- New research indicates that about 5 percent of people diagnosed with prediabetes develop type 2 diabetes within a year.
- However, experts say that risk increases over time if a person with prediabetes doesn’t adopt lifestyle changes such as a healthier diet or a regular exercise program.
- Experts say diet is usually the best place to start and changes should be made gradually.
Health professionals advise people diagnosed with
Experts also say these changes should be made sooner rather than later.
That’s because although prediabetes usually doesn’t initially progress to type 2 diabetes, prediabetes can develop into a more serious condition over time if action isn’t taken.
Researchers reported that slightly more than 5 percent of these people per year developed type 2 diabetes.
Researchers looked at blood sugar levels over time. Levels of hemoglobin A1C of 5.7 percent to 6.4 percent after fasting for 8 hours indicated prediabetes.
Older adults with obesity were at greater risk of developing diabetes after prediabetes diagnosis as were older Black adults, low-income seniors, and those with a family history of diabetes. Older adults with blood sugar between 6 percent and 6.4 on the A1C range were also at higher risk. Men also had a slightly higher risk when compared to women.
Experts point out that those numbers increase the longer someone waits to address the issue. The initial diagnosis helps health professionals individualize a program.
“That is a very surprising number since 37 million adults in the United States have diabetes and roughly 20 percent of them don’t even know they have it, according to the CDC,” Dana Ellis Hunnes, Ph.D., RD, MPH, a senior clinical dietitian at UCLA Medical Center and assistant professor at the UCLA Fielding School of Public Health, told Healthline.
“Having diabetes is extremely expensive and can be highly debilitating, so, yes, anything someone can do to prevent going from prediabetes to diabetes is absolutely worth it,” Hunnes said. “Anything a person can do to improve their health will help them avoid polypharmacy, or other expensive and debilitating chronic diseases, including heart disease or stroke.”
“I would urge anyone with a diagnosis of prediabetes to make every effort they can to avoid a worsening of that into diabetes, or of their health in general,” she added.
Dr. David Cutler, a family practitioner at Providence Saint John’s Health Center in Santa Monica, California, told Healthline prediabetes is easy for some to ignore. They shouldn’t.
“It’s important to recognize and address prediabetes while keeping its risk in perspective,” Cutler said. “Prediabetes is not a disease. There are rarely complications from prediabetes and no medication is necessary.”
“But this is a glass seen half full or half empty because 25 to 50 percent of people with prediabetes will [eventually] go on to develop… diabetes,” Cutler said. “You may ignore this problem counting on the fact that 95 percent of prediabetics each year do not progress to diabetes.”
“On the other hand, if you understand the risks of diabetes and want to take reasonable measures to prevent diabetes, then aggressively managing prediabetes is the logical thing to do,” he added.
Cutler said most doctors avoid medication with a prediabetes diagnosis, opting to recommend a better diet and more exercise.
“I do not think we label too many people as prediabetes,” Cutler said. “I think it’s a good warning to people to improve their health. And since overweight and obesity are somewhat predictive of prediabetes and diabetes and more and more people are becoming overweight and obese, I think having that diagnosis or that warning can be a good thing if it awakens people to the need for improving their diet and physical activity and other health behaviors.”
If they don’t, that’s when the problem can start, Dr. Eva Shelton, a resident at Harvard and Brigham and Women’s Hospital in Boston, told Healthline.
“However, some very simple changes can make drastic differences, such as switching from white rice to brown rice, from caramel macchiato to black coffee, and exercising a few times a week can decrease the risk of diabetes by 58 percent,” Shelton said.
“Some may also consider starting medications like metformin to help decrease blood glucose levels. These easy changes can prevent or delay diabetes down the road,” Shelton said. “Prediabetes and diabetes are on one spectrum and share similar risks such as increased risks for cardiovascular diseases like heart attacks or strokes.”
Dr. Lisa McAdams, the senior medical director at Zing Health – a healthcare provider specializing in Medicare-eligible older adults and people with disabilities – told Healthline overcoming diabetes starts progressively with diet.
“Start by looking at the food you eat and making some key changes,” McAdams said. “You don’t have to make huge changes all at once and you don’t have to completely avoid the foods that you love.”
“Start with small changes that you add to over time,” McAdam said. “Increase the fresh whole fruits, vegetables, and grains that you eat, and decrease processed foods, and foods that are high in saturated fats (meat and dairy).”
“Whole plant-based foods have more nutrients, including fiber, and will help you to feel full and satisfied with fewer calories,” she added. “Eating more of them and less processed foods, meat, and dairy will help you to drop a few pounds and reduce your risk of diabetes.”
Dr. Lindsay Harrison, a diabetes specialist with Texas Diabetes and Endocrinology, told Healthline it’s important to keep up with diet and lifestyle changes once the commitment is made.
“The benefits of intervention persisted over 10 years after the start of the study,” Harrison said. “There is evidence that reverting to normal glucose even briefly had a long-term reduction of progression to diabetes. Overall, lifestyle intervention is both effective and cost-effective.”
“Although lifestyle changes have not been shown to reduce morbidity or mortality thus far, lifestyle changes are generally beneficial and do not have adverse effects,” Harrison added.