your glucose levels:

1. Eat a protein and fiber-rich diet

Prioritizing fiber and protein in your diet is a game-changer for your health. Let's start with fiber. Opt for nutrient-packed, whole foods loaded with fiber - vegetables take the lead, offering a sugar-friendly alternative. Fiber not only boasts a low glycemic index but also forms a protective mesh, slowing down the breakdown of subsequent foods. Have fiber at the start of your meal as it aids digestion and acts as a body detox.

Now, onto protein - another great way to blunt your blood sugar spikes. Protein's slow digestion means a gradual release of sugar into your bloodstream. Try different combinations of eggs, tofu, tempeh, fish, and so on.

Pro-tip: Kickstart your day with a breakfast packed with high protein and fiber. It's the secret to unbeatable, long-lasting energy. (6)

2. Stop counting calories

While it's a widely used measure, fixating on calorie counting can mess with your hormones. Not only does it hike up cortisol levels, but it also strains your relationship with food, triggering additional stress. Counting calories can throw your hunger hormones, leptin, and ghrelin, out of whack, potentially leading to weight gain. Instead, try to shift your focus to macro-nutrients - fiber, proteins, and carbs. Optimize your food sequence (fiber>protein>carbs) to naturally cut down on carbs and meal size. Say goodbye to calorie counting and hello to improved blood glucose, insulin resistance, and weight management.

3. Regular exercises

Embrace physical exercise - it's a powerhouse against prediabetes, forming a barrier to its progression into diabetes. When you exercise, your body efficiently uses glucose, promoting its absorption by cells and reducing elevated blood sugar. Blend strength training with enjoyable aerobic activities like dancing or swimming for optimal glucose utilization by your muscles. Plus, it's a double win for prediabetes as it supports weight management. You can fit in a workout at any time, but steer clear of intense activities before bedtime to keep cortisol levels in check. (7)(8)

Pro-tip: Pick activities you enjoy; even a post-meal stroll can help regulate blood sugar.

4. Eat food in the right order

Beyond choosing the right foods, the order in which you eat them matters. We often overlook the sequencing of our meals, but research from the American Diabetes Association highlights its positive impact on glucose and insulin levels. Consuming fiber and protein before carbs helps you slow down glucose absorption, giving your body ample time to handle it. The result? Lower glucose levels. So start with fiber and protein, especially at breakfast and your body will stay energized through the day! (9)

5. Practice Intermittent fasting

It's not just what you eat, it's also when you eat it. The key? To sync with the sun-moon or sleep-wake cycle. Aim to conclude dinner before sunset, and if you're in a colder region, try to at least keep a 3-4 hour gap between dinner and bedtime. Typically, the fasting window spans 12-16 hours. Insights from the American Heart Association's research indicate that intermittent fasting, intertwined with lifestyle habits, circadian biology, and gut microbiome, can potentially lower insulin resistance. Bonus perks? It's a weight-loss ally and slashes the risk of cardiometabolic diseases. (10)

6. Regulate Circadian Rhythm

Dr. Satchin Panda, author of ‘The Circadian Diabetes Code,' stresses the importance of aligning with your body's internal clock in managing prediabetes. Beyond regulating sleep, your circadian rhythm significantly influences hormonal activity, especially related to sleep and hunger. Disruptions in this rhythm, coupled with sleep disturbances, can lead to increased carb cravings, binge eating, and heightened hunger due to imbalances in hormones like leptin and ghrelin. This hormonal imbalance doesn't just stop there; it contributes to impaired glucose metabolism, elevating your risk of diabetes.

To reset your circadian rhythm and promote health:

• Aim for 7-9 hours of quality sleep tailored to your needs.

• Soak in morning sunlight to reinforce your body's natural rhythm.

• Finish eating at least 3-4 hours before bedtime to support a restful night's sleep.

• Reduce exposure to bright lights in the evening to signal to your body that it's time to wind down.

• Choose a light dinner to aid digestion before bedtime.

• Limit caffeine intake after 2 PM to avoid interference with your sleep.

• Engage in moderate exercise earlier in the day to facilitate a more relaxed evening.

7. Stress management

Though eliminating stress is challenging, it's crucial to find coping mechanisms. Integrate stress-relief practices into your daily routine, particularly if you're managing prediabetes. Simple activities like journaling, meditation, yoga, or deep-breathing exercises can significantly lower cortisol, the stress hormone, making stress more manageable. And don't overlook the impact of soaking in the morning sun - taking a moment to relax in the morning can ease stress and provide a healthy boost, particularly beneficial for those dealing with prediabetes.

8. Manage weight

Weight management is essential. Make sure to achieve a healthy weight, as it will help you have more energy and also reduce your risk of serious complications like stroke and heart disease. Moreover, losing around 5% of your body weight will improve your insulin sensitivity and also prevent the progression of prediabetes to diabetes. (11)

9. Watch How Much You Drink

Keep an eye on your alcohol intake to manage prediabetes. Stick to the one-drink-a-day rule suggested by the American Diabetes Association - whether it's a glass of wine, a beer, or a shot. Going over these limits significantly increases the risk of moving to type 2 diabetes. (12)

10. Kick the Smoking Habit

Ditching cigarettes is a big deal in reversing prediabetes. Smoking increases the risk of progressing to type 2 diabetes by 30% to 40%, and it gets worse with more smoking. If you're aiming for better health and saying goodbye to prediabetes, kicking the smoking habit is a crucial step. It's all about giving your body the best shot at healing and finding balance. (13)

11. Stay Hydrated with Water

Try to improve your water intake. Studies show that folks with prediabetes who drink more than one liter of water a day tend to have a 28% lower risk of hyperglycemia than those who don't. Water helps flush out extra glucose from your blood, keeping your blood volume steady and your sugar levels in check when you stay well-hydrated. (14)

Other things you can do:

1. Stay connected with your healthcare team

Keep the lines of communication open with your healthcare professionals. In addition to prescribing and managing your medications, they can offer guidance, monitor your progress, and tailor your plan based on your individual responses. Inquire about diabetes prevention programs (DPP) that support lifestyle interventions - they may have valuable recommendations. In the United States, the Diabetes Prevention Program (DPP) trial has produced substantial evidence in favor of lifestyle interventions for diabetes prevention. This trial demonstrated that making significant lifestyle changes could result in an impressive 58% reduction in the risk of developing type 2 diabetes over a three-year period.

2. Consider medication

The final step in prediabetes treatments involves the use of medications. These medications aim to stabilize fluctuating glucose levels. However, it's crucial to emphasize that the true success of treatment hinges on maintaining healthy lifestyle choices.

At times, your body may require additional support in managing elevated glucose levels. Prediabetes medications, such as Biguanides, Thiazolidinediones (TZDs), Alpha-glucosidase inhibitors, and supplements like Myo-inositol, d-chiro-inositol, Berberine, and Alpha-lipoic acid (ALA), can provide this assistance. It's essential to consult with your doctor before starting any medication to ensure the correct dosage and timing.

Although direct recommendations are not provided, it's advisable to have a conversation with your doctor about these options.

Conclusion

To combat prediabetes and take control of your health, a proactive and varied approach is key. Recognize subtle signs early through tests like HbA1c and fasting glucose. Lifestyle factors like diet, stress management, hydration, and exercise significantly influence results. Adopt a healthy lifestyle with a focus on a protein and fiber-rich diet, intermittent fasting, circadian rhythm regulation, and stress management. Regular physical activity, maintaining a healthy weight, and staying hydrated contribute to overall well-being. Stay connected with your healthcare team and consider medications when needed for a comprehensive approach to prediabetes. Prediabetes treatment and reversal is in your hands with informed choices, proactive measures, and collaborative healthcare efforts.

Reference

1. Prediabetes diagnosis and treatment: A review - PMC

2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes - 2018

3. Latest ADA Annual Standards of Care Includes Changes to Diabetes Screening, First-Line Therapy, Pregnancy, and Technology

4. Prediabetes diagnosis and treatment: A review - PMC

5. Diabetes Prevention Program (DPP) - NIDDK

6. The Ultimate 2024 Savoury Breakfast Guide for Glucose

7. Exercise and Type 2 Diabetes - PMC

8. The essential role of exercise in the management of type 2 diabetes - PMC

9. Food Order Has a Significant Impact on Postprandial Glucose and Insulin Levels - PMC

10. The role of intermittent fasting and meal timing in weight management and metabolic health | Proceedings of the Nutrition Society | Cambridge Core

11. Weight Management: Obesity to Diabetes - PMC

12. Alcohol and Diabetes | ADA

13. Smoking and Diabetes | Overviews of Diseases/Conditions | Tips From Former Smokers | CDC

14. Water - Effect on Blood Glucose and How Much Should I Drink