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To answer How long does it take to reverse prediabetes1?’ you need to understand the process behind it and identify the responsible factors. Prediabetes is a widely prevalent health condition where a person’s blood glucose levels are higher than the normal prescribed limits, although not high enough for it to be diagnosed as diabetes.
A person is said to be prediabetic if their fasting blood sugar level ranges from 100 mg/dl to 125 mg/dl (5.6 mmol/L to 7.0 mmol/L). This condition is also known as Borderline Diabetes.2
Prediabetes is an ongoing health crisis worldwide. Over 470 million individuals are estimated to be suffering from this condition by 2030, according to peer-reviewed research published in the medical journal Lancet.
According to the CDC (Centres for Disease Control and Prevention), more than 1 in 3 American adults are prediabetic, with over 80% of them remaining completely unaware of their condition.
In addition, what makes the situation even worse is that it can go undetected without showing any apparent symptoms until it becomes too late to undo the damage. At this point, it takes the form of diabetes.3
1. Early Signs & Symptoms
The early-stage signs often get ignored by a large majority of the patients, and it is highly recommended you keep an eye out for them as soon as possible.
As the saying goes, ‘Prevention is better than the cure’. You don’t want to end up with a potential chronic health problem leaving permanent damage to your body and severely impacting your life.
1.1. Early Signs To Look For
- Increased hunger
- Increased urge to urinate/urinary tract infections
- Increased thirst
- Blurred vision
- Increased fatigue or exhaustion
- Dry mouth
- Numbness or burning sensations
- Slow wound healing
- Unusual weight loss
- Dark patches on the skin
- Skin tags
It’s important to acknowledge the early warning signals to pinpoint the cause, make the required changes in your lifestyle and diet, and seek available treatment options well ahead of time to stop developing diabetes.4
2. Prediabetes Diagnosis
If you have already noticed the warning signs, it is time to get a blood test done at your nearest clinic.
There are several different tests to diagnose prediabetes5. Over time, it can take one or more tests if you have varied symptoms and the test reading is abnormally high.
Your doctor may perform the following test(s) to confirm the diagnosis:
2.1. A1C Test
The A1C test–also known as the H1A1C test–determines your average blood sugar levels over two to three months. It does not require you to fast before the testing. The A1C test determines the percentage of glucose-coated hemoglobin proteins in your blood.
An A1C measure below 5.7% is considered as ‘Normal’, a range between 5.7% to 6.7% is diagnosed as ‘Prediabetes’, and a reading over 6.5% is a sign of diabetes.
2.2. Fasting Plasma Glucose Test (FPG Test)
An FPG test requires you to undergo overnight fasting before the blood sample is drawn. The fasting involves no food, or flavored/sugary drinks for at least 8 hours followed by the test, which is then conducted in the morning.
A fasting blood glucose level below 100 mg/dl is considered to be ‘Normal’, between 100 mg/dl to 120 mg/dl is diagnosed as ‘Prediabetes’, and any reading over 126 mg/dl is a sure sign of diabetes.
2.3. Glucose Tolerance Test
There are several variations of glucose tolerance tests primarily used to diagnose diabetes, metabolism disorder, insulin resistance, etc. However, the Oral Glucose Tolerance Test (OGTT test) is the most common way to diagnose gestational diabetes6 in pregnant women.
The process may require one or more steps in order to confirm the diagnosis. It is usually a 2- step process:
2.3.1. Oral Glucose Challenge Test
Also known as the glucose screening test, the Oral Glucose Challenge Test or OGCT requires you to drink a sugary liquid one hour before the blood sample is drawn.
If your reading comes out to be higher than normal, you need to return to the clinic for another 3-hour glucose tolerance test.
It doesn’t require fasting prior to the test.
2.3.2. Oral Glucose Tolerance Test
The Oral Glucose Tolerance Test or OGTT requires a fasting period of 8 hours before your blood sample is drawn for the test.
You will be asked to consume a sugary liquid afterward and your blood sample will be taken every hour for 2 to 3 hours.
An OGTT reading below 100 mg/dl is normal, between the range 100-125 mg/dl is prediabetes, and over 153 mg/dl is a diagnosis of gestational diabetes.
3. Causes
During the food intake process, your pancreas releases the hormone insulin, which allows sugar from your blood to enter your body cells and function as an energy source. This way, insulin aids in managing your blood sugar levels.
The main causes that may lead your body to show up visible signs of prediabetes include:
3.1. Insulin Resistance
Prediabetes is a sign that your body is losing its ability to use insulin as well as before. In prediabetes, your body cells do not have a normal response to insulin and this induces the pancreas to produce even more insulin in order to get the cells to respond.
When your body rejects insulin, your blood glucose levels rise resulting in prediabetes and if the process is allowed to continue, it may lead up to prediabetes and type 2 diabetes afterward.
3.2. Metabolic Disorder
Excess body fat, hyperglycemia, high levels of bad cholesterol, and insulin resistance can impact your metabolism which can later manifest into prediabetes. Cleveland Clinic, Ohio recommends getting certain necessary tests done including, lipid profile (triglycerides and HDL), blood pressure, and blood glucose tests to confirm the diagnosis.
4. Side Effects And Complications
If remain untreated for long, prediabetes can turn into type 2 diabetes and can cause further serious health conditions.
Some of the major complications that can occur include:
- Heart disease
- Ketoacidosis
- Nerve damage (diabetic neuropathy)
- Skin complications (infections, rashes, etc.)
- Eye complications (cataracts, glaucoma, etc.)
- Kidney disease (nephropathy)
- Foot infections
- Stroke
- Alzheimer’s disease
The good news is prediabetes can very well be reversed, provided one follows the recommendations of their healthcare provider with respect to dietary restrictions and exercise.
5. Are You At Risk?
Prediabetes can affect anyone, but there are certain pre-established factors that increase your chances of developing the condition. Researchers believe that lifestyle and genetic factors play a big role in this matter.
Some of the major risk factors may include:
- Bodyweight– If you are overweight, you are at the highest risk for prediabetes. A BMI or Body Mass Index of over 25 makes you all the more susceptible to getting the disease.
- Age– Research suggests individuals who are 45 and older are the most at risk.
- Waist size– Insulin resistance may occur in individuals with a large waist size–35 inches or more in women and 40 inches or more in men.
- Physical activity– A sedentary lifestyle can contribute to a greater risk, which further prevents your body to use up more glucose to produce energy.
- Race/Ethnicity– A CDC Report notes the higher prevalence of the condition among certain races/ethnicity. African-Americans, Hispanics/Latinos, Alaska Natives, and American Indians might be more prone to getting the disease for unknown reasons.
- Diet– Increased consumption of foods that are highly processed and carbohydrate-rich, red meat, and sugary beverages may increase your risk of getting prediabetes.
- Genetic factors– Your risk may increase multifold if you already have a parent or sibling at your home living with type 2 diabetes.
- Medical record– If you have previously suffered from certain underlying health conditions like sleep apnea, high cholesterol, polycystic ovary syndrome(PCOS), high blood pressure, and so on–it may indicate higher insulin resistance and may prepare the ground for diabetes.
Individuals who are overweight (BMI of over 25 kg/m2) and have any of the additional risk factors listed above should start getting tested for diabetes at the age of 45, according to the American Diabetes Association (ADA).
6. Treatment
6.1. Healthy Diet
Adopting ‘cleaner’ choices with regard to one’s diet can go a long way to regulating normal blood sugar levels and reversing the condition.
A diet consisting of fresh vegetables, fruits, lean meats, and whole grains can do wonders for your blood sugar control. A restriction in complex carbohydrate servings may prove useful for those with obesity, diabetes, or insulin resistance.
A British medical journal (BMJ) study confirms the fact that fruits like blueberries, apples, and grapes can lower the risk of type 2 diabetes and are good for your health. Ideally, fruits low in carbohydrates and added sugars should be preferred.
People who wish to lose weight and avoid the onset of type 2 diabetes are recommended to follow a low-fat and low-calorie diet plan, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
6.2. Regular Exercise
A sedentary lifestyle with little to no activity can be harmful as it may lead to unchecked weight gain and insulin resistance. Regular exercise can also help persons with type 2 diabetes minimize their dependence on oral medicines and insulin.
Prediabetes patients should consider low-impact workouts. It aids in the progressive management of blood sugar levels without triggering pain points or injury.
The CDC recommends at least 150 minutes of routine moderate-intensity physical activity per week which can help you:
- Lose bodyweight
- Lower blood sugar levels
- Enhance your memory
- Manage blood pressure
- Lower your LDL (bad cholesterol) and raise HDL (good) cholesterol levels
6.3. Weight Loss
The importance of weight loss measures in minimizing the risk of prediabetes can not be understated.
A loss of 7% of body weight and mild to moderate physical activity (150 minutes/week) can eliminate the risk of diabetes by up to 58%, according to research. A substantial reduction in diabetes risk as a result of lifestyle and drug-based intervention has been supported by the findings of several evidence-based trials.
6.4. Get Enough Sleep
Sleep apnea is one of the several risk factors linked with insulin resistance. It’s a serious disorder that obstructs your breathing patterns during sleep, and you are often required to take an oral appliance to keep the throat open.
The symptoms include gasping for breath, choking, snoring, etc. during sleep. It has been found that the blood sugar levels in persons with prediabetes improved following 2 weeks of continuous positive airway pressure (CPAP) treatment for sleep apnea, according to a study.
6.5. Stop Smoking
Smoking not only exuberates the risk of heart and lung-related disorders but is also associated with insulin resistance and type 2 diabetes risk.
The risk of diabetes is 30 to 40% higher in active smokers, according to a CDC report. One should take prescription medicines, seek help from support groups, and widely available alternatives like nicotine patches to lower the risk.
7. Conclusion
A diagnosis of prediabetes isn’t necessarily the end of the world. It doesn’t have to end up in diabetes. Your doctor can assist you in developing an effective plan to maintain your blood sugar levels and prevent diabetes in the long term.
Dr. Marilyn Tan, the chief endocrinologist at the Stanford Endocrinology clinic attributes this trend in part to the greater availability of more processed foods and increasingly sedentary lifestyles.
A healthy lifestyle combined with a proper nutrition regimen may take you around 4 to 6 weeks to start showing visible improvements in your blood sugar levels and insulin sensitivity.
FAQ
1. Can medications be used to reverse prediabetes?
A: Medications are not typically used to reverse prediabetes. However, in some cases, healthcare professionals may prescribe certain medications, such as metformin, to help manage blood sugar levels and reduce the risk of developing type 2 diabetes. Medications are usually combined with lifestyle changes for better results.
2. How often should I check my blood sugar levels if I have prediabetes?
A: The frequency of checking blood sugar levels may vary depending on individual circumstances and healthcare provider recommendations. In general, individuals with prediabetes may be advised to monitor their blood sugar periodically, such as once a year or as recommended by their healthcare provider.
3. Can prediabetes return after it has been reversed?
A: Yes, there is a possibility that prediabetes can return even after it has been reversed. It’s important to maintain a healthy lifestyle and continue with the recommended changes in the long term to reduce the risk of developing type 2 diabetes. Regular check-ups with healthcare professionals are also important to monitor blood sugar levels and overall health.
- Galaviz, Karla I., et al. “Interventions for reversing prediabetes: a systematic review and meta-analysis.” American journal of preventive medicine 62.4 (2022): 614-625. ↩︎
- Jarrett, R. J., et al. “Worsening to diabetes in men with impaired glucose tolerance (“borderline diabetes”).” Diabetologia 16 (1979): 25-30. ↩︎
- Flannick, Jason, Stefan Johansson, and Pål R. Njølstad. “Common and rare forms of diabetes mellitus: towards a continuum of diabetes subtypes.” Nature Reviews Endocrinology 12.7 (2016): 394-406. ↩︎
- Bonaventura, Aldo, and Fabrizio Montecucco. “The STOP DIABETES study: when prevention works.” Acta Diabetologica 56.5 (2019): 501-504. ↩︎
- Alberti, K. G. M. M. “Screening and diagnosis of prediabetes: where are we headed?.” Diabetes, Obesity and Metabolism 9 (2007): 12-16. ↩︎
- Ryan, E. A. “Diagnosing gestational diabetes.” Diabetologia 54.3 (2011): 480-486. ↩︎
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