What is pre-diabetes?

Pre-diabetes is a condition in which blood glucose levels are:

  • Higher than normal; and
  • Not high enough to be diagnosed as type 2 diabetes.

(Source: Diabetes Australia)

If you are diagnosed with pre-diabetes, it means that you have a 10 to 20 times greater risk of going on to develop type 2 diabetes (Source: HealthDirect).

Are there any symptoms for pre-diabetes?

There are no symptoms for pre-diabetes. If a doctor suspects that their patient has type 2 diabetes, they will order a blood test that can also detect pre-diabetes. At that point, the doctor and the person with pre-diabetes can work together to prevent pre-diabetes from developing into type 2 diabetes.

Are there signs that pre-diabetes has developed into type 2 diabetes?

It is strongly recommended that you see your doctor regularly if you have been told that you have pre-diabetes, and especially if you have one of the following new symptoms:

  • Feeling thirsty;
  • Urinating a lot;
  • Feeling exhausted; and
  • Blurred vision.

What are the risk factors for pre-diabetes?

Pre-diabetes shares the same risk factors as type 2 diabetes, which means that a person is at a higher risk of pre-diabetes if they:

  • Have a family history of type 2 diabetes; 
  • Have an unhealthy weight;
  • Have a larger waist measurement;
    • in Caucasian men – greater than 94 cm
    • in Asian men – greater than 90 cm
    • in women – greater than 80 cm
  • Engage in a low level of physical activity;
  • Smoke;
  • Have high blood pressure and/or high cholesterol (blood fats);
  • Have been diagnosed with gestational diabetes (diabetes during pregnancy);
  • Have polycystic ovary syndrome; and
  • Are taking some antipsychotic medications.

 (Source: BetterHealth)

What happens if I ignore pre-diabetes?

Not taking the steps to manage pre-diabetes increases the likelihood of developing type 2 diabetes and/or cardiovascular disease (CVD).

Type 2 diabetes is a condition in which cells within the body have a resistance to insulin and/or the body isn’t able to make enough insulin to meet the needs of the person to keep blood glucose levels within range.

CVD includes a number of conditions that involve narrowed or blocked blood vessels leading to complications, including;

  • Coronary heart disease
  • Heart attack
  • Heart failure
  • Stroke
  • Arrhythmias – abnormal heartbeats
  • Aneurysm – a bulge caused by a weakening of the heart muscle or artery
  • Septal defect – an abnormal opening between the left and right sides of the heart;
  • Peripheral vascular disease – a disease of the large blood vessels of the arms, legs, and feet
  • Rheumatic heart disease – caused by rheumatic fever, and mainly affecting the heart valves and
  • Congenital heart disease – defects or malformations in the heart or blood vessels that occur before birth.

How can I manage pre-diabetes?

There are many ways to manage pre-diabetes. Outlined below are some of the ways to help to improve your health and reduce your likelihood of developing type 2 diabetes, heart disease and stroke.

Physical Activity

Exercise is important for managing pre-diabetes. Try to aim for at least 30 minutes of moderate-intensity physical activity each day of the week. This could be organised into:

  • Shorter sessions: 10 minutes, 3 times per day
  • Longer sessions: 30 minutes (or more)/day, every day of the week

Exercise can be performed in many different ways, whatever you most enjoy; such as dancing, individual/team sports, swimming, aerobics, personal training, gym sets, gardening, etc. The only requirement is that it is a physical activity that gets your heart pumping.

Quitting Smoking

It is very important for people with pre-diabetes to stop smoking. This is because you are at high risk of heart disease, and smoking further increases that risk. Stop smoking for 6 months and you are less likely to start again. Stop smoking for 2 years and you have a 96% chance of never smoking again.

If you are considering quitting smoking, we recommend you:

  • Call Quitline on 131 848 or visit the Quitline website
  • Talk to your doctor or chemist about additional options

Healthy Eating

In order to manage pre-diabetes, it is important to have a healthy diet that includes:

  • A wide variety of foods that include a range of colours;
  • Plenty of wholegrain cereals, vegetables, legumes and fruits;
  • Low-fat milk, yoghurt, cheese and/or dairy alternatives;
  • Lean meat, fish, poultry and/or meat alternatives;
  • Regular meals throughout the day. Irregular meals can lead to overeating at a single meal, or snacking on inappropriate foods;
  • Limited added sugar, honey, syrup and foods that are high in these ingredients e.g. soft drinks;
  • Limited highly refined and fatty foods (e.g. chocolates, cakes, biscuits, fried foods or foods with pastry);
  • No added salt to cooking or at the table; and
  • Limited alcohol intake (if you choose to drink).

Portion Sizes

According to the Australian Guide to Healthy Eating, it is important that a daily meals consist of servings* of:

  • Grain foods – mostly whole grain bread and high fibre cereals;
  • Vegetables and legumes/beans;
  • Lean meats, poultry, fish, eggs, tofu, nuts and seeds;
  • Fruit;
  • Reduced fat dairy products (milk, yoghurt, cheese and/or alternatives); and
  • A reduced amount of “extras”

Extra foods include:

  • Fried foods;
  • Baked goods such as cakes and muffins;
  • Sugar-heavy foods such as lollies or chocolate;
  • Savoury pastries;
  • Pizza;
  • Potato chips, etc.

Extra foods contain excessive amounts of energy from sugar, fat or salt. Try not to make them part of your everyday eating patterns and consume them in small amounts.

* Serving amounts vary depending on your age and sex. You can find the recommended portion sizes for:

Carbohydrates

Carbohydrates are your body’s preferred source of energy. When you eat foods containing carbohydrates, they get broken down into glucose (sugar) which is then absorbed into your blood. The glucose moves from the blood to cells where it fuels the body.

The best sources of carbohydrates to consume include:

  • Wholegrain foods such as multigrain bread and rolls, wholemeal pasta and rolled oats;
  • Fresh, tinned or dried fruit;
  • Starchy vegetables such as corn, sweet potato, potato or taro;
  • Legumes such as baked beans, kidney beans, chickpeas and lentils; and
  • Low-fat dairy products such as milk and no-added-sugar yoghurt. 

The Glycemic Index

The Glycemic Index (GI) is a rating of how quickly different carbohydrate foods are broken down in your body. People with pre-diabetes are encouraged to choose low Glycemic Index (low GI) foods. Low GI foods break down slowly into glucose, which causes a smaller rise in your blood glucose levels. In pre-diabetes, low GI foods help to keep blood glucose levels stable, allow you to feel fuller for longer, may help reduce blood fats, and assist with weight management and sports endurance.

Low GI foods include:

  • Rolled oats
  • Dense whole grain breads
  • Lentils and legumes
  • Sweet potato
  • Milk
  • Yoghurt
  • Pasta
  • Most types of fresh fruit
  • Doongara rice

(Source: Diabetes Australia)

Fats

It is important to consider the types of fats we eat. Fats contain a lot of energy, and can contribute to unwanted weight gain over time. People with pre-diabetes already have higher than normal blood glucose levels, and gaining weight can make this more difficult.

Try to:

  • Limit saturated and trans fats* as much as possible; 
  • Choose monounsaturated and polyunsaturated fats for cooking, but only in small amounts;
  • To get enough omega-3 fats, aim to eat oily fish 2-3 times per week
    • For example; Salmon, Mackerel, Tuna, Rainbow Trout, Sardines, Barramundi, Silver Perch, and some frozen fish fillets.
  • Up to 6 eggs per week

* Foods with unhealthy saturated/trans fats increase your risk of heart disease by significantly increasing your bad cholesterol.

Saturated fats are typically found in the following foods:

  • Butter 
  • Coconut oil 
  • Palm oil (often called vegetable oil in products) 
  • Processed foods, such as biscuits, cakes, pastries, pies, and takeaway foods 
  • Lard 
  • Ghee 
  • Copha 
  • Dripping 
  • Fat on meat  
  • The skin on chicken and other poultry 
  • Processed or deli-style meats, such as salami, ham, and bacon 
  • Cream 
  • Ice cream

Trans fats are found in several kinds of foods, including:

  • Deep-fried foods 
  • Biscuits, cakes and pastries 
  • Butter 
  • Takeaway foods, such as hamburgers, pizza and hot chips 
  • Foods that list ‘hydrogenated oils’ or ‘partially hydrogenated vegetable oils’ on the ingredients list. 

** Good fats such as monounsaturated and polyunsaturated fats are better for cholesterol levels, because they lower the bad cholesterol and increase the good cholesterol, reducing your risk of heart disease.

Foods that contain healthy monounsaturated fats include:

  • Avocados 
  • Unsalted nuts such as almonds, cashews and peanuts  
  • Olives  
  • Cooking oils made from plants or seeds, including: olive, canola, peanut, sunflower, soybean, sesame and safflower

Foods that contain healthy polyunsaturated fats (omega-3 and omega-6) include: 

  • Fish 
  • Tahini (sesame seed spread) 
  • Linseed (flaxseed) and chia seeds 
  • Soybean, sunflower, safflower, canola oil and margarine spreads made from these oils 
  • Pine nuts, walnuts and brazil nuts

Stress Management

High stress levels can raise your blood glucose levels and increase your risk of progressing to

type 2 diabetes. Stress arises when a person has to respond to demanding situations.

In order to manage stress, it is recommended that you:

  • Don’t ignore stress when it arises;
  • Identify what you can change about stressful situations;
  • Learn to moderate your physical responses to stress;
  • Engage in regular exercise and a healthy diet to decrease stress; and
  • Maintain your emotional reserves (i.e. relationships, goals, etc.).

How can the Life! program help me manage pre-diabetes?

The Life! program 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. 

The first step is to check your eligibility for Life! program with our free online test. The Life! program’ health check is an easy-to-use questionnaire that assesses your risk factors for pre-diabetes (as well as other conditions including type 2 diabetes and cardiovascular disease). This is a big first step towards improving your lifestyle so that you can manage pre-diabetes. 

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

https://www.diabetesaustralia.com.au/about-diabetes/pre-diabetes/

https://www.diabetesaustralia.com.au/living-with-diabetes/managing-your-diabetes/blood-glucose-monitoring/ 

https://www.healthdirect.gov.au/pre-diabetes

https://www.eatforhealth.gov.au/food-essentials/how-much-do-we-need-each-day/recommended-number-serves-children-adolescents-and 

https://www.eatforhealth.gov.au/food-essentials/how-much-do-we-need-each-day/recommended-number-serves-adults 

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/diabetes-pre-diabetes

https://health.act.gov.au/sites/default/files/2018-09/IGT%20Pre-diabetes%20booklet.pdf

https://www.eatforhealth.gov.au/guidelines/australian-guide-healthy-eating 

https://www.diabetesaustralia.com.au/food-activity/eating-well/what-should-i-eat/

Reviewers:

Elleni Kaias, Accredited Practicing Dietitian | Primary Care Engagement Lead

Kristie Cocotis, Head of Prevention and Health Promotion

Sarah Dubé, Strategy and Engagement Lead

Ria Cheripuram, Digital Communications Officer

Tegan Kohlman, Communications and Social Marketing Officer