Diabetes, a condition in which the body cannot control blood glucose levels, is a leading cause of death and disability worldwide.
In 2021, 529 million peopleTrusted Source had diabetes, and the number is forecast to rise to 1.31 billion by 2050. Of these, some 96% have type 2 diabetes, a condition that is often linked to lifestyle factors, such as poor diet, overweight and obesity, or lack of exercise.
According to the Centers for Disease Control and Prevention (CDC)Trusted Source, more than one in three American adults has prediabetes, where blood glucose levels are above healthy levels, but not high enough to be classed as type 2 diabetes. Of these, around one-third will progress to type 2 diabetes.
Now, an Indian study, published in The Journal of Diabetes & Metabolic Disorders, has found that if people take steps to control their prediabetes within 2 years of diagnosis, they have a good chance of preventing it progressing to type 2 diabetes.
Jack Ogden, MBChB, BSc, LLM, IBLM, MRCGP, a primary care physician with a specialization in diabetes, from The Lagom Clinic, Bristol, United Kingdom, who was not involved in this research, commented to Medical News Today that:
“The study employs a well-constructed retrospective cohort using 10 years of electronic medical record data from a closed urban population. The use of multi-state modeling is robust, with transitions aligning well with other cohort studies. However, there are some limitations to consider, such as reliance on opportunistic testing, potential selection bias, and limited generalizability due to the specific population studied. This study was only in a small area of India with its own culture and food preferences, making its less generalizable to many other people.”
What are the signs of prediabetes?
Most people with prediabetes do not experience symptomsTrusted Source.
However, a few people are diagnosed following symptoms that may include:
increased appetite
unexplained weight loss/weight gain
high body mass index (BMI)
weakness
fatigue
sweating
blurred vision
slow healing cuts or bruises
recurrent skin infections/gum bleeding.
Because prediabetes is usually symptom-free, Ogden advised that “it’s crucial to focus on risk factors like being overweight, having a family history of diabetes, or conditions such as hypertension.“
“Testing is generally recommended from the age of 35, or earlier for individuals with these risk factors. For higher-risk populations, such as South Asians, earlier testing from around age 25 may be appropriate,” he told MNT.
For most, the condition will be detected by a blood glucose test — the hemoglobin A1c, or HbA1c testTrusted Source. This simple blood test shows average blood glucose levels over the preceding 3 months, with the results given as a percentage, as follows:
normal blood sugar — below 5.7%
prediabetes — between 5.7 and 6.4%
type 2 diabetes — above 6.4%.
Controlling blood sugar levels in prediabetes is key
Type 2 diabetes is far more common in people who have had prediabetes than in those who have normal blood glucose levels, so lifestyle changes that reverse prediabetes are key to preventing it progressing to the more serious condition.
“Preventing progression to type 2 diabetes requires prompt lifestyle modifications. Aiming for 5-10% weight loss, engaging in at least 150 minutes of physical activity per week, and focusing on a diet rich in whole grains, vegetables, and lean proteins can be impactful. Addressing lifestyle factors such as sleep quality, stress management, and smoking cessation is also vital.”
– Jack Ogden, MBChB, BSc, LLM, IBLM, MRCGP
Studies have shown that several lifestyle interventions are effective in reversing prediabetes in adults. These include:
weight lossTrusted Source — keeping to a healthy weight (BMI of less than 25) or, if overweight, losing 5-7% of your body weight
increasing your physical activity — one study found that just 150 minutes of exercise a week could bring blood glucose back to healthy levels
following a healthy diet, such as the Mediterranean or DASH diet, which focuses on complex, fiber-rich carbohydrates and healthy unsaturated fats, while restricting sugars, processed foods, and saturated fats
getting adequate sleep.
“Nutrition (whole foods, balanced intake, moderated caloric load), mindful movement, and lifestyle stewardship aren’t just wellness buzzwords but proven intervention tools,” advised Barbara Eichorst, MS, RD, CDCES, vice president of health care programs at the American Diabetes Association, likewise not involved in the recent study.
Alternatively, if lifestyle changes are ineffective, medications such as GLP-1 agonists, AGIsTrusted Source, biguanides such as metformin, lipase inhibitors, and fenofibrateTrusted Source, can also reverse prediabetes.
Reinforcing findings from other studies
This study is not alone in suggesting that lifestyle modifications can be very effective, as Eichorst emphasized:
“Results from the landmark Diabetes Prevention ProgramTrusted Source show that individuals at high risk for type 2 diabetes who engaged in a structured lifestyle-change program like modest weight loss (about 7% of body weight) plus about 150 minutes per week of physical activity, reduced their risk of developing type 2 diabetes by 58% over three years, compared with placebo.”
“What’s more,” she added, “these benefits endure. Long-term follow-up demonstrated that the lifestyle intervention continued to delay onset of diabetes and reduced long-term incidence over 10 to 15 years.”
“These findings powerfully affirm that through intentional, consistent choices around nutrition, physical activity, and weight management, many people with prediabetes can significantly delay progression to type 2 diabetes,” said Eichorst.
Act fast to avoid type 2 diabetes
The longer a person has had prediabetes, the harder it is to reverse it, so Ogden advised that taking steps as soon as prediabetes is diagnosed is key.
“The study emphasizes the importance of timely action, particularly within the first 2-3 years of a prediabetes diagnosis, as this period is the most effective window for reversal,” he pointed out.
“It also underscores that, despite healthcare accessibility, approximately 30% of individuals with prediabetes progress to diabetes within a decade, whereas up to 60% revert in the early stages. This highlights the potential for targeted, early interventions to yield significant benefits,” added Ogden.