Pre-diabetes affects almost 90 million adults in the United States and is linked to higher risk of type 2 diabetes (T2D), heart disease, and other serious complications. In recent years, major clinical trials have shown that, while lifestyle (diet and exercise) changes can prevent pre-diabetes from becoming T2D, most people have persistent pre-diabetes rather than returning to normal glucose (blood sugar) levels. We have just learned that changing lifestyle soon after a diagnosis of pre-diabetes makes people more likely to move back to normal glucose levels.

Lifestyle interventions and psychological support in pre-diabetes

In a new study, African Americans and European Americans with different durations pre-diabetes were offered counseling with dieticians focused on increasing physical activity and eating fewer calories. Psychological support was also offered to study participants. Participants were compared by the length of time from the diagnosis of pre-diabetes (less than 3 years, 3 to 5 years, or over 5 years) compared to a group without pre-diabetes.

Changing lifestyle works especially if you do not wait too long

Of 223 participants (average age 53 years), 138 had pre-diabetes while 72 had normal glucose levels. Participants with pre-diabetes began lifestyle interventions on average after 4 years of pre-diabetes (range 3 months-8 years). The lifestyle intervention was associated with a decrease in glucose, weight, and body fat. In all, 43% of participants reverted to normal, 50% had persistent pre-diabetes, and 7% developed T2D after 5 years. These outcomes were similar across race, but much more benefit occurred when the lifestyle intervention began within 5 years of pre-diabetes diagnosis.

Usually, pre-diabetes is discovered incidentally instead of during regular blood glucose screening. These new findings suggest that screening and prompt lifestyle intervention in people with pre-diabetes may prevent T2D or reverse pre-diabetes in most people.


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