More than 1 out of 3 American adults now have prediabetes, according to the Centers for Disease Control and Prevention (CDC). Before you assume that doesn’t include you or anyone you love, here’s an even more startling estimate: the CDC says 90% of people with prediabetes don’t know they have it.
Prediabetes is one of those “fork in the road” times in life. Ignore it, and you are on the road that puts you at high risk of developing diabetes, and other health risks begin even before diabetes develops. But with even some relatively small steps now, you are still at the point when all these risks can be prevented or at least delayed.
It’s not a bury-your-head-in-the-sand moment.
Read on for a quiz that lets you know in less than a minute whether you’re among those at risk. And if you’re at that “fork in the road”, get tips from a prediabetes expert about doable steps you can take to get on the path to a healthier future….
Are You at Risk of Prediabetes?
Given the statistics on how common prediabetes has become, it’s well worth taking this under-a-minute quiz recommended by the CDC to check your risk. Remember, prediabetes may not be the news you want, but it’s a lot easier to deal with than what comes when you wait until diabetes develops.
Prediabetes: What We All Need to Know
When it comes to prediabetes, knowledge is power. For solid science on diabetes and prediabetes, one of my go-to experts is my friend, Jill Weisenberger, MS, RDN, CDE, CHWC, FAND. Jill is a registered dietitian nutritionist who is also a certified diabetes educator and a best-selling author in this field. I respect Jill’s knowledge of the latest science and her practical insights on how to use it for healthier living. So I’ve asked Jill to help provide clarity to the concerns about prediabetes and what can be done.
What do you consider the most important points for people to know about prediabetes? How should someone who has been diagnosed with prediabetes view this finding? 
“Prediabetes – like diabetes – is defined by blood sugar levels. And because of this, lots of people think that both type 2 diabetes and prediabetes are only about blood sugar levels. But this just isn’t true. These are metabolic disorders that need attention to prevent harm to the body. People with prediabetes have other problems associated with insulin resistance such as blood vessel dysfunction, fatty liver and chronic inflammation.”
“I want my clients and my readers to take a much bigger view of prediabetes than simply a blood sugar view. Prediabetes is a risk factor for type 2 diabetes, heart disease, stroke and some types of cancer. The problem is bigger, so the strategies to manage it need to be bigger too.”
“But there is good news here. The diagnosis of prediabetes is a wake-up call. Now you know that you have a problem and that it needs your attention. And it’s quite possible to reverse the problem or at least slow down its progression.”
What are some of the headlines you’ve seen related to prediabetes or diabetes prevention that frustrate you most for the way they miscommunicate current science to people?
“I’ve seen all kinds of headlines claiming ways to prevent type 2 diabetes. I’ve read that we should stop using mouthwash and that we should keep the air conditioner turned to a colder temperature. I’m pretty sure that neither one of these things can cure a metabolic disorder. Other headlines have claimed that avoiding sugar or added sugar or carbs is the way to go.”
“But the truth is that we need to take a more holistic view than simply avoiding sugars or carbohydrates. Though I admit that it does sound logical: Blood sugar levels are elevated with prediabetes, and sugars and other carbohydrates in food raise blood sugars. Also lots of people with prediabetes will benefit from weight loss, so reducing certain foods or food groups might be helpful. And it is possible that weight loss alone will allow for a short-term or even long-term reversal of prediabetes.”
“Cutting out major food groups is rarely a good idea, however. In fact, some of the best foods for prediabetes and diabetes are rich in carbohydrates. Specifically, oats, barley and legumes contain compounds that help the body use insulin more effectively. These are precisely the foods I recommend to people with prediabetes and diabetes. I encourage people with prediabetes to make food choices based on wholesomeness of the food – not on the content of carbohydrate, fat or protein (called macronutrients). Foods are so much more than their major macronutrient.”
[clickToTweet tweet=”“If all we cared about was a food’s major macronutrient, we’d put jelly beans and black beans in the same category. Indeed, many people do, and it breaks my nutritionist heart,” says @NutritionJill.” quote=”“If all we cared about was a food’s major macronutrient, we’d put jelly beans and black beans in the same category. Indeed, many people do, and it breaks my nutritionist heart,” says Jill Weisenberger.”]
For someone with a diagnosis of prediabetes, is developing diabetes inevitable?
“Prediabetes is likely to progress to type 2 diabetes, but it doesn’t have to. We have good studies showing that lifestyle changes can prevent or delay the onset of type 2 diabetes. Some important strategies include healthy eating (and no, I don’t mean carbohydrate avoidance), regular exercise, reducing excessive sitting, weight loss if necessary, getting to bed on time, and avoiding tobacco. And some people will benefit from a medication to help their bodies become more sensitive to insulin.”
“We have the Diabetes Prevention Program (DPP) to give us hope and confidence. In the DPP – a study of more than 3000 overweight people at risk for type 2 diabetes – subjects who were encouraged and supported to lose 7% of their body weight and to exercise 150 minutes per week reduced their risk of developing type 2 diabetes by 58% during the 3-year study. And 15 years after the study started, they still had better odds of avoiding diabetes. They were 27% less likely to have the disease than the group who was given just general diabetes and exercise advice. Plus they even had better cholesterol levels, healthier blood pressure and less chronic inflammation. Overall, a very good picture. We have other studies, including the Finnish Diabetes Prevention Study, which also show big results with lifestyle changes.”
[clickToTweet tweet=”“Without making changes, 37% of people with prediabetes are likely to progress to full-blown diabetes within 4 years, and most will have the diagnosis within 10 years,” says @NutritionJill. Studies show we can change this.” quote=”“Without making changes, 37% of people with prediabetes are likely to progress to full-blown diabetes within 4 years, and most will have the diagnosis within 10 years,” says Weisenberger. Diabetes prevention studies show we can change this.”]
Finding Doable Steps to Deal with Prediabetes
If someone with prediabetes is truly concerned about the health risks that could lie ahead, but struggles with the idea of changing eating habits, what do you suggest? 
Do you recommend starting with a few small changes, or do you think it’s better to select just one or two steps that could have the most dramatic effect on health?
“If lifestyle changes were easy, everyone would have healthy habits. We’d all be trim, exercise daily and eat fruits and vegetables with every meal. But it’s not easy. And it’s not likely to suddenly get easy. That’s why it’s smart to pick a few things – or even one thing – to work on at a time.”
“It’s okay to pick something very, very small. Just pick something and get started. I rarely see someone who makes lots of radical changes at once be successful in the long term. Short term, yes, but what’s the point of that? It’s a huge waste of time and energy to make difficult changes only to later toss them aside and end up right back where you started.”
“To start moving forward, you may want to pick something easy to accomplish. Maybe you don’t get much exercise, but you think that walking 5 minutes before work will be a breeze. Then do that and give yourself praise for forming a new routine. Then pick something else. Or maybe you want to start with something harder that you think will have big results – like trading in sugary drinks for calorie-free drinks. It doesn’t matter what you do. What matters is being consistent with your changes.”
“In my book [on prediabetes], I show step-by-step ways to make changes in a personalized way. I show readers how to pick goals, plan for them, assess their progress, look for obstacles and more. We start off looking at their broad goals and desires and break down the steps to get there.”
What about weight? 
Weight is often – but not always — beyond the recommended healthy range in people with prediabetes. For those who have already spent years trying to lose weight but not achieving any loss, or losing and regaining it all, what is your advice?
“Some people are fed up with trying to lose weight and don’t want to try anymore. To this person, I suggest simply focusing on healthy habits such as daily movement, tons of vegetables, a plant slant diet, more home-prepared meals, a good night’s sleep and those types of things. The important things are healthy living and to avoid further weight gain. An awful lot of good comes from healthy living. Weight loss isn’t everything. But by focusing on the process of living healthfully and not focusing on the weight, some weight may come off anyway.”
Do you have any success stories to share that can inspire people with prediabetes?
“Lots of success stories. Here’s an interesting one because the woman doesn’t fit the typical profile of someone with prediabetes. She is very, very slim and a daily exerciser. She tries to eat well and usually does. When she came to see me, her A1C was 6.2%. This is a measure of her average blood sugar level for about 3 months. The prediabetes range is 5.7% to 6.4%, so you can see that she was pretty far into the prediabetes range. (Diabetes is defined by an A1C of 6.5% or higher.) This is some of what she did:
- Ate more defined meals and snacks instead of grazing throughout
- Ate fruits and/or vegetables with every meal and snack
- Included more oats and barley
- Ate legumes several times per week
And the results were stunning. In only several weeks, she dropped her A1C all the way into the normal range. We were both thrilled with the beautiful result of 5.4%!”
“Other clients have watched their blood sugar levels drop by making different changes such as adding a 20-minute walk after a meal, or trading in packaged snack foods for fruits or nuts, or following a Mediterranean-style eating plan. Usually, it takes a combination of strategies for the best results. There are lots of ways to get to the same place. And that’s what I show in my book. Each person can find his or own path, but the important part is to stay with it. Consistency is key.”
What prompted you to write your latest book, focusing specifically on prediabetes?
“Prediabetes: A Complete Guide covers nearly all of my passion points. It’s empowering, not punishing. It’s all about prevention and confidence and healthy living. And it gives the reader structure and flexibility at the same time. We cover weight loss, but we also cover the benefits of healthy eating and exercise that have nothing to do with weight loss. (They help prediabetes even without weight loss.) I focus on a positive mindset, building habits and changing behaviors. Prediabetes: A Complete Guide gave me a chance to put what I do with patients and clients into a single book. I think the subtitle describes the content so well: Your Lifestyle Reset to Stop Prediabetes and Other Chronic Illnesses.”
Bottom Line on Prediabetes:
Prediabetes is not a diagnosis that any of us want to get. But don’t avoid testing or ignore the diagnosis in hopes it will go away. Accept it as a heads-up that now is your moment to make changes – doable steps – that can make a difference in having the health to live the life you want.
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*My sincere thanks to my friend and colleague, Jill Weisenberger, for sharing her knowledge here. You can read her blog and find information about her prediabetes book on her website. I have not been paid to share news about the book, and receive no financial benefit from sales. I simply like to share news about solid information that can help support good health.
Photo credits:
Fork in road: Copyright: <a href=’https://www.123rf.com/profile_ardisd’>ardisd / 123RF Stock Photo</a>
Tape measure: Copyright: <a href=’https://www.123rf.com/profile_gioiak2′>gioiak2 / 123RF Stock Photo</a>
Mountaintop success: Copyright: <a href=’https://www.123rf.com/profile_blasbike’>blasbike / 123RF Stock Photo</a>
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