Can prediabetes go away? Science has good news about a prediabetes reversal

Can prediabetes go away? The short answer is yes. But it doesn’t always, and sometimes it comes back. Here’s the scoop about reversing prediabetes.

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If getting the prediabetes diagnosis gave you a jolt, you’re not alone. It is jolting.

But there’s lots of good news too. But first, some details.

Prediabetes – which is characterized by blood sugar levels above normal but below the diabetes range – is your alarm bell ringing loudly, telling you to take action quickly. Taking smart action is how you can make prediabetes go away or get a reversal.

Prediabetes is a sign that something has been wrong for a while. Until now, the problem was invisible. But now it shows up in your blood sugar level, finally sounding that alarm bell. Most people who have prediabetes don’t know it. You at least know it’s time for action. That’s the first bit of good news.

So what’s the problem?

If you have prediabetes, you likely have two problems. Reversing prediabetes requires tending to both.

1. You have insulin resistance. The cells in various parts of your body stubbornly refuse to respond to insulin. So instead of readily allowing glucose or sugar to enter the cells, the sugar builds up in your blood.
2. You’ve lost some ability to make insulin. When you have prediabetes, the beta-cells of your pancreas still make insulin, but they don’t make as much as they used to.

What problem was going on before your blood sugar got to the prediabetes range?

You had insulin resistance.

But the beta-cells of your pancreas produced extra insulin. With high levels of insulin in your blood, your liver, muscle, and fat cells softened enough to let glucose in, so your blood sugar tests were normal. And the problem of insulin resistance was hidden.

It’s no longer hidden.

Eventually, the beta-cells started to fail. You no longer produce enough insulin to compensate for your insulin resistance. So now your blood sugar level is in the prediabetes range.

Insulin resistance can lead to prediabetes and then type 2 diabetes. But insulin resistance is also associated with other problems related to the heart, liver and blood vessels. Prediabetes is a risk factor for type 2 diabetes, heart disease and stroke.

It’s confusing because prediabetes is defined by blood sugar levels, but the problem is about more than just high blood sugar.

And all of that is why I say prediabetes is not pre-problem.

When is the best time for a prediabetes reversal?

Today. Yesterday was better, but we still have today.

The longer insulin resistance goes on, the more likely you’ll continue losing beta-cell function and the ability to produce insulin. And that is the driving force behind a prediabetes diagnosis becoming full-blown type 2 diabetes.

You reverse prediabetes and potentially bring on a remission when you dial back insulin resistance and keep those beta-cells healthy.

What science says about reversing prediabetes

There’s more good news here: Research tells us that reversing prediabetes is possible. In fact, a recent study, called PROP-ABC, showed that 43% of people with prediabetes turned their prediabetes around with lifestyle solutions only. Some of them had prediabetes for as long as 8 years.

The most significant natural strategies to turn prediabetes around in this and other studies probably won’t surprise you.

• be physically active
• eat well
• lose weight if you have overweight or obesity

What else is important?

• stop smoking
• metformin, a common drug for type 2 diabetes. Check out medications for prediabetes to learn when metformin might be appropriate.

Noteworthy research

Here’s some of the science around lifestyle changes and stopping prediabetes.

• In the US Diabetes Prevention Program (DPP), behavioral changes and weight loss led to a 58% reduction in the risk of developing type 2 diabetes. The participants’ goals were to exercise at least 150 minutes per week and to lose 7% – 10% of their starting weight (14 – 20 pounds for someone starting at 200 pounds). Even 15 years after the start of the study, participants in the lifestyle change group were 27% less likely to develop diabetes.

 

• The PROP-ABC study followed 223 subjects with prediabetes who also had at least one parent with type 2 diabetes. The participants were guided to cut calories and to exercise for at least 180 minutes each week. Only 7% of them developed type 2 diabetes. BIG, BIG NEWS: 93% of these people with prediabetes either reversed their prediabetes to normal blood sugar levels or stayed in the prediabetes range!

• A Finnish study focused on a healthy diet that included increasing fiber and decreasing saturated fats (the type of fat known to raise blood cholesterol levels). This intervention reduced the risk of developing diabetes by 38% more than a decade after the study began. Interestingly, those participants who ate the most fat and the least carbohydrate were the most likely to progress to full-blown diabetes.

 

• Indian researchers found excellent results without weight loss. And this is great news for those of you who either have no excess weight to lose or have become weary of weight loss efforts and prefer to focus on health, not pounds. In this study, the participants aimed to exercise 30 minutes daily (not 5 times a week) and decrease their intake of refined carbohydrates and fats. Without losing weight over the 3-year study period, the risk of developing type 2 diabetes dropped by 28.5%.

 

• A Chinese study included people of various weights. Only those who had overweight or obesity were instructed to cut calories. Researchers advised everyone to eat lots of vegetables (my #1 piece of advice for practically everything!) and to consume little alcohol and sugar. This intervention reduced the risk of developing diabetes by 39% and reduced the risk of death from heart disease.

• In a small study of just 24 people lasting only 6 months, a high protein diet worked better than a high carbohydrate diet to reverse prediabetes. Both diets were fairly low in fat and led to weight loss and improvements in blood sugar, but the high-protein diet led to a reversal for all 12 participants in that arm of the study.

 

• Other studies find weight loss is a strong predictor of prediabetes reversal.

Is a prediabetes reversal permanent?

Sometimes yes and sometimes no. Sorry to be wishy-washy, but the body works in complicated ways.

If you reverse prediabetes enough to routinely have blood sugar levels in the normal range, you have experienced remission. We don’t say cure; we say remission because those two initial problems – insulin resistance and failing beta-cell function – can return at any time.

Aim for prediabetes remission, and celebrate your successes, but don’t throw caution to the wind. And don’t stop your regular health screenings for prediabetes and diabetes.

Even a temporary remission has long-term benefits. In one study, individuals who had even a short remission from prediabetes were 56% less likely to develop type 2 diabetes many years later.

 

Take action now to reverse prediabetes

The earlier you take action, the more likely you are to achieve a prediabetes reversal. Remember that the longer the problem goes on, the greater the chances of losing your ability to produce insulin (loss of beta-cell function).

• Drop a few pounds. Because the body secretes hormones and other compounds that can induce insulin resistance, excess body fat is a major contributor to prediabetes and type 2 diabetes. Even moderate weight loss improves the function of the insulin-producing beta-cells, reduces liver fat, and improves insulin sensitivity of the cells of the muscle, liver, and fat tissues. Any amount of weight loss is beneficial if you have overweight or obesity. But remember that study in India: Weight loss is NOT a requirement to achieve a good result.
• Choose a wholesome diet. No surprise to anyone who knows me, but I don’t favor low-carb diets for prediabetes. While you can definitely lose weight on a low-carb diet, you’re missing the very foods and nutrients that boost insulin sensitivity, reduce inflammation, and fight diseases like heart disease and some cancers. This is my guess as to why the Finnish study showed that participants who had the least carbs and the most fat were the most likely to develop type 2 diabetes (they weren’t getting enough of those health-boosting phytonutrients).
• Get moving. Every single time you exercise – and all types of exercise –  you boost insulin sensitivity.
• And so much more: From trimming calories to trading up on carb-rich foods to getting a good night’s sleep, here are many steps you can take right now to start reversing prediabetes.

And that’s the best news; You have some power over prediabetes.