On the road to diabetes: How to halt disease progression and turn back to health

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The key to preventing pre-diabetes from becoming Type 2 diabetes, which isn’t usually reversible, is changing behavior around weight, diet, physical activity and sleep. This isn’t easy and must be an ongoing, personal process.

Weight loss: Reversing pre-diabetes requires no further weight gain and, if possible, a 5 percent reduction in body weight through both dietary changes and increased physical activity. Key strategies include:

  • Weighing yourself once a week
  • Learning to tolerate a small amount of hunger
  • Avoiding high calorie foods, especially sweets
  • Seeking support from friends, family members and, ideally, a health professional

Dietary practices: There are several key long-term goals for reversing pre-diabetes. They include:

  • Avoid sweets and sugar-containing beverages
  • Increase fibrous vegetables and whole grains
  • Reduce white starches
  • Reduce animal fats

These goals can most easily be achieved by eating a diet dominated by unprocessed, plant-based foods. Eating this way can help with weight loss, but can also independently keep insulin resistance from worsening.

Physical activity: Gradually increase physical activity to 60 minutes day (about 8,000 steps). Exercise helps with weight loss, but also trains muscles to become better at removing sugar from the bloodstream.

Sleep: Getting at least seven hours of high quality sleep per night can help reverse pre-diabetes. Sleep deprivation has been shown to increase insulin resistance.

Medication: In addition to lifestyle changes, the drug metformin may help reverse pre-diabetes. It helps with weight loss and lessens insulin resistance. Use of this diabetes medication in pre-diabetes is controversial and should be combined with lifestyle changes.

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