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Your guide to reversing prediabetes with diet and treatments

You undergo routine blood tests only to get a call from your doctor. You have prediabetes, a condition where your blood sugar levels are higher than normal, but not high enough for a diagnosis of type 2 diabetes.

Approximately 84 million Americans have prediabetes, according to the Centers for Disease Control and Prevention (CDC), which can ultimately increase your risk of developing type 2 diabetes, heart disease, or stroke. Type 2 diabetes is different than type 1 diabetes, a condition where people don’t produce insulin. People with type 2 diabetes don’t respond to insulin as well as they should, then later in the disease, their bodies stop producing enough insulin.

What is prediabetes?

You’re considered to have prediabetes if your blood sugar is between 100 and 125 mg/dl on two or more fasting blood glucose tests, or if your numbers fall between 5.7% and 6.4% on an AIC test that measures your average blood sugar levels for the past two to three months.

A prediabetes diagnosis can sound scary. But, the good news is reversing prediabetes is possible—with simple lifestyle changes you can prevent it from progressing to type 2 diabetes.

“It’s a diagnosis that should be taken seriously, but with early intervention, such as following a healthy diet, maintaining a healthy weight, and getting regular exercise, people can reduce their risk of developing type 2 diabetes,” says Osama Hamdy, MD, author of the book, The Diabetes Breakthrough.

RELATED: Guide to prediabetes

9 ways to start reversing prediabetes naturally

Here are some more expert tips designed to help you get your blood sugar levels in check and prevent type 2 diabetes. Start with one or two simple steps and once you’ve mastered those, add a couple more.

1. Shed a few pounds. 

Gaining weight, especially around your abdominal area, increases your risk of developing type 2 diabetes. Even moderate weight loss can help reduce this danger and improve your blood sugar levels. In his research, Dr. Hamdy found that those who lost 7% of their body weight (the equivalent of 16 pounds in a 225-pound woman), improved their ability to respond to insulin by approximately 57%. That’s a big difference!

2. Choose the right foods. 

Dr. Hamdy’s research shows that those who followed a Mediterranean eating plan, without restricting calories, showed a greater improvement in glycemic control and insulin sensitivity than those who followed other diets.

“Foods such as oats, whole grains, yogurt and dairy products, green leafy vegetables, apples, blueberries, walnuts, brown rice and legumes are associated with a reduced diabetes risk,” Dr. Hamdy explains. “It’s important to eat protein such as fish, chicken and turkey, whole grains and dairy.”

He also recommends using the glycemic index (GI) as a tool to determine how certain foods can affect your blood sugar. The index ranks foods on a scale from 1 to 100. Foods that are high on the GI, such as those with lots of processed carbohydrates, will raise your blood sugar faster. Foods ranked lower on the GI scale—such as those rich in fiber, protein, and fat—more gradually raise blood sugar levels. The American Diabetes Association offers more information on the GI as well as diabetes-friendly recipes.

And don’t forget to practice portion control. Consider switching to a smaller plate and drinking a full glass of water with every meal to curb your appetite.

3. Avoid certain foods. 

Diet has a big impact on blood glucose levels and eating the wrong foods can raise your risk of developing type 2 diabetes.

“Limit saturated fats and refined carbohydrates,” Dr. Hamdy says. “Minimize your consumption of processed meats and anything made with white flour such as pizza, bagels, and pasta, and sugary foods such as ice cream, milk chocolate, and juice.”

Other foods to avoid or limit if you’re working on reversing prediabetes include fried foods, anything with trans fats, and high-calorie, high-fat foods.

4. Increase your fiber intake. 

Getting the recommended daily amount of fiber in your diet can help control blood glucose levels.

“Most people don’t get the recommended intake of 25 to 30 grams of dietary fiber per day,” says Leigh Tracy, RD, a dietitian and diabetes educator at the Center for Endocrinology at Mercy Medical Center in Baltimore. “Increasing their intake of non-starchy vegetables (asparagus, beans, carrots and more) to half a plate at both lunch and dinner is a great way to get to reach that goal.”

5. Choose the right beverages. 

For those with prediabetes, sweetened beverages loaded with fructose are the worst choices and are linked to insulin resistance.

“Rather than drinking soda or a sugary coffee drink, I encourage hydrating the body with water, unsweetened tea, or water infused with fruit for added flavor,” Tracy says.

It’s also important to stay properly hydrated. Studies have found the amount of water you drink can play a role in how your body regulates blood sugar. When you don’t drink enough water, the glucose in your bloodstream becomes more concentrated, leading to higher blood sugar levels.

Most people need to drink 8-10 cups of water each day (more if it’s hot and humid).

6. Embrace regular exercise. 

Research has shown that low activity levels are associated with higher blood sugar levels, even in adults who are at a healthy weight.

“I recommend engaging in some type of movement you enjoy and will continue to do,” Tracy says. “If walking in the park is fun for you, go for it and aim for three to five days of some type of movement.”

Hamdy says the best exercise regimen for reversing prediabetes involves a combination of stretching, aerobic exercise, and strength or resistance training.

“Stretching involves blood flow, increases range of motion for joints and prevents injuries,” he says. “Aerobic exercise, which can include swimming or brisk walking is good for heart health and strength training keeps the muscle mass up.”

While he recommends trying to ultimately reach 300 minutes per week of exercise, he says it’s also possible to accomplish that by breaking it up in short bursts of 10 minutes at a time.

“Take a walk after lunch and dinner and use resistance bands or weights while watching your favorite television show,” Hamdy says. “Research has shown that if you do an activity every day for 66 days, it becomes a habit.”

7. Monitor your blood sugar with your doctor. 

Those with prediabetes typically have their blood sugar levels checked once a year at their yearly checkups. If you have prediabetes, you have a higher risk of developing type 2 diabetes if you:

  • Are over the age of 60
  • Have high body mass index (BMI)
  • Have a history of gestational diabetes

For high-risk patients, doctors may prescribe a medication called metformin, that works to lower the amount of sugar in the blood.

The American Diabetes Association (ADA) recommends that people age 45 or older are screened annually—sooner for those who are overweight, or who have a family history of diabetes. Certain racial and ethnic groups such as African Americans, Hispanic Americans, Native Americans, and Asian Americans are more likely to develop prediabetes.

8. Ensure you get enough sleep. 

Too little sleep—less than seven hours a night—and poor sleep quality, can increase insulin resistance.

Getting quality sleep (7.5-8 hours per night) is vital to health,” Tracy says. “Not getting enough quality sleep can increase stress hormones in the body, which can lead to elevated blood sugar levels.”

Experts recommend maintaining a regular sleep schedule when possible, seeking medical help if you have insomnia or suffer from snoring (which could be a sign of sleep apnea), and practicing good sleep hygiene. That means no electronic devices in the bedroom, keeping your bedroom dark, cool and quiet and not eating food or drinking alcohol late in the evening.

9. Reduce your stress. 

When you’re under physical stress, your blood sugar levels can increase.

“Managing mental stress is a key part of both weight loss and effective glucose control,” Hamdy says. “It’s important to practice breathing and relaxation techniques to help deal with daily stressors.”

While some people have found yoga to be a good antidote, prayer, meditation, physically activity, talking to a therapist or friend about your stress, or joining a support group (online or in-person) can also help lower your stress levels.

With persistence, and the support of your healthcare team, you can start on the road to reversing prediabetes and improving your overall health.