1 in 3 U.S. adults have prediabetes, a health condition defined by higher than normal blood sugar levels and which often precedes type 2 diabetes. While it can be overwhelming to receive a diagnosis of prediabetes, the condition is both treatable and reversible. Simple lifestyle changes, sometimes combined with medication, can prevent prediabetes from progressing into type 2 diabetes.

Here’s an overview of common next steps after a prediabetes diagnosis. This is intended to provide general information about managing prediabetes. Always follow your doctor’s recommendations.

What is prediabetes?

Prediabetes is primarily defined by blood sugar levels that are higher than normal but still below the official range for a type 2 diabetes diagnosis. Two tests may be used to diagnose prediabetes:

• The fasting blood sugar test, which measures your blood sugar after an overnight fast. A fasting blood sugar level between 100-125 mg/dL indicates a prediabetes diagnosis.

• The A1C test, which measures your average blood sugar levels over the past three months. An A1C level of 5.7%-6.4% indicates a prediabetes diagnosis.

Prediabetes does not have visible symptoms. More than 84% of all those living with the condition don’t know that they have it. It’s important to be proactive about testing if you are at risk. Speak with your doctor if you are:

• Overweight

• Physically inactive

• Over 45 years old

• Black, Hispanic/Latino, Native American, Asian American, or Pacific Islander — for reasons not yet understood, researchers have found higher rates of type 2 diabetes in these racial and ethnic groups

Diet and nutrition

Nutrition plays a significant role in the management of prediabetes and type 2 diabetes. Prioritizing certain foods and avoiding or reducing your intake of others can help you maintain healthy blood sugar levels.

Here are general dietary considerations for people with prediabetes. It’s important to work closely with a doctor or dietitian before starting a new diet plan.

Load up on fiber-rich foods

Fiber is a carbohydrate found in plant-based foods, and which the body can’t digest. Since it isn’t digested, it does not increase glucose levels. It is commonly found in:

• Fruits including apples, bananas, oranges, and strawberries

• Non-starchy vegetables including beets, brussels sprouts, broccoli, cabbage, and carrots

• Nuts and seeds including almonds, chestnuts, chia seeds, flax seeds, sesame seeds, sunflower seeds, and pistachios

• Whole grains - check nutrition labels for the words “whole” or “whole grains”

• Legumes including black beans, chickpeas, kidney beans, lentils, and peas

Limit your intake of sweetened, sugary beverages

Without any fat or protein to balance carbohydrates, sweetened beverages are associated with a greater risk for type 2 diabetes. Limit your intake of soda, sweetened tea, sports drinks, and other sugary beverages.

Speak with your doctor about your recommended carbohydrate intake

Certain carbohydrates affect blood sugar levels more than others, specifically refined carbohydrates such as white bread, white rice, and some potatoes. (Soda and some types of juice also fall under this category.) They digest quickly and should be consumed in small amounts by those with prediabetes and diabetes.

At the same time, it’s a misconception that you should avoid all carbohydrates if you have prediabetes. Low-carb diets may not be appropriate for some individuals with other health conditions such as high cholesterol or heart disease. Speak with your doctor for individualized recommendations.

Exercise

There are several reasons why physical activity is important for individuals with prediabetes:

• It increases your body’s sensitivity to insulin.

• It can help balance blood sugar levels.

• It can help you maintain a healthy weight.

The American Heart Association recommends about 150 minutes of moderate-intensity physical activity a week, or 20-25 minutes each day. Activities that fall under that category include brisk walking, swimming, or biking.

To build a fitness routine that sticks, start off slower and build your way up to a more intense workout, and be sure to find activities that you enjoy.

Smoking cessation

Smoking is a known risk factor for type 2 diabetes. It increases inflammation and oxidative stress, both of which have been associated with diabetes. Heavier, more frequent smoking is linked to a greater risk for diabetes.

If you are finding it challenging to quit, ask your doctor for resources that may help. Nicotine replacement therapy can ease withdrawal symptoms and cravings.

Medication

In some cases, your doctor may recommend supplementing the above lifestyle changes with medication to keep your blood sugar levels in a healthy range.

Metformin is one of the most common oral medications used to treat prediabetes and type 2 diabetes. It regulates your blood sugar levels by reducing how much glucose is produced during digestion.

To experience the full benefits of metformin, it’s important to maintain a healthy lifestyle while taking the medication.

Read What to Know About Metformin for additional information.

Some individuals with prediabetes may be prescribed weight loss medications for short-term use, as maintaining a healthy weight is part of managing prediabetes. Many of these medications are associated with health risks like high blood pressure and may not be appropriate for some individuals.

Keep in mind that your treatment needs may change over time. If you are prescribed medication for prediabetes, you won’t necessarily have to take it indefinitely. For instance, if lifestyle changes and metformin are effective at restoring healthy blood sugar levels, your doctor may have you taper off of the medication.

Your partner in health

Managing prediabetes is easier with the right pharmacy partner by your side. The Alto app simplifies medication management and our dedicated diabetes support team is here to make sure you have everything you need.

To learn more, reach out any time through secure in-app messaging or by phone at 1-800-874-5881.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.