Can You Reverse Prediabetes?

According to CDC estimates, more than one in three American adults has prediabetes - a health condition marked by blood sugar levels that are higher than average but not yet high enough to be diagnosed as diabetes.

Because prediabetes has no clear symptoms, approximately 80% of patients with the condition may not know they have it and are at higher risk of developing type 2 diabetes in the future.

The good news? You can take steps to reduce your risk of type 2 diabetes and possibly even reverse prediabetes.

Learn how prediabetes is treated and how to reverse prediabetes from an endocrinology specialist at Franciscan Health.

How Is Prediabetes Diagnosed?

Prediabetes is typically diagnosed through two simple blood tests, which can be tested at a primary care physician's office.

The first type of prediabetes screening, known as a fasting blood sugar test, measures the amount of glucose, or sugar, in the blood following an eight- to 12-hour period of fasting. Results of 99 mg/dL or lower are considered normal fasting blood sugar levels. Prediabetes levels fall between 100 and 125 mg/dL, while a result of 126 mg/dL or higher indicates diabetes.

A second prediabetes screening test measures A1C levels in the blood. An A1C test measures your average blood sugar level over the last two to three months. An A1C level below 5.7% is considered normal, whereas results between 5.7% to 6.4% are considered indicators of prediabetes. Meanwhile, A1C readings of 6.5% or above indicate diabetes.

What Are Risk Factors For Prediabetes?

The risk factors for prediabetes are generally the same as the risk factors for developing diabetes.

"Some risk factors for prediabetes are modifiable, while some are not modifiable," explains Alexis Harper, APN, an advanced practice nurse in endocrinology with Franciscan Health Olympia Fields.

Specifically, people who are overweight, who smoke, or who are over age 45 may face a higher risk of developing prediabetes than others. Other risk factors for prediabetes include:

• Being a person of color (Black, Hispanic, American Indian and Asian Americans experience higher rates of prediabetes than White Americans)
• Consuming a diet high in sugary foods and red or processed meats
• Experiencing gestational diabetes during pregnancy
• Having an immediate family member with Type 2 diabetes
• Having polycystic ovary syndrome (PCOS)
• Not getting enough exercise.

Can Prediabetes Be Treated?

Prediabetes can be treated through both lifestyle changes and medicine if needed. In fact, positive lifestyle changes - including adding exercise and eating a healthy diet - have been shown to lower the risk of developing Type 2 diabetes following a prediabetes diagnosis by 40-70%.

Can You Reverse Prediabetes?

"Only 5-10% of patients with prediabetes develop diabetes annually," Harper says. "So, with early treatment and moderate lifestyle changes, the vast majority of patients can return their blood sugar levels to a normal range and effectively delay or prevent a Type 2 diabetes diagnosis."

What Lifestyle Changes Can Help Reverse Prediabetes?

With early treatment and moderate lifestyle changes, some people with prediabetes can return their blood sugar levels to a normal range, effectively delaying or preventing developing type 2 diabetes. Patients with prediabetes can incorporate exercise and healthier eating habits as a means of lowering their blood sugar levels.  

The American Diabetes Association recommends getting at least 150 minutes of exercise a week - whether by walking or other physical activities - for effective prediabetes management.

And, when it comes to diet, balance is key.

"We recommend getting a balanced meal with the right amount of carbs and proteins and a small amount of fat," Harper says.

She suggests dividing the dinner plate so that one half is filled with non-starchy vegetables, while ¼ is filled with a starch and the final ¼ is filled with lean protein.

Additionally, giving up cigarettes - since smoking has been linked to diabetes risk - can significantly reduce the risk of developing prediabetes.

What Medications Are Used To Treat Prediabetes?

Certain medications - including metformin or a class of medications known as incretins - may be prescribed to help treat prediabetes. These medications have been used to effectively treat Type 2 diabetes.

"For patients who have a high body mass index or are unable to get moving physically - or who live in a setting where they don't have control over their food intake - adding medication to lifestyle changes may be key to treating prediabetes effectively," Harper says.

How Long Does It Take To Reverse Prediabetes?

There is no single timeline for how to reverse prediabetes effectively. For some patients, a return to normal blood sugar levels may come over a few months, while for others, it may take years.

"We repeat the A1C test with our prediabetes patients every three or six months, so we can monitor their progress in getting those A1C levels down," Harper says.

When Should I Get Screened for Prediabetes?

If you have any of the risk factors for prediabetes - mainly if you are overweight, a current or former smoker or if you're over the age of 45 - you should ask your primary care physician about getting a prediabetes screening test and, if you have prediabetes, discussing how to reverse prediabetes with them.

With screening and appropriate intervention, it's possible to effectively reverse prediabetes and delay or prevent having type 2 diabetes in the future.