Prediabetes affects almost 100 million Americans, but many don't know it. A patient shares their wake-up call, while a doctor reveals the most common symptom.
How I Knew I Had Pre-Diabetes: A Patient’s Story of Reversing Diabetes Before It Kicked In
Published on Dec. 03, 2024
Nearly 98 million Americans are prediabetic, yet more than 80% of those with the condition are unaware they have it. Often, prediabetes remains silent until a routine blood test reveals elevated blood sugar levels. For many, this discovery can serve as a chance to make meaningful lifestyle changes and prevent the progression to Type 2 diabetes.
“Diabetes is a metabolic and endocrine dysfunction,” explains Shirisha Avadhanula, MD, a board-certified endocrinologist at the Cleveland Clinic. Dr. Avadhanula explains that when sugar builds up in the bloodstream, “this sugar can then deposit into small blood vessels in the body, which can then lead to organ dysfunction.” This makes early intervention and prevention essential to long-term health.
Ahead, we share what you need to know about prediabetes, including how to manage and potentially reverse it. We also hear from Angela Larson, 45, from Tampa, FL, who shares her personal journey of receiving a prediabetes diagnosis and taking steps toward better health.
What is prediabetes?
Prediabetes is a condition where blood sugar levels are elevated beyond the normal range but not high enough to be diagnosed as Type 2 diabetes. It often develops due to a combination of factors, including genetics, lifestyle habits and diet. These influences can lead to insulin resistance, a state in which the body becomes less effective at processing glucose. Over time, this can cause blood sugar levels to rise.
If left untreated, prediabetes can progress to Type 2 diabetes and increase the risk of serious complications, including heart disease, stroke, kidney issues and nerve damage.
The good news? Early detection and proactive lifestyle changes, such as improving your diet, increasing physical activity and maintaining a healthy weight, can often stop prediabetes in its tracks or even reverse it.
How is prediabetes diagnosed?
Prediabetes can be diagnosed through one or more blood tests:
- A1C test: This measures your average blood sugar levels over the past two to three months. An A1C result between 5.7% and 6.4% indicates prediabetes.
- Fasting blood sugar test: This test checks your blood sugar levels after an overnight fast. A result between 100 and 125 milligrams per deciliter (mg/dL) signals prediabetes.
- Glucose tolerance test: This test measures your blood sugar levels before and after drinking a glucose solution. Prediabetes is indicated by a result between 140 and 199 mg/dL two hours after drinking the solution.
The American Diabetes Association (ADA) recommends regular diabetes screenings starting at age 35, or earlier if you’re overweight, obese or have risk factors like a family history of diabetes.
Symptoms of prediabetes
One of the challenges with prediabetes is that it often has no noticeable symptoms. As Dr. Avadhanula notes, “The most common symptom is no symptom at all.”
This was the case for Angela who discovered her condition during a routine checkup: “I didn’t feel any different,” Angela recalls. “But my mom was diagnosed with diabetes around my age, so I made it a point to stay on top of my checkups. My sugar levels had always been on the higher end, so when my doctor told me I had prediabetes after my bloodwork, I can’t say I was completely shocked. Still, it was frustrating. I knew I had to take it seriously if I wanted to avoid diabetes.”
While most people with prediabetes don’t experience symptoms, certain signs can indicate you’re borderline diabetic. These include:
- Increased thirst and frequent urination: Excess glucose in the blood is flushed out through urination, which can lead to dehydration and constant thirst.
- Fatigue: When your body struggles to process glucose for energy, it can leave you feeling drained.
- Blurred vision: High blood sugar levels can cause fluid shifts in the eyes, making your vision blurry.
- Unexpected weight changes: Insulin resistance may cause sudden, unexplained weight loss or gain.
If you experience any of these symptoms, it’s important to consult your doctor. Even if you don’t have noticeable symptoms, regular screenings can catch prediabetes early and give you a chance to take action.
What food should you eat if you have prediabetes?
If you’ve been diagnosed with prediabetes, your diet is one area where small changes can make a big difference. A balanced, nutrient-rich diet is key, and certain foods can help stabilize blood sugar levels, reduce insulin resistance and keep you feeling satisfied. Here’s what to focus on:
- Whole grains: Opt for whole-grain bread, brown rice, and quinoa over refined grains. These options have more fiber, which can help prevent blood sugar spikes.
- Lean proteins: Chicken, fish, eggs and tofu are excellent choices that don’t raise blood sugar levels.
- Healthy fats: Avocado, nuts, seeds and olive oil can help you feel full and provide essential nutrients.
- Non-starchy vegetables: Load up on leafy greens, peppers, broccoli and other non-starchy vegetables, as they’re low in carbs and packed with fiber and nutrients.
“You want to aim for caloric restriction, but there are many different pathways to get there,” advises Dr. Avadhanula. “The most important thing is that you’re able to adhere to whatever healthy eating style you pick.” Recommended approaches include the Mediterranean diet and the DASH diet, both of which emphasize whole, nutrient-dense foods.
Dr. Avadhanula also stresses that monitoring the quality of the foods you eat is just as important as managing calorie intake. If possible, consulting with a registered dietitian can provide valuable guidance that fits your specific needs.
Angela shares her experience: “I’ve found it’s about eating foods that keep you full and feeling good, not just ones that taste good in the moment. I swapped sugary cereals for oatmeal topped with fruit and replaced chips with a handful of nuts. Another favorite snack is carrots and hummus.” She adds, “Keeping things simple has made a huge difference.”
Dining out with prediabetes
When dining out, choose grilled or baked options, ask for dressings on the side and swap out refined carbs like white bread for whole grains or extra veggies. Fast food joints often offer salads, grilled chicken and other lower-carb options if you ask. Also avoid sugary drinks like sodas.
“I still love going out with friends, and I didn’t want that to change,” Angela says. “Now, I’ll look at the menu ahead of time and plan what to eat if I can.”
What to avoid eating if you have prediabetes
Certain foods can make it harder to manage blood sugar levels. Here’s what to avoid or limit:
- Sugary foods and drinks: Sodas, desserts and sugary snacks can cause blood sugar spikes. Try replacing them with fruit or sugar-free options, but be mindful of artificial sweeteners.
- Refined grains: White bread, what pasta and white rice have a high glycemic index, meaning they can spike blood sugar quickly. One helpful strategy is to start your meal with a large salad before eating pasta. The fiber in the salad helps slow the absorption of carbohydrates, preventing sharp blood sugar spikes and promoting more stable levels.
- Alcohol: Alcoholic beverages can impact blood sugar levels unpredictably, especially those with added sugars like cocktails. Limit alcohol and stick to lower-carb options if you do drink.
Can I eat bananas?
Yes, bananas can be eaten in moderation. They are high in potassium and fiber, which can help manage blood sugar levels. Opt for smaller, ripe bananas and pair them with protein or healthy fat, like a handful of nuts, to slow sugar absorption.
How to reverse prediabetes
While prediabetes is a precursor to diabetes, lifestyle changes can often reverse it.
Still, it’s essential to work with a healthcare provider to monitor blood sugar levels regularly, usually every three to six months. They can tell you if your steps to prevent prediabetes are working or if medication is needed.
Here’s what to know.
Weight management
Even small amounts of weight loss can make a big difference in blood sugar levels. “The best way to reverse the prediabetes process and for you not to develop Type 2 diabetes is weight loss,” explains Dr. Avadhanula. “As we gain more weight, our cells become more and more resistant to the effects of insulin. And unfortunately, insulin resistance is the first key step in developing Type 2 diabetes.”
Consistent research supports this, showing that losing just 5% to 7% of your body weight, combined with at least 150 minutes of exercise per week, can reduce your risk of Type 2 diabetes by as much as 58%.
Regular exercise
Physical activity increases insulin sensitivity and helps your muscles use glucose. In addition to 150 minutes of exercise per week, incorporate at least two to three strength training sessions.
Medications
Metformin is a common prediabetes medication that helps lower glucose production in the liver and improves insulin sensitivity.
Ozempic for prediabetes
While Ozempic is typically prescribed for Type 2 diabetes, some doctors may recommend it for prediabetes in specific cases. Ozempic helps to control blood sugar levels and promote weight loss.
Support groups
Angela shares the value of having a strong support system: “What really didn’t get me into despair was my doctor reassuring me that I could potentially reverse prediabetes. She referred me to a diabetes prevention program that is designed for those to prevent a diabetes diagnosis… and help implement some good healthy changes.”
For Angela, the program has been transformative: “It taught me so much about myself and made healthy choices feel less overwhelming. It’s even more encouraging to do it in a group.”
If you’re looking for some extra support, ask your doctor about similar programs that might be available in your area.
Additional tips for managing prediabetes
Research suggests that consuming your largest meal in the morning or early afternoon can help stabilize blood sugar levels and maintain energy throughout the day. This approach aligns with your body’s natural rhythms, as insulin sensitivity tends to be higher earlier in the day.
Both sleep and stress have a significant impact on insulin sensitivity and blood sugar control. Try to get seven to nine hours of quality sleep each night and consider relaxation techniques like meditation, journaling or deep breathing to manage stress.
Angela concludes, “My levels are still prediabetic, but I’ve managed to keep 10 pounds off, which is so exciting for me. I still have five months left in the program…I’m looking forward to seeing what else I can achieve.”
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