Understanding the risks and taking action
to reverse pre-diabetes
What you need to know about managing pre-diabetes and reducing your type 2 diabetes risk
What is pre-diabetes?
Pre-diabetes means you have higher than normal blood sugar. However, it is not high enough to be considered type 2 diabetes yet.
Additionally, being pre-diabetic means you are at a higher risk of developing type 2 diabetes. It’s a warning sign.
What does pre-diabetes mean?
Pre-diabetes is sometimes called borderline diabetes, and in medical settings, higher than normal blood sugars are often referred to by other terms.
Such as:
- Impaired glucose regulation (IGR)
- Non-diabetic hyperglycemia
- Impaired fasting glucose (IFG)
- Impaired glucose tolerance (IGT)
Pre-diabetes can be diagnosed with blood tests to detect higher-than-normal blood sugars.
The most common blood test checks your HbA1c levels. This is a measure of your average blood sugar levels for the last two to three months.
If your HbA1c level is between 42mmol/mol (6%) – 47mmol/mol (6.4%) this means it is higher than normal and you are at risk of developing type 2 diabetes.
Pre-diabetes can also be detected with a fasting blood sugar test, which measures blood sugar after an overnight fast, and a glucose tolerance test, which measures blood sugar before and after drinking a glucose liquid.
How does pre-diabetes develop?
Prediabetes develops when the body has trouble processing glucose. This can be due to insulin resistance or an inability to produce enough insulin.
Insulin resistance means your body’s cells do not respond properly to insulin – whether it’s insulin your body makes or the insulin you inject as a medication.
When this happens, your body can’t use glucose/sugar from your blood for energy, the sugar stays in your blood and your blood sugar levels increase.
Then, the body responds by producing extra insulin in a bid to bring your blood sugar levels back down to a ‘safe’ range, known as homeostasis. The result is higher insulin and fluctuating blood sugar levels.
What causes pre-diabetes?
According to Diabetes UK, more than 3.2 million people are at an increased risk of type 2 diabetes in the UK based on blood sugar levels.
It estimates that 1.2 million people are currently living with type 2 diabetes but are yet to be diagnosed.
There are many risk factors for pre-diabetes and type 2 diabetes.
It can be genetic. You’re two to six times more likely to get type 2 diabetes if you have a parent, brother, sister, or child with diabetes.
Race and ethnicity can also influence your pre-diabetes and type 2 diabetes risk. Type 2 diabetes is two to four times more likely in people of South Asian descent and African-Caribbean or Black African descent.
Certain conditions can make pre-diabetes more likely too. For example, an estimated 30–40% of people with Polycystic Ovary Syndrome (PCOS) have prediabetes.
Additionally, you are more at risk if you are overweight or living with obesity. However, you don’t have to be of a larger body size to have high blood sugar.
Many of the causes of pre-diabetes are linked to lifestyle and are preventable. These include:
- A diet high in processed food and sugary drinks
- A sedentary lifestyle
- Smoking
- Poor quality sleep
- Chronic high-stress levels
Signs of pre-diabetes
For some people, pre-diabetes is a silent condition. It often does not have any symptoms, and if you start to develop symptoms of type 2 diabetes, it’s worth getting checked out by a doctor.
One possible sign of prediabetes is darkened skin on certain parts of the body, such as the armpit, neck, or groin, known as acanthosis nigricans
A lot of people don’t get pre-diabetes symptoms. However, symptoms can also be classed as ‘normal’ and may only become debilitating when you have moved from pre-diabetes to type 2 diabetes. These include:
- Frequent urination
- Increased hunger
- Fatigue
- Blurred vision
- Increased thirst
- Frequent infections
- Slow-healing wounds
What is the difference between pre-diabetes and type 2 diabetes?
Pre-diabetes is a condition where your blood sugar levels are higher than normal, but they are not high enough to be diagnosed as type 2 diabetes. It’s a warning sign so you have time to make changes.
Type 2 diabetes is preceded by pre-diabetes. It develops when the body can produce insulin but insulin may not be able to perform its essential role.
This is due to elevated sugar in the blood creating a constant demand for insulin and the cells become ‘insulin resistant’.
When people with type 2 diabetes do not manage their blood sugars, they may go on to need insulin injections on top of regular type 2 diabetes medication.
Research suggests that around 70% of people with pre-diabetes will go on to develop type 2 diabetes.
However, you can greatly reduce your risk with diet and lifestyle adjustments, like our client Jan. Before discovering Integral Wellness, Jan was struggling with psoriasis and weight gain.
A recent blood test showed she was only one number away from pre-diabetes. She also had an autoimmune condition (psoriasis) which increases the risk of higher blood sugars and some long standing digestive issues.
To overcome these issues, we build a bespoke plan that included adding anti-inflammatory foods into Jan’s diet and removing gluten.
With our support, Jan also added more protein and healthy fats to her diet and cut down on snacking.
After six months, Jan’s blood sugar levels were balanced and she was no longer one number away from being pre-diabetic.
Her psoriasis completely cleared up, her blood pressure became stable, and she lost 7lbs. Read Jan’s story here.
How does diet and lifestyle impact the development of pre-diabetes?
Many of the risk factors for pre-diabetes and type 2 diabetes are modifiable and lifestyle-based.
They include:
Body weight
Being overweight is a major risk factor for prediabetes. This is because the more excess weight you have, the more resistant your muscle and tissue cells become to insulin.
Harvard Health estimates that around 85% of people who develop type 2 diabetes are overweight or obese.
Waist circumference is considered a better indicator of diabetes risk than BMI. Carrying extra weight around your waist means fat can build up around organs.
In turn, this can contribute to insulin resistance.
However, losing small amounts of weight can help. In fact, losing just 5% of your body weight can reduce your risk.
While we often think of type 2 diabetes as a condition that only affects people who are overweight or obese, it’s important to note that it can affect people who are a healthy weight too.
Gut health
Poor gut health is also linked to the development of pre-diabetes. This is due to the role the gut microbiome plays in regulating glucose and lipid metabolism.
A healthy gut produces short-chain fatty acids (SCFAs) which promote insulin sensitivity.
An imbalanced gut, on the other hand, can contribute to inflammation, insulin resistance, and obesity: all prediabetes risk factors.
Physical activity
Prolonged sedentary behaviour can increase your risk of pre-diabetes. Being inactive makes you more prone to insulin resistance and reduces the body’s ability to regulate blood sugar and insulin levels.
Additionally, physical activity can contribute to weight gain, which is another pre-diabetes risk factor.
However, you can reduce your pre-diabetes risk by finding ways to move more.
The NHS recommends 150 minutes of physical activity per week for adults spread across the week.
Walking can be a great exercise to add to your weekly routine and is shown to reduce the risk of developing type 2 diabetes by up to 40%.
Exercises that build muscle mass are also linked with better blood sugar control and health longevity.
Alcohol
If you’re worried about pre-diabetes risk and you drink alcohol, it may be beneficial to reduce your intake.
Excess alcohol intake is associated with an increased risk of pre-diabetes and type 2 diabetes. This is because drinking alcohol can interfere with blood sugar balance.
The NHS guidelines are for men and women not to drink more than 14 units a week on a regular basis.
You are also advised to spread your drinking over 3 or more days if you regularly drink as much as 14 units a week.
Pre-diabetes and nutrition
Diet can contribute to the development of pre-diabetes in several ways. What you eat and drink affects your blood sugar levels.
And certain foods can cause rapid blood sugar spikes and subsequent crashes. Over time, this can contribute to insulin resistance and the development of pre-diabetes.
Refined carbohydrates (like sugary snacks, cereals, and bread) are one food type associated with a higher risk of pre-diabetes. This is because refined carbohydrates cause blood sugars to spike quickly.
If you have pre-diabetes your body will have a harder time lowering your blood sugars after eating these foods.
Other foods that can cause rapid spikes in blood sugar include:
- Sugary and artificially sweetened drinks
- Some fresh fruits
- Breakfast cereals
- Low-fat dairy products that contain added sugars
When should you be worried about pre-diabetes?
Pre-diabetes often doesn’t have symptoms so it can be hard to spot. If you suspect you have pre-diabetes, or simply want to check, you should go to your doctor for blood tests.
If your HbA1c level is between 42mmol/mol (6%) – 47mmol/mol (6.4%) this indicates pre-diabetes as your blood sugars are higher than normal and you are at risk of developing type 2 diabetes.
You will have been insulin resistant for some time by this point, but may not be aware of it. It’s easy to brush off things like fatigue, difficulty waking up in the morning, and catching an illness as a part of everyday life.
Can you prevent pre-diabetes from developing into type 2 diabetes?
Receiving a pre-diabetes diagnosis can feel scary and overwhelming. It is a warning sign that your blood sugar and insulin levels are rising.
Fortunately, lifestyle adjustments can be effective in preventing pre-diabetes from developing into type 2 diabetes.
Our client Nige was able to reverse his pre-diabetes diagnosis in 12 weeks. Before finding Integral Wellness, Nige was just one number away from being diabetic.
By changing his eating habits, improving the quality of his sleep, and increasing his movement, Nige was able to avoid a type 2 diabetes diagnosis. You can read his inspiring story here.
If Nige can reduce his pre-diabetes and type 2 diabetes risk with lifestyle adjustments, you can too.
Book a call with a nutritional therapist to start taking control of your blood sugars and overall metabolic health.
