nutrition counseling for prediabetes

What to Do for Prediabetes

This article is provided for educational purposes only. If you have prediabetes or are concerned about having prediabetes, please consult with a physician. The following approaches are provided to increase knowledge and education regarding prediabetes and do not substitute for individualized medical advice.

In a recent article, I addressed the question, “What is PreDiabetes?” But, I didn’t discuss what to do for prediabetes. So, what if you’ve been told you have prediabetes? Or, maybe no one has told you that your blood sugar is high but you’ve noticed that it’s in the category of prediabetes. So, what should you do now?

First of all, don’t panic.

It’s easier said than done, right? Prediabetes sounds scary, and it is. You’re absolutely right to be scared.

  • Without intervention, 15-30% of people with prediabetes will develop type 2 diabetes in 3-5 years.
  • Over time, that risk increases, with experts estimating that 70% or more will progress to type 2 diabetes eventually.

Yes, prediabetes is scary. But, instead of panicking, it’s time to take action.

The Good News About Prediabetes

The good news is that prediabetes does not have to progress to type 2 diabetes, and prediabetes can be reversed. But, to do that, you have to heed the wake up call, and take action.

The key is to be informed, and take action where you have the most control. So, let’s look at the diabetes risk factors with this in mind.

Risk Factors

The risk factors for developing diabetes can be split into two different categories; those we can control, and those we cannot. Let’s start with the risk factors you can’t control.

Wish as we may, we can’t control these:

  • Your Age – Risk increases over the age of 45
  • Gender – Those born as a male have a higher risk than women
  • Ethnicity – African Americans, Native Americans and Latinos are at a higher risk.
  • Genetics – If your family has a history of type 2 diabetes, you are at a higher risk.

Okay, now that that’s out of the way, let’s see what we do have some control over.

The following increase your risk for diabetes:

  • Being overweight or obese (BMI ≥ 25)
  • Sedentary lifestyle
  • High blood pressure (≥130/85)
  • High triglycerides (≥150)
  • Low HDL cholesterol (<40) (AKA – the “good” cholesterol)
  • Sleep deprivation (<7 hours per night)
  • Smoking

The Diabetes Prevention Program

Now that you know the risk factors for diabetes, start thinking about your own risk factors. What are some changes you could make to reduce your own risk? You might not know the answer, and that’s okay. But it’s still good to reflect and identify areas that place you at an increased risk.

Fortunately, we can also look at the Diabetes Prevention Program (DPP) for a few clues on how to prevent diabetes and reverse prediabetes.

What is the Diabetes Prevention Program?

The DPP was a diabetes prevention study that was originally conducted from 1996-2001. It included 3,234 people with a high risk of developing type 2 diabetes. Each person was randomly assigned into one of three groups to test the effectiveness of varying treatments.

Those in the Lifestyle Change Group:

  • Tried to lose 7% of their weight
  • Exercised for 150 minutes per week
  • Received intensive training on healthy eating, stress management, etc.

A second group was given Metformin, a common medication for treating diabetes, which helps with blood sugar management by increasing insulin sensitivity, and decreasing glucose production in the liver. This group also received advice on diet and physical activity.

A third group was the placebo group. These participants were given a Metformin placebo, and then provided advice on diet and physical activity.

What Were the DPP Results?

After 3 years, the DPP showed that there was a decreased risk for both the Lifestyle Change Group and the Metformin group. But the Lifestyle Group actually had better results.

Compared to placebo:

  • The Lifestyle Group reduced their risk by 58%
  • The Metformin Group reduced their risk by 31%

Okay, so what’s the point? We started out talking about what to do for prediabetes, and now we’re here talking about a study on diabetes prevention. Well, if you want to know what to do for prediabetes, you might start by looking at what they did in the Diabetes Prevention Program. After all, the lifestyle group reduced their risk by 58% with lifestyle changes, alone.

What to Do for Prediabetes

First, it’s important to start out by speaking with your physician. That way you can work together to find the appropriate treatment for you. But secondly, let’s look at what the Diabetes Prevention Program has shown to be effective, in terms of lifestyle change.

Weight Loss

One of the main focuses of the diabetes prevention program was on weight loss. That’s because obesity and excess fat is associated with reduced insulin sensitivity, which then raises blood sugar.

The DPP targets a weight loss of 7%, which is supported through both diet and exercise. So, let’s put that into context with an example.

Let’s say I weigh 240 lbs, and my height is 5’10”. That would mean my BMI is 34, which falls into the obese category. If I lost 7% body fat, that would be about a 17 lb loss, bringing me to 223 lbs and a BMI of 31.

Now, in that example my BMI still falls into the obese category. So, ideally, I’d want to lose some additional weight to reduce my risk further. However, there’s still benefit to that initial weight loss of 17 lbs. Even a moderate amount of fat loss can improve insulin sensitivity and reduce your risk of diabetes and heart disease.

Okay, so how do you go about that weight loss? You’re best off incorporating am approach that includes both diet and physical activity.

Physical Activity

Physical activity can include a number of things. Yeah, we often think of going to the gym, or going for a jog, but physical activity can mean more than just that narrow definition. It can mean going for a bike ride with your daughter, taking a brisk walk on your lunch break, or maybe even doing some gardening.

The American College of Sports Medicine recommends a total of at least 150 minutes per week of moderate level activity. So, think about doing a brisk walk. You could do that 5 days a week, for 30 minutes. Or, you can break your activity up into smaller micro-breaks. So, maybe you take 3 10 minutes breaks per day to get some activity. You could do a quick at-home workout, run in place, or use a jump rope.

By breaking up your activity goals into smaller bite size pieces, it can become a lot more easier to achieve. Sometimes it’s hard to find 30 minutes of uninterrupted time. But most of us can find 10 minutes out of our day. And, a blast of activity will probably wake up your brain and boost productivity as well.


People often want the keys to a perfect diet. Unfortunately, there is no single best diet that’s perfect for everyone. But there are some patterns that we can identify when we look at healthy diets such as the Mediterranean diet, DASH diet, and others.

These diets tend to be higher in:

  • Vegetables
  • Fruit
  • Whole grains
  • Nuts and seeds
  • Fiber
  • Fish, or lean meat sources (instead of red meat)

Meanwhile, they minimize the intake of:

  • Red meat and processed meats
  • Refined grains
  • Packaged foods
  • Sugar-sweetened beverages (soda and juice)

Obviously, there is more to maintaining a healthy diet, but this gives us a foundation to start building on.

If you compare these elements of a healthy diet above to the average American diet, which is highly processed convenience foods, you’ll notice some incongruencies.

Test Yourself With the Plate Method

To get started with your own diet, take an inventory of your plate the next time you sit down to a meal. Draw an imaginary plate down the middle. That one half of your plate should be reserved for non-starchy vegetables like broccoli, green beans, or brussels sprouts.

Then divide the remaining part of your plate into quarters. One quarter should include a protein source, like salmon, lentils, chicken, or lean beaf. The remaining quarter is there for starchy foods like corn, peas, potatoes, or brown rice.

What does your plate look like?


How many hours of sleep did you get last night? Was it between 7-8 hours? If not, your body is not getting enough sleep, which can also reduce insulin sensitivity and increase your risk for diabetes.

Yeah, I know, it’s hard to sleep when you’re stress out with a lot on your mind. And let’s be honest – that’s something we all face right now. But, sleep is imperative to your health. The less sleep you get, the less time your body has to heal, and the more stress you get. Lack of sleep can become a vicious cycle.

So, what can you do about it?

First, set a sleep schedule and try as hard as you can to stick to it. Plan to be in bed every night at the same time and then get up at the same time in the morning. Getting into this routine can be challenging, but once you do, it’ll be easier to maintain.

Second, limit your screen time before bed. If you’re like me, you’ve been known to endlessly scroll through the news feed. But the light on your phone is not conducive to sleep, and reading the news right before you go to bed can increase anxiety, which also can interrupt your sleep.

Lastly, I almost forgot. If you’re increasing your physical activity level, that alone can help improve your sleep. All the more reason to get moving.

Changing Habits is Hard

There’s no doubt about it. Change is hard. Our habits are often established through years of repetition, which can make it very hard to alter course. But that doesn’t mean it can’t be done.

To change those habits it’s important to remember a few different things.

  1. You are capable of making healthy changes in your life.
  2. Success requires taking action. Taking action requires bravery. And, you are brave.
  3. Sometimes you’ll mess up, feel lost, or feel like you’ve failed. That’s just part of the process.
  4. Enjoy every success and learn from every failure.
  5. Rinse, refine and repeat.

If you’re interested in making a change, I recommend starting out by creating a personal wellness statement. This will help you to develop an image of what you want for the future. And with that you can develop a gameplay to reach it. Trust me, it’s a very powerful exercise. Change begins with you.

If you’re looking for more resources on prediabetes, I recommend checking out the CDC Diabetes Prevention Program. They offer classes in a number of communities.

I also recommend two books to get you started:

Additionally, stay tuned for future posts on diet and fitness.

If you have questions, please feel to contact me here.

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