Do You Have Prediabetes?

Prediabetes means a person has a higher-than-normal blood sugar level but it is not yet high enough to be considered type 2 diabetes. According to the CDC, more than 1 in 3 Americans have prediabetes (PD). Of those individuals with prediabetes, more than 80% do not know they have it. If untreated, 37% of the individuals with prediabetes may have diabetes in four years and up to 70% of prediabetic persons will develop diabetes during their lifetime. Prediabetes significantly increases the risk of developing type 2 diabetes, kidney damage, and cardiovascular diseases. So, this is serious business indeed!  This blog will teach you nine science-backed, natural strategies to reverse prediabetes.

Three tests help to confirm the diagnosis of prediabetes or diabetes: a fasting blood glucose level, an oral glucose tolerance test, and the A1C (which measures your average blood glucose level over the past two or three months).

Test Results Speak Volumes:

Fasting blood sugar:

• Normal: less than 100 mg/dl
• Prediabetes: 100 to 125 mg/dl
• Diabetes: 126 mg/dl or above

A1C test:*

• Normal: less than 5.7%
• Prediabetes: 5.7-6.4%
• Diabetes: 6.5% or greater on two occasions

Oral Glucose Test

• Normal: Less than 140 mg/dl
• Prediabetes: an OGT test 2 hours (after eating) of 140-199 mg./dl
• Diabetes: Any value over 200 mg/dl.

*Please note: Kidney disease, liver disease, anemia, early and late pregnancy, and certain medications reduce the accuracy of the A1C test.  Thyroid medications decrease the accuracy of the A1C test. For individuals with these conditions, the authors recommend using two tests instead of just repeating the A1C test. Two consecutive tests or two different tests are needed to confirm the diagnosis of diabetes.

Risk factors:

• Impaired glucose test previously
• Being 45 or older
• Having a family history of diabetes
• Being overweight, especially having belly-fat
• Having a waist size greater than half your height
• Being sedentary
• Having high pressure and/or elevated triglycerides, or low levels of HDL cholesterol
• Having/had gestational diabetes or a baby weighing 9 pounds or more at birth
• Blacks, Latinos, Asians, Pacific Islanders, Native Americans, and natives of Alaska have a higher risk for diabetes.

Additional risk factors not commonly mentioned include sarcopenia (loss of skeletal muscle mass and strength), liver inflammation, a low level of vitamin D, and heavy alcohol consumption.

Dangers from Prediabetes

Just as diabetes affects virtually every body system and many vital organs including the heart, brain, kidneys, and liver, prediabetes also compromises many organs and systems. Prediabetes increases one’s risk of unwanted blood clots, stroke risk, chronic kidney disease, and cardiovascular diseases.  In other words, you do not have to develop frank diabetes to be in serious trouble. Even though one might not have any noticeable symptoms with prediabetes, trouble is brewing.  Over time, prediabetes:

• Impairs the ability of  blood vessels to dilate
• Damages both large and small blood vessels
• Increases risk of heart attack and stroke
• Damages kidneys as indicated by protein in the urine
• May lead to the development of neuropathy, or disease of the nerves, eventually leading to numbness, tingling, and burning sensation in your extremities, slowing of reflex, and muscle atrophy
• Greater risk of brain shrinkage that occurs with aging and diseases such as dementia
• Increases the risk for cancer by 15% ¹

Fully developed diabetes accelerates, intensifies, and increases the risk of the above conditions even more.

Prediabetes Harms the Brain

Prediabetes causes loss of brain cells.² In a study of 500,000 individuals (average age 58) with blood sugar levels in the prediabetes range were 42% more likely to experience cognitive decline over an average of four years. They also were 54% more likely to develop vascular dementia over an average of eight years. People with diabetes, meanwhile, were three times more likely to develop vascular dementia than people who had normal blood sugar levels. They were also more likely to develop Alzheimer’s disease.³

Insulin Made Simple

Insulin is the hormone the pancreas makes that allows our bodies to utilize and store glucose. Insulin lowers blood glucose levels by helping cells in the skeletal muscle, adipose tissue, and liver to absorb glucose from the bloodstream. It stimulates the liver and muscle tissue to store excess glucose as glycogen. Additionally, insulin also lowers blood glucose levels by reducing glucose production in the liver. Insulin also promotes the entry of amino acids and fatty acids into the cells. Whatever hinders insulin from performing its jobs is a disservice to the entire body because each cell needs fuel (glucose) to function correctly. The body suffers when deprived of this fuel.

Compromised Insulin Efficiency

When our fasting blood glucose (sugar) level rises to prediabetes levels, the doctor may refer to it as insulin resistance, a condition in which the body produces insulin but does not use it effectively. When people have insulin resistance, glucose builds up in the blood instead of being absorbed by the cells, leading to prediabetes or type 2 diabetes. What do the experts say causes insulin resistance? In simple terms, excess weight and lack of exercise significantly contribute to this condition. Saturated fats and trans fats are two dietary culprits that damage insulin receptors. Excessive amounts of cortisol can also do it. Belly fat plays an important role in insulin resistance and is more than just a storage area for future fuel. It produces hormones and inflammatory agents that can cause serious health problems such as insulin resistance, high blood pressure, elevated cholesterol, and cardiovascular disease.

To compensate for this problem, the pancreas releases more insulin. However, this does not help because the problem is that the insulin receptors on the cells are damaged. Unfortunately, excess insulin (especially if other cardiovascular factors are present) accelerates the process of atherosclerosis, increases the risk of cancer, and makes appetite more challenging to control. Eventually, the pancreas’ beta-cells that manufacture insulin become dysfunctional.

Lifestyle Changes Help

Professor Guangwei Li presented the results from the 23-year follow-up of the Da Qing Diabetes Prevention Study. It showed that people with impaired glucose tolerance who followed improved lifestyle interventions (dietary changes and regular exercise) had significantly reduced death rates from cardiovascular disease and all causes, compared to those in a control group.⁴  Professor Nick Wareham of Cambridge University, UK, and author of a linked comment on the study, describes the results as “a real breakthrough, showing that lifestyle intervention can reduce the risk of long-term cardiovascular consequences of diabetes.”⁵

Weight Loss Helps Prediabetes

Weight loss helps to reduce the risk of developing diabetes in individuals who are obese. If one is obese, losing 7-10% of his body weight is helpful even if he does not reach his ideal weight. A 200-pound man could lose 10 to 15 pounds and reduce his risk substantially. This is certainly achievable.

One study suggests that there can be a 58% reduction in the progression from prediabetes to diabetes on a program consisting of a healthful diet, regular exercise, and a 5-7% weight loss.⁶ If these lifestyle changes are not within your grasp, consider coming to Wildwood Lifestyle Center where a professional staff will make an achievable, tailor-made program that will help to reverse your prediabetes and improve type 2 diabetes.

Enjoy a Whole Food, Plant-Based Diet

As for lifestyle strategies, a healthful, plant-based diet and regular exercise remain the cornerstones in diabetes prevention and treatment. Meat-eaters have a significantly higher risk of developing diabetes compared with people who avoid meat.^{7 8} In contrast, a well-balanced, plant-based, high fiber diet (whole grains, whole fruits, vegetables, legumes, nuts and seeds) combined with exercise helps to reduce elevated glucose levels even when not accompanied by weight loss. At least six studies have demonstrated that a vegetarian diet improves A1C.⁹

Prediabetes and diabetes increase the risk of cardiovascular disease. Several studies show that consumption of a vegetarian diet is associated with lower blood pressure.¹⁰ Plant-based diets―i.e., eating patterns that emphasize legumes, whole grains, vegetables, fruits, nuts, and seeds, and discourage most or all animal products―are especially potent in preventing type 2 diabetes. They have been associated with much lower rates of obesity, hypertension, hyperlipidemia, cardiovascular mortality, and cancer. ¹¹ Additionally, a whole food, plant-based diet suppresses inflammation.¹² so common in obesity, prediabetes, diabetes, and hypertension.

Researchers from Loma Linda University examined 8,401 participants (ages 45-88 years) and followed them for 17 years.¹³  They discovered:

• Subjects who were weekly consumers of all meats were 29% more likely to develop diabetes than those who ate no meat.
• Subjects who consumed any processed meats (salted fish and frankfurters) were 38% more likely to develop diabetes.
• Long-term adherence (over a 17-year interval) to a diet that included at least weekly meat intake was associated with a 74% increase in odds of diabetes relative to long-term adherence to a vegetarian diet (zero meat intake).
• Although some of this might be attributable to obesity, the researchers found that “even after control for weight and weight change, weekly meat intake remained an important risk factor.”

When adopting a vegetarian diet, be sure to keep your B-12 and vitamin D levels within a good (not low normal) range.

Intact Grains

Replacing meat with refined grains and carbs is counterproductive. Brown rice is much better than white rice regarding blood sugar. Other intact grains (such as whole oats, barley, bulgur or cracked wheat, quinoa, and millet) improve blood sugar levels. Whole-grain bread made with more intact, coarsely ground whole grains reduced postprandial glucose in adults with type 2 diabetes more than whole-grain bread made with finely milled whole grains.¹⁴

Eat Whole, Low-Glycemic Fruits

People who consume two servings of whole fruit (not fruit juice) per day have 36 percent lower odds of developing type 2 diabetes than those who consume less than half a serving.¹⁵ Emphasize whole fruits that have a low glycemic index score: apples, berries, cherries, grapefruit, oranges, pears, and plums. Avoid fruit juices and seriously limit tropical and dried fruits with high glycemic index scores.

Watch the Fat

We need to eat fats to live, but a high saturated fat diet activates immune cells to produce an inflammatory protein, called interleukin-1beta. It acts on tissues and organs such as the liver, muscle, and fat (adipose) to turn off their response to insulin, making them insulin resistant.¹⁶

In contrast to saturated fats, monounsaturated fats help prediabetes and type 2 diabetes. A few studies show that incorporating almonds into the diets of participants with type 2 diabetes positively affected blood sugar and reduced the risk of cardiovascular disease.^{17 18} Unsalted nuts are the best because prediabetes increases the risk of heart disease and hypertension. It is much healthier to consume unprocessed nuts than nuts with added salt and oil. Usually, the serving size for nuts is a scant 1/4 cup or one ounce by weight.

Pistachios are high in monounsaturated fats. In a controlled, cross-over study, prediabetic participants who consumed pistachios for four months reaped health benefits. Compared to the participants on the control diet, those who ate the pistachios had significantly lower fasting blood glucose levels and improved measurements for insulin resistance. Consistent pistachio consumption has the potential to reduce the risk for undesirable clotting seen in prediabetes.¹⁹

Go Easy on the Salt

Everyone needs some salt for the nerves, heart, and muscle cells to function. Excessive sodium intake has been linked to increased risk for type 2 diabetes and Latent Adult Autoimmune Diabetes (LADA).²⁰ LADA is a form of type 1 diabetes in which an autoimmune process destroys the insulin-producing cells in the pancreas.

Unlike typical type 1 diabetes, it occurs in adulthood instead of childhood. Prediabetes increases the risk of chronic kidney disease. Excessive salt intake has been consistently linked to worsening kidney function and increased risk for heart disease. Salt intake accelerated kidney scarring in rats with chronic kidney disease.²¹

Your Teeth Are More than for Smiles!

Periodontitis is associated with the prediabetic condition. Good control in prediabetic patients can reduce the severity of periodontal disease. Diabetes is a significant risk factor for periodontitis. The risk of periodontitis in diabetes will be greater if blood glucose control is poor.²²

The relationship between diabetes and periodontal disease is bidirectional. Periodontal inflammation makes it more difficult to control blood sugar. Periodontal disease triples the risk of dying from heart and renal diseases in those who have elevated blood sugar! Treatment of periodontitis is associated with HbA1c reductions of approximately 0.4%.²³

Move to Live

Exercise just 30 minutes, five days a week, and improve your cells’ ability to respond to insulin. 150 min/week of moderate-intensity physical activity, such as brisk walking, showed beneficial effects in those with prediabetes. A study investigated the effectiveness of lifestyle interventions compared to metformin in lowering the risk of developing type 2 diabetes in prediabetic individuals. What were the results? The lifestyle intervention of exercise and 7% weight loss reduced the risk of prediabetes transitioning into type 2 diabetes by 58 percent. Metformin reduces the risk by 31%. In other words, exercise and 7% weight loss were nearly twice as effective than metformin. ²⁴

As you can tolerate, include some mild weight training and resistance exercise. Fifteen minutes of interval training alternating high-intensity exercise with lower-intensity exercise is beneficial if one can tolerate it. A short walk after each meal lowers the blood sugar just as effectively as one moderately paced 45-minute walk during the day.²⁵  Moderate-intense exercise reduces the amount of fat stored around the heart, in the liver, and in the abdomen of people with type 2 diabetes mellitus. Additionally, moderate exercise reduces the risk of chronic kidney disease and inflammation—all of which are important for individuals with prediabetes or diabetes.

Forward Look

Losing extra pounds, regular brisk exercise, and a healthful diet significantly improve the chances of elevated blood sugar in prediabetes returning to normal levels and reducing cardiovascular diseases. You are important! Perhaps with all of life’s responsibilities, burdens, and perplexities, prediabetes crept up on you. Now is your day of opportunity. Grab it! C.S. Lewis observed. “You can’t go back and change the beginning, but you can start where you are and change the ending.” What an encouragement! Too often, in the rush of life, we run on emergency-mode thinking. Now we need to breathe and devote some time to helpful self-care. You are definitely worth the investment!

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3. University College London. “Prediabetes may be linked to worse brain health: People with prediabetes, whose blood sugar levels are higher than normal, may have an increased risk of cognitive decline and vascular dementia, according to a new study led by UCL researchers.” ScienceDaily. ScienceDaily, 11 February 2021. <www.sciencedaily.com/releases/2021/02/210211195335.htm>.[↩]
4. Guangwei Li, Cardiovascular mortality, all-cause mortality, and diabetes incidence after lifestyle intervention for people with impaired glucose tolerance in the Da Qing Diabetes Prevention Study: a 23-year follow-up study. The Lancet Diabetes & Endocrinology, 2014; DOI: 10.1016/S2213-8587(14)70057-9[↩]
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19. Hernandez-Alonso M. Beneficial Effect of Pistachio Consumption on Glucose Metabolism, Insulin Resistance, Inflammation, and Related Metabolic Risk Markers: A Randomized Clinical Trial.  Diabetes Care. vol. 37:11, Nov. 1, 2014 https://diabetesjournals.org/care/article/37/11/3098/28838/Beneficial-Effect-of-Pistachio-Consumption-on[↩]
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