Here’s when to think beyond lifestyle changes for prediabetes.
A prediabetes diagnosis may rattle your nerves, but it’s actually something to be grateful for: It’s an opportunity to take action and improve your health before you have full-blown diabetes.
“When patients find out they have prediabetes, they’re naturally concerned,” says Sonal Chaudhry, MD, an endocrinologist at NYU Langone Health in New York City. “They want to know what they can do to reduce their risk further.”
The first step to reducing the risk of diabetes includes key lifestyle changes. These are your basic recommendations that docs advise everyone, like exercising regularly and eating a balanced diet rich in fruits, veggies, and whole grains. (Learn more lifestyle tips to manage and prevent diabetes here.)
The goal is to reverse the development of insulin resistance, which is when the body stops responding to insulin and therefore does not absorb enough glucose from the bloodstream. (Here’s more information on how insulin resistance affects the body.) While lifestyle changes for prediabetes can help many patients, these changes alone sometimes won’t cut it.
Medication for prediabetes may supplement exercise and diet tweaks to keep diabetes from progressing. Doctors may prescribe medication for prediabetes patients with the following criteria, according to Dr. Chaudhry.
Being overweight or obese
An A1C level greater than 6
A history of gestational diabetes
A common medication for managing prediabetes is metformin, which makes the body more sensitive to insulin, according to Minisha Sood, MD, an endocrinologist in New York City. This medication acts on the liver and muscles to decrease the amount of glucose taken in from food and made by the liver. By reducing glucose, says Dr. Sood, the body can use insulin more effectively, thus preventing type 2 diabetes.
The takeaway? If you’ve been diagnosed with prediabetes, you have options. You are not “doomed” to develop diabetes. While medication for prediabetes can help, your best tools are diet, exercise, and weight loss, according to the American Heart Association.
“Prediabetes means it can be reversed,” says Sandra Arévalo, RDN, a spokesperson for the American Association of Diabetes Educators. “Prediabetes is giving you the opportunity to make some changes and work on avoiding the diagnosis of diabetes.”
Dr. Chaudhry is an endocrinologist at NYU Langone Health in New York City.Minisha Sood
Dr. Sood is a board-certified endocrinologist in private practice in New York City and an assistant professor at Hofstra School of Medicine.Sandra Arevalo
Sandra Arevalo is a spokesperson for the American Association of Diabetes Educators and Academy of Nutrition and Dietetics and director of nutrition services and community outreach at South Bronx Health Center.
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When patients find out that they have
prediabetes, they're naturally concerned.
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They don't wanna develop type 2 diabetes,
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they wanna know what they can
do to reduce their risk further.
00:00:11,940 --> 00:00:18,750
00:00:18,750 --> 00:00:23,700
I sometimes consider treating patients
who have prediabetes with medicines.
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If they're overweight or obese, or
if their A1C levels are higher than 6, or
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if they have a history
of gestational diabetes,
00:00:31,000 --> 00:00:34,500
all of those factors really increase
the risk of type 2 diabetes,
00:00:34,500 --> 00:00:36,860
and I wanna minimize that
risk as much as possible.
00:00:36,860 --> 00:00:39,923
If I consider treating a patient
with prediabetes with medicine,
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I usually will treat them with metformin.
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what it does is it makes the body
more sensitive to insulin.
00:00:45,190 --> 00:00:46,860
It mainly acts at the liver level,
00:00:46,860 --> 00:00:51,840
a little bit at the muscle level, to
improve how insulin works in those organs,
00:00:51,840 --> 00:00:54,580
and so, blood sugar can get
to where it needs to be.
00:00:54,580 --> 00:00:56,850
And insulin can be
effective in those organs,
00:00:56,850 --> 00:00:59,420
If you are told that you have
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prediabetes, it's actually good news.
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Don't take it the wrong way because
prediabetes means it can be reversed.
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We detected something
before diabetes starts.
00:01:09,190 --> 00:01:14,152
Prediabetes is giving you
the opportunity to make some changes and
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work on avoiding
the diagnosis of diabetes.
00:01:17,525 --> 00:01:23,749
Medication or lifestyle changes for pre-diabetes. Dallas, TX: American Heart Association, 2016. (Accessed on January 19, 2018 at http://www.heart.org/HEARTORG/Conditions/More/Diabetes/AboutDiabetes/Medication-or-Lifestyle-for-Pre-diabetes_UCM_461537_Article.jsp#.WmInF5M-fBI.)
Metformin. Washington, DC: U.S. National Library of Medicine. (Accessed on January 19, 2018 at https://medlineplus.gov/druginfo/meds/a696005.html.)Prediabetes & insulin resistance. Bethesda, MD: U.S. Department of Health and Human Services, 2009. (Accessed on January 19, 2018 at https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance.)