Prediabetes To Diabetes – Can We Prevent Progression?

Type 2 diabetes is a rapidly rising problem across the world. It is expected that over 130 million people will be affected globally in the next decade.

A large majority of individuals who undergo  routine blood investigations are diagnosed  to have  slightly elevated blood sugar levels.  These individuals  suffer from a condition called prediabetes.  Prediabetes is a condition that precedes the onset of Type 2diabetes.

There is sufficient clinical evidence currently available to support the fact that performing a regular exercise and following a healthy diet can help prevent diabetes from developing. But before we look into how prediabetes  can turn into diabetes,  it is important for us to understand certain basic facts about prediabetes itself.

Prediabetes Is A Disease, Not Just a Diagnosis

We have discussed prediabetes in a great deal of detail here. However,  it is important to review certain important facts about this disease before we proceed further.

Firstly, prediabetes is accompanied by changes in the small and large blood vessels.  These changes increase the risk of development of heart disease, kidney disease  and stroke.

One particular marker  that is important in determining whether diabetes is affecting the vital organs is the presence of microalbuminuria. This is a state of microscopic quantities of protein leak through the kidneys into the urine.

In one clinical survey, it is found that  17.7% of people   with prediabetes had some form of kidney disease compared to just 10.6% of those without the condition.  Similarly, other clinical trials  have found that prediabetes can affect the nerve fibers and lead to polyneuropathy twice is more often compared to those who have normal blood sugars.

Eye changes have also been seen in prediabetes patients.

In a nutshell,  it appears that prediabetes seems to have similar effects on the vital systems  when compared to full-blown diabetes. This means that it is important to take certain steps  that can prevent the progression of prediabetes to diabetes.

What Are The Risk Factors  That  Promote Conversion of Prediabetes to Diabetes?

There are a multitude of factors that are responsible  for this change. it is usually a combination of  lifestyle, behavior, increasing age, environmental risk factors and level of education  that contribute to the shift from prediabetes to diabetes.

Below is a table that lists some of the conditions that can increase the risk of progression to diabetes..

FACTORS THAT INCREASE THE RISK OF PROGRESSION OF PRE-DIABETES TO DIABETES

1. Family history of diabetes

2. The presence of heart disease

3. Obesity or being overweight

4. Lack of exercise, sedentary lifestyle

5. Asian ethnicity 6. History of gestational diabetes

7. Polycystic ovarian syndrome

8. Certain medication such as anti-depressants and anti-psychotics

9. High blood pressure

10. High triglyceride and low HDL levels

Another important factor that is responsible for development of diabetes in adult hood is low birthweight. If we are born underweight, our body tries to catch up in order to reach the standard weight all of us should be at each particular age.  In an attempt to do so,  there is accumulation of great deal of fat in the body which is accompanied by resistance to the effects of insulin.

Obesity combined with insulin resistance can lead to diabetes in adult hood.

Preventing Progression of Prediabetes to Diabetes

So now that we have an understanding as to  the risk factors that promote the conversion of prediabetes in to diabetes, it is time for us to see what you can do to prevent this from happening.

Westernisation of the Indian diets has led to a dietary pattern and exercise routine that is very different to what was seen 3 to 4 decades ago. Our busy work lives leave little time to exercise, and eating out often is becoming the norm of society given the number of restaurants that keep cropping up all the time.

Change Your Diet

High intake of saturated fats, trans fats, salt and sugar all contribute to the development of obesity, type 2 diabetes and heart disease.

The solution is simple. Just cut out these bad elements from your diet and follow a healthy balanced diet. This should be your first step.

In the reputed Finnish diabetes study, adopting a diet that was low in fat and high in fiber significantly reduced the chances of turning prediabetes to diabetes. This was particularly seen when combined with increased physical activity.

Crash diets may work in the short term, but are terribly difficult to continue following in the long term. Furthermore, cutting down carbohydrates and certain kinds of fat only has short term benefits on health.

Follow a healthy, balanced diet. Eat the recommended quantity of fruits and vegetable, eat unrefined grains with high fiber content, use oils like olive oil or rice bran oil and consume fish for protein. A high fiber diet has been shown to reduce cholesterol levels and reduce spikes in blood sugar levels after meals. Achieving this can be hard, and certain supplements can help if you wish to take them.

Exercise Regularly

This is quite obvious advice. It is clearly evident that exercise has a number of benefits on overall health, and can control blood sugar increases and prevent type 2 diabetes.

Combine a cardio routine with a strength training routine. In other words, brisk walk and light weight training can help. Any activity of moderate intensity can help. Yoga can help but only when combined with a strict aerobic exercise routine.

The recommended exercise duration is 150 minutes per week. However, if you are serious about your health, crank it up to 60 minutes a day. It works better.

Read more on how exercise can reverse diabetes here.

Lifestyle Change

Next, change your lifestyle by altering your daily exercise routine. Try and walk everyday for at least 30 to 60 minutes a day. If you cannot achieve that, cover at least 10,000 steps a day by using a pedometer or a cool gadget like a Fitbit. There is sufficient evidence that exercising at moderate intensity can help prevent progression of prediabetes to diabetes, and possibly even reverse diabetes itself. can fitbit control diabetes

In a Finnish diabetes study, it was found that regular diet and exercise reduced the risk of progression of pre-diabetes to diabetes by 58%. In another study that looked at the use of single drug medical therapy versus lifestyle changes in patients with pre-diabetes, the incidence of diabetes developing was significantly lower in the lifestyle intervention group as compared to those taking medicines.

One primary reason why lifestyle changes help in prediabetes is the weight loss that accompanies it. A beneficial effect is seen even with the slightest weight loss, so make sure you do everything you can to reduce your body weight.

Medicines

Certain medicines such as metformin and acarbose are useful in preventing progression of prediabetes to diabetes. We have not gone into details regarding this here, but there are a number of different medicines that can help.

But why resort to those when you can just change the way you lead your life?

Weight Loss Surgery

Bariatric surgery has a number of different benefits, and has been proven to reverse diabetes. While the benefit seems to be mostly in people with diabetes, this is likely to extend to those with prediabetes. Weight loss surgery can reduce the chances of developing diabetes by 87% in those with prediabetes.

Closing Remarks

Prediabetes carries a similar risk to diabetes when it comes to complications. Simple measures can help reduce the chances of progression of prediabetes to diabetes.


References

Prevalence of chronic kidney disease in US adults with undiagnosed diabetes or prediabetes. Plantinga LC, Crews DC, Coresh J, Miller ER 3rd, Saran R, Yee J, Hedgeman E, Pavkov M, Eberhardt MS, Williams DE, Powe NR, CDC CKD Surveillance Team Clin J Am Soc Nephrol. 2010 Apr; 5(4):673-82.

Diagnosis and management of prediabetes in the continuum of hyperglycemia: when do the risks of diabetes begin? A consensus statement from the American College of Endocrinology and the American Association of Clinical Endocrinologists. Garber AJ, Handelsman Y, Einhorn D, Bergman DA, Bloomgarden ZT, Fonseca V, Garvey WT, Gavin JR 3rd, Grunberger G, Horton ES, Jellinger PS, Jones KL, Lebovitz H, Levy P, McGuire DK, Moghissi ES, Nesto RW Endocr Pract. 2008 Oct; 14(7):933-46.

Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. Tuomilehto J, Lindström J, Eriksson JG, Valle TT, Hämäläinen H, Ilanne-Parikka P, Keinänen-Kiukaanniemi S, Laakso M, Louheranta A, Rastas M, Salminen V, Uusitupa M, Finnish Diabetes Prevention Study Group N Engl J Med. 2001 May 3; 344(18):1343-50.

Meta-analysis: the effect of dietary counseling for weight loss. Dansinger ML, Tatsioni A, Wong JB, Chung M, Balk EM Ann Intern Med. 2007 Jul 3; 147(1):41-50.

Bariatric surgery and prevention of type 2 diabetes in Swedish obese subjects. Carlsson LM, Peltonen M, Ahlin S, Anveden Å, Bouchard C, Carlsson B, Jacobson P, Lönroth H, Maglio C, Näslund I, Pirazzi C, Romeo S, Sjöholm K, Sjöström E, Wedel H, Svensson PA, Sjöström L. N Engl J Med. 2012 Aug 23; 367(8):695-704.

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