DEAR MAYO CLINIC: I’m a 36-year-old man recently diagnosed with prediabetes. Is there a way to reverse this, or am I destined to eventually get diabetes? My healthcare provider says I’ve likely been in the prediabetes stage for a year or more.
ANSWER: There are steps you can take to slow the progression of prediabetes to type 2 diabetes. You may even be able to stop or reverse it. That’s important because once type 2 diabetes develops, the disease can lead to complications that can cause serious, long-term health problems.
Diabetes occurs when the level of sugar in the blood is too high. That happens because of a problem with the hormone insulin, which is made in the pancreas. When you eat, the pancreas releases insulin into the bloodstream. This allows sugar to enter your cells, lowering the amount of sugar in your blood.
In type 2 diabetes, the pancreas does not make enough insulin, and the body can’t use insulin as well as it should. That means sugar cannot move into the cells, and it builds up in the blood. Prediabetes is a condition in which blood sugar is higher than normal, but it’s not high enough to be considered type 2 diabetes. People who have prediabetes are at high risk to develop type 2 diabetes.
As in your case, a person’s blood sugar can be at a prediabetes level for quite some time. Although it doesn’t carry all the risks of the full disease, prediabetes isn’t harmless. The damage diabetes can do to your body may start in the prediabetes stage, particularly complications that affect the blood vessels, heart, and kidneys.
The good news is that there are ways to reverse this condition. Certain lifestyle changes can lower your blood sugar level and decrease your risk of developing diabetes.
One key is getting to and maintaining a healthy weight. The root cause of type 2 diabetes is not completely clear, but being overweight plays a role. In people who are overweight, the body may need two to three times more insulin than it would at a healthy weight. When the pancreas tries to produce that much additional insulin, it can be pushed beyond its capacity, and insulin-producing cells start to die. That worsens the situation because the pancreas then has even fewer cells with which to make insulin.
Compounding the problem, research also has shown that the fat cells of people who are obese and who have more abdominal fat release molecules that can harm the pancreas. So the more abdominal fat you have, the higher the risk of damage to your pancreas.
If you need to lose weight, changes in eating habits are often necessary. Eat a healthy diet that’s rich in vegetables, fruits, and whole grains. For guidance, consider talking with a dietitian. To maintain a healthy weight, exercise regularly. For best results, get 150 minutes or more of moderate aerobic physical activity a week or at least 30 minutes most days. If you count steps as a way to monitor activity, it probably will require 10,000 to 15,000 steps a day to stay at a lower weight. Another benefit of physical activity is that muscle can take up and burn sugar without insulin, taking pressure off the pancreas.
Controlling high blood pressure and high cholesterol can ease your risk of future disease, too. And because smoking can worsen insulin resistance in the body, don’t smoke. For help quitting, talk to your healthcare provider.
Preventing prediabetes from progressing to type 2 diabetes is vital for your long-term health. Over time, type 2 diabetes can affect nearly every major organ in your body, including the blood vessels, nerves, eyes, and kidneys. If left untreated, diabetes complications may be disabling or even life-threatening. But if you lower your blood sugar level, your risk of type 2 diabetes and its potential complications decrease dramatically. — Michael Jensen, MD, Endocrinology, Diabetes and Metabolism, Mayo Clinic, Rochester, Minnesota