Reversing prediabetes can cut heart disease risk by over 50%, says study: Why this matters more than just preventing diabetes

This is significant in the light of recent research showing that lifestyle changes alone do not lower cardiovascular risk in people with prediabetes. “Lifestyle management, including exercise, weight loss and dietary improvements, are largely driven by individual commitment to discipline. Many give up midway. But this study reconfirms that prediabetes is a marker of metabolic imbalance with a linear risk and can cause other chronic conditions. Therefore, addressing prediabetes is as important and don’t wait for it to progress to diabetes,” says Dr Saptarshi Bhattacharya, senior consultant, endocrinology, Indraprastha Apollo Hospitals, Delhi. Excerpts:

What is prediabetes?

Prediabetes is a condition where blood glucose levels are higher than normal but not yet high enough to be diagnosed with type 2 diabetes (100–125 mg/dL). While the condition frequently progresses to type 2 diabetes, it also carries risk of cardiovascular disease – one of the leading causes of death globally. Around 136 million (15.3%) Indians are prediabetic, while over 100 million are diabetic, according to the ICMR-INDIAB study. More than half of these prediabetic individuals could transition to diabetes within five years if lifestyle isn’t managed.

How prediabetes can harm your heart

When your blood sugar levels are higher than normal, then they damage blood vessels and nerves controlling the heart over time. Prediabetes often co-exists with hypertension, high cholesterol and obesity, all major heart disease drivers. Many studies have already shown that prediabetes raises the risk of acute coronary syndrome (heart attack), ischemic stroke and heart failure. So, your heart is under stress even before diabetes has set in.

What are takeaways from the study?

The key takeaway is to treat prediabetes seriously. For years, people were told that exercising, losing weight and a clean diet were enough for prediabetes. Now we know that these, while being valuable and mandatory, were not enough to reduce cardiovascular disease. This suggests that delaying diabetes onset alone does not guarantee cardiovascular protection unless important metabolic changes occur.

Only swift remission of prediabetes is associated with a reduction in fatal cardiac events.

What should one do when diagnosed with prediabetes?

First of all, go by the advisory of a medical professional and a holistic approach. Diet, exercise, sleep, addressing other chronic conditions and weight loss must all go in tandem. Focus on a balanced diet rich in whole foods, fibre and lean proteins. Avoid refined carbs, saturated and trans fats. Aim for a 30-40 minute of exercise everyday, even if split over 24 hours and do muscle-strengthening activities at least two times a week. If you are overweight, losing even 5% to 7% of your total body weight can significantly reduce your risk of developing type 2 diabetes. Aim for 7 to 8 hours of quality sleep per night. Manage stress. Quit smoking and limit alcohol.

In select, high-risk cases, where lifestyle changes are not effective enough, the doctor may prescribe metformin even during prediabetes and weight loss drugs for obesity.