How To Reverse Pre-diabetes

Diabetes

All you need to know about improving your HbA1c result

13/05/2018


Daniel Grant
MBBS BSc

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If your blood test results show that you are ‘pre-diabetic’ or almost pre-diabetic it can be a little confusing to understand what that means, why has it happened and what you can do about it. Read on to find out more about how to reverse pre-diabetes.

What is pre-diabetes? 

Diabetes is a condition where you have trouble controlling your blood sugar levels. When your sugar levels are too high it can cause a whole host of serious problems, ranging from problems with your sight and extremities as well as increasing the risk of heart attacks and strokes. Diabetes is currently one of the biggest health issues in the UK. It is vitally important to stay on top of it and ideally, prevent it from ever happening in the first place. The good news is that if you catch it early you can reverse diabetes and effectively “cure” yourself through simple lifestyle measures alone. 

Pre-diabetes is the term used to describe the transition between not having diabetes and having it. If you have been told you have pre-diabetes you’re certainly not alone –it is estimated that about 7 million people in the UK have pre-diabetes. 

How is pre-diabetes diagnosed?

At Medichecks, we look at your HbA1c level. HbA1c or Haemoglobin A1c is a longer-term measure of glucose levels in your blood compared to testing blood glucose alone. Glucose attaches itself to the haemoglobin in your red blood cells, and as your cells live for around 8-12 weeks it provides a good indication of the level of sugar in your blood over a 2-3 month period.

HbA1c is not only a good snapshot measurement but also ideal to track your blood sugar levels over time. As you introduce changes into your lifestyle you’ll hopefully begin to see your HbA1c level come down and eventually drop below the pre-diabetic threshold back into the normal range, which would be amazing. You’re in control of your health and you can track your own improvements over time. 

If you have a high HbA1c result then there are some clear targets to aim for: 

  • A HbA1c result over 48 mmol/mol indicates diabetes 
  • A result between 42-47.9 mmol/mol is considered to be pre-diabetic

If it’s below 42 then you’ve “reversed” your diabetes, which is brilliant news – though of course, you should keep your lifestyle modification up to keep diabetes at bay! 

Why can pre-diabetes be reversed?

Pre-diabetes is more often than not a disease of lifestyle and can develop for many reasons. There’s nothing you can do about your gender or your genetics, but there are a number of risk factors which you can potentially do something about. 

  • Being overweight or obese. This is a big risk factor and almost all people with pre-diabetes are a bit too heavy. 
  • Not being active. The more physical activity you do, the more likely you will keep diabetes at bay. 
  • Having other medical conditions such as high blood pressure or high cholesterol.

Risk factors that you can’t do anything about include:

  • Your ethnicity
  • Your age
  • Being a man
  • If a close relative has diabetes
  • If you are a woman and have polycystic ovaries or developed deranged sugar control during pregnancy (gestational diabetes) 

What can I do if I have been diagnosed with pre-diabetes? 

You’ve already taken the first step – and that’s monitoring yourself. Well done! Most people don’t know they have diabetes until it is too late, but you’ve picked up on pre-diabetes early and can also monitor it going forward. But there are many things to consider...

  • Your risk:

First of all, let’s work out what your risk is for progressing from pre-diabetes to diabetes. Click here to check your diabetes risk.

If you are “high risk”, as well as all the lifestyle measures below you can also discuss things directly with your GP who may want to discuss various programmes with your or, if you are physically unable to be very active, prescribe medication at this early stage. 

If you are “moderate” or “low” risk then you can embrace some lifestyle changes. 

  • Set realistic goals:

Remember that lifestyle changes should be simple to stick to, so don’t go mad – small, manageable and sustainable changes are best. Your HbA1c levels will change over months, not overnight. 

  • Your diet:

You should eat a healthy balanced diet and in particular, look to cut down refined sugars (white bread, white pasta and rice, potatoes, sweets, cake, fizzy drinks, etc). Try to make a list of your current diet and then see what you can take out/modify. Have a think about your portion size too. Many people say they eat healthily but eat way too much healthy stuff, which is also not good! If you drink alcohol try to cut that down too. 

  • Levels of physical activity

If you can, try to get as active as possible. The minimum level of exercise recommended is 30 minutes of brisk walking at least 5 times per week. That is the minimum though – hopefully you can do more! Physical activity like this doesn’t just keep diabetes at bay, but can also help to lower blood pressure, lower cholesterol and help to prevent strokes and heart attacks. 

  • Try to lose weight (if you’re overweight)

Hopefully, through diet and activity, you can start to lose some weight over time. Working out your BMI is a crude measure of weight, but still useful. You should aim for the healthy range but really just making sure you’re moving in the right direction is a great start. 

  • Stop smoking

If this applies to you, then cut it out - for good. 

  • Get support

There are loads of support services out there ranging from weight loss groups, to dieticians, to diabetes prevention programmes, to gym groups, to social gardening clubs, good gym and many more. Talk to your family and friends so that they understand what you’re doing and why.

  • Medication

Lifestyle changes should be most people’s priority. However, if you struggle to achieve these due to physical or medical reasons then your GP may prescribe some medication for you. If you are very overweight your GP can also potentially prescribe medication to help you lose weight. 

  • Monitor yourself

You can use Medichecks to continue to monitor your HbA1c and trend your improvements over time. Your dashboard will provide a really useful graph for you. Every 3 months is the earliest you should re-test (remember the life-cycle of a red blood cell), but most people monitor themselves every 6 months to a year. 


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