Can diet and exercise reverse prediabetes?

 

Diabetes — specifically type 2 diabetes— is becoming one of the most challenging health problems of the 21st century. By 2025, 380 million people worldwide are expected to be diagnosed with diabetes. 

As diabetes is a risk factor for many other diseases and chronic health conditions — cardiovascular disease, renal disease, stroke and blindness to name a few — its management and treatment is ever more crucial. 

Before people go on to develop type 2 diabetes, many people are considered in a precursor stage called prediabetes. Prediabetes is a condition where blood sugar levels are higher than normal but not quite high enough to classify as diabetes. If left unchecked, prediabetes can develop into type 2 diabetes. Thus it is a warning sign that an individual is at an increased risk of developing type 2 diabetes. If it goes unmanaged, prediabetes can lead to long-term damage, including to the heart and blood vessels.

Prediabetes usually does not present with symptoms. However, in some cases, people may experience frequent thirst, get up at night to pee, experience sugar spikes, or crashes in energy levels. 

Being overweight or having a high BMI, or having obesity are some of the most well-known risk factors for developing prediabetes and type 2 diabetes. 

“Also age — the older we get, the more at risk we become. And the reason for this is that, as we age, insulin becomes slightly less effective, and its receptors and the beta cells cannot function quite as well. So, the risk of developing prediabetes and diabetes increases as we get older,” said Dr. Thomas Barber, associate clinical professor at Warwick Medical School and consultant endocrinologist at University Hospitals Coventry and Warwickshire.

Dr. Barber also said that stress and having a diet high in high glycemic foods and sugary drinks can also increase risk. While on the other hand, having a diet rich in fiber and low in simple carbohydrates can prevent the onset of dysglycemia. 

“[If] you’re sedentary and you sit or lie most of the day, and particularly watching TV—which is, I think, the worst activity in terms of sedentariness— that can impact on risk. [B]eing sedentary can worsen the risk of insulin resistance, which is a risk factor for prediabetes and type 2 diabetes.”

Other factors to take into account are ethnic origin and genetics.

When there is a strong family history, patients will not necessarily fit the classic phenotype of type 2 diabetes — having obesity, being middle-aged, male and having a large abdomen.

Lifestyle changes to reverse prediabetes

 “We know that intensive lifestyle treatments [w]ith focus on diet, physical activity, weight loss, and so on, can really help in preventing, or at least delaying the onset of type two diabetes,” said Dr. Barber.

Increasing muscle mass via strength training can help with insulin resistance and improve insulin sensitivity. 

Dr. Barber said that the act of exercising and the release of myokines from muscles could mediate cardiometabolic benefits. 

Studies have shown that regular physical activity—and not only the high intensity kind—can help stabilize blood sugar and improve its management. 

“[W]hen we talk about exercise, most people think about going on a treadmill and doing a 5k run, [g]etting in a sweat, which you know, is good exercise, but actually the message should be avoidance of sedentariness,” said Dr. Barber. 

“[W]e know that when you’re standing, you burn more calories; it’s better for health. If you’re walking around, that’s even better,” he said.