Pre-diabetes occurs when the body stops processing blood glucose properly. As its name suggests, it can be regarded as a precursor to diabetes: people with the condition have an increased risk of developing type 2 diabetes (and cardiovascular disease, too).
However, the good news is that adopting sustainable healthy habits can, in many cases, help to prevent or delay the onset of type 2 diabetes.
In this article, we’ll focus on the habits that are helpful in managing weight to prevent diabetes.
Understanding pre-diabetes
Glucose is the body’s main source of energy. When we eat or drink, it enters our bloodstream, causing the pancreas to release the hormone insulin, which regulates the amount of glucose in the blood. If enough insulin isn’t produced or our cells don’t react well to it, the amount of glucose in the blood can rise to the level that is described as pre-diabetes.
There are several tests available to confirm pre-diabetes:
- A fasting blood glucose test (FBGT): a blood sample is taken to show the level of glucose in your blood. This is done as a fasting blood test (after 8–10 hours of not eating and only drinking water).
- Glucose tolerance test (GTT): If your fasting blood glucose test is high, your GP may arrange for you to have a GTT. This test looks at both a fasting reading and then at a one- and two-hour reading, after a glucose drink, to see your body’s response. This will take up to three hours.
- Hba1c: This non-fasting test can be taken at any time. It shows the average of your blood glucose level over a period of three months.
A person may be diagnosed with pre-diabetes if their:
- fasting blood glucose levels are between 6.1 and 6.9 mmol/L and;
- are less than 11.1 mmol/L for the glucose tolerance test.
Early detection of pre-diabetes presents the opportunity to adopt the healthy habits that can delay or prevent the onset of type 2 diabetes. It’s important to act quickly—the sooner you start, the sooner your risk level will decrease. Studies have shown that diabetic complications such as retinopathy and cardiovascular disease can already be present or developing before a diagnosis of diabetes is made. Early detection and treatment of pre-diabetes can be of great benefit in such cases.
Pre-diabetes has the same risk factors as type 2 diabetes. Some of these can be changed (are modifiable) while others cannot (are non-modifiable).
Modifiable risk factors include:
- having excess body fat
- having a larger waist measurement (greater than 80 cm for women and 94 cm for men)
- being physically inactive
- having high levels of triglycerides (a type of fat in your blood) and low levels of HDL-C (the ‘good’ kind of cholesterol)
- having high blood pressure
- smoking.
Non-modifiable risk factors include:
- having a close relative such as a parent or brother/sister with type 2 diabetes
- having an ethnic background of Aboriginal and Torres Strait Islander, Pacific Islander, Asian (e.g. Chinese), South Asian (e.g. from India, Pakistan or Sri Lanka), Middle-Eastern or North African
- age–although diabetes can develop at any age, the risk of this happening increases after the age of 35
- having Polycystic Ovarian Syndrome (PCOS)
- having had diabetes in pregnancy (gestational diabetes) or given birth to a big baby (more than 4.5 kg).
Treatment of pre-diabetes—reaching and maintaining a healthy weight
Managing weight to help prevent or delay diabetes can be achieved through following a healthy diet and being physically active.
Following a healthy diet
The goal is to eat nutritious foods, such as those that are high in fibre, polyunsaturated and monounsaturated fats and protein.
The Australian Dietary Guidelines and the Australian Guide to Healthy Eating provide information and advice about what a healthy diet is. The Guidelines recommend enjoying a wide variety of foods from the following five groups every day.
- Fruits
- Vegetables
- Grains—includes foods made from wheat, rice, oats, cornmeal, barley or other cereal grains. Examples include bread, pasta, porridge and cereals.
- Protein—includes lean meat, poultry, seafood, beans and peas, eggs, nuts and seeds
- Dairy—includes low-fat milk, yoghurt, cheese and fortified soy milk.
Drinking plenty of water is also beneficial.
The Australian Guide to Healthy Eating shows the ideal proportions of the five food groups.
It’s beneficial for people who are living with pre-diabetes to eat a wide range of foods from these groups that are high in fibre and low in the glycaemic index (GI). The glycaemic index shows how quickly the carbohydrates in a food are broken down and absorbed into the bloodstream. Foods with a high GI cause a rapid rise in blood glucose levels; foods with a low GI result in a slower, steadier rise.
Foods that are high in fibre can also help regulate blood glucose levels by slowing down the absorption of glucose into the bloodstream.
Foods that are both low GI and high in fibre include:
- almonds
- apples
- barley
- black beans
- broccoli
- carrots
- chia seeds
- chickpeas
- kidney beans
- lentils
- oats
- oranges
- pears
- quinoa
- spinach
- sweet potatoes.
Even with nutritious food, keeping an eye on portion control is important. Eating smaller, more frequent meals can also help prevent blood glucose spikes or drops.
There are certain foods that people with pre-diabetes should eat less often. These include:
- sugary drinks such as fruit juice and sports drinks
- biscuits, cakes and pies
- processed snacks such as chips and crackers
- white bread, white rice and white pasta
- foods containing trans fats such as frozen pizza and commercially fried food.
If you drink alcohol, it’s helpful to reduce the amount.
Being physically active
Exercise can be very beneficial for people with pre-diabetes. It can decrease insulin resistance, reduce blood glucose levels and enhance joint and muscle movement. It can also help with weight management, lower blood pressure and reduce the risk of heart disease. Additionally, exercise promotes improved mental health.
The Australian Government guidelines recommend that adults do at least 30 minutes of moderate intensity physical activity most days. Moderate intensity exercise is any activity that causes your heart to beat faster and makes you breathe harder. Examples are:
- cycling
- brisk walking
- gardening
- mowing the lawn.
As an alternative, you could do three short bursts of 10–15 minutes of activity.
Resistance training also supports weight management. Resistance training is any activity that makes your muscles work harder than usual, increasing their strength, size, power and endurance.
Resistance training can bring the following health benefits:
- improved stamina
- improved flexibility and balance
- bone growth
- reduced symptoms of depression and anxiety
- improved sleep.
It’s not hard to incorporate exercise into your daily life. Tips for doing so include:
- plan when you’re going to exercise
- do forms of exercise that you enjoy
- have a positive attitude: any increase in the amount of physical exercise that you do is helpful.
Don’t forget to speak to your doctor before starting any new type of physical activity. If you’re not used to doing exercise, start gently.
Conclusion
As pre-diabetes increases the risk of developing type 2 diabetes, taking steps to avoid or delay the former progressing to the latter makes a lot of sense. One of the most helpful steps you can take is to manage your weight by eating healthily and doing the recommended amount of exercise.
How can the Life! program help me avoid or manage pre-diabetes?
To avoid pre-diabetes and type 2 diabetes, it’s important to know your risk. The Life! program provides this health check that determines your risk of type 2 diabetes.
Life! is a free healthy lifestyle program that helps you improve your eating habits, increase your physical activity and manage stress. You can choose from a group course or the Telephone Health Coaching service.
Our experienced health professionals will help you make small changes to your lifestyle so that you can achieve your health goals and reduce your risk of type 2 diabetes and cardiovascular disease. Life! is funded by the Victorian government and managed by Diabetes Victoria. You can check your eligibility for the program here.
Sources
Diabetes – Pre-diabetes – Better Health Channel
What are the Australian Dietary Guidelines? – Dietitians Australia
Prediabetes Diet: Tips on Fiber, Carbs, Meat, Alcohol, and More – Healthline
