Can diet and exercise reverse prediabetes？
Prediabetes increases the chance of type 2 diabetes. Untreated prediabetes may damage the heart and blood vessels. Is it fixable? Can diet and exercise change this?
Type 2 diabetes is one of the biggest health challenges of the 21st century. 380 million people will have diabetes by 2025. Its care and treatment are becoming more significant as a risk factor for many other illnesses and chronic health disorders, including cardiovascular disease, renal disease, stroke, and blindness.
If prediabetes leads to type 2 diabetes, can diet and exercise cure it? Healthline Media and Medical News Today managing editor Angela Chao shared her prediabetes reversal and lifestyle changes.
Thin, young, and active, Angela does not fit the traditional prediabetes or diabetes risk profile. She said her lifestyle was sedentary. However, several doctors and her medical acquaintances became worried about prediabetes threshold changes.
"The diagnosis woke me up." "Whether or not the threshold has changed, you must increase your physical activity and make some lifestyle modifications to return to a healthy range."—Angela Chao
Prediabetes definitions vary by nation and are continually changing. A few years ago, the WHO recommended hemoglobin A1C for diabetes diagnosis. Dr. Barber says doctors mostly utilize A1C, although glucose measurements may help. "In terms of prediabetes [in the U.K.], this is based on an A1C between 39 and 47 mmol per mol, and 39 is equivalent to 5.7%," he said. Hemoglobin A1C readings over 48 millimoles per mole (6.5%) indicate diabetes.
Angela had prediabetes with an A1C of 5.8%. Dr. Barber reminded us that diagnostic standards for diabetes have fallen over the years, and Angela's values at the time would not have been termed prediabetes in the UK since they were "not quite under cut-off but very close to normal."
Prediabetes symptoms?
Prediabetes might go unnoticed for months or years. It may go undiagnosed without testing.
Angela recounted:
I had little symptoms. I have drank water. I couldn't tell whether anything was changing." Before the diagnosis, she had low blood sugar, especially after long fasts.
Prediabetes may refer to fasting or post-meal glucose elevations. Dr. Barber said blood sugar swings were frequent with insulin resistance.
Who's at risk for prediabetes?
Obesity and overweight are established risk factors for type 2 diabetes. Age, stress, and high-glycemic meals and drinks increase risk. Ethnicity and genetics also matter.
"If you're sedentary and recline or lie down for most of the day, especially if you watch TV, which I think is the most sedentary activity, this can increase your risk." — Thomas Barber, Ph.D.
Dr. Barber and colleagues found that South Asians had the same chance of having diabetes at 23.9 as whites did at 30 in a UK research. Angela's family background raised her danger.
Dr. Barber said that lifestyle decisions are often blamed for diabetes, although it's a hereditary issue. Patients with a strong family history of type 2 diabetes may not fit the traditional phenotype: obese, middle-aged, male, and big abdomen.
Lifestyle changes reverse prediabetes.
Angela reversed her diabetes with "a combination of intermittent fasting, a balanced diet with an increased amount of lower-glycemic index foods and complex carbs, and a significantly increased level of physical activity." She did not change her diet and worked with a personal trainer on weight and resistance training.
She said, "No keto, strict dieting, or short-term drastic changes that are not sustainable."
"Angela's method worked, but it was accepted that few individuals could make such major life changes and would find it difficult. "We know that intensive lifestyle treatments with a focus on diet, physical activity, weight loss, etc., can prevent or at least delay the onset of type 2 diabetes," Dr. Barber said.
Dr. Barber says this is a message that lifestyles need to change. It's good if it inspires lifestyle changes.
資料來源：Yasemin Nicola Sakay(2023) — Fact checked by Hilary Guite, FFPH, MRCGP , “In Conversation: Can diet and exercise reverse prediabetes? ”. Medical News Today. https://www.medicalnewstoday.com/articles/in-conversation-can-diet-and-exercise-reverse-prediabetes