Smart blood sugar management can reverse prediabetes: Here’s what a new study reveals

Dr V Mohan, Chairman, Dr Mohan’s Diabetes Specialities Centre, Chennai, on his new study that shows how remission can be achieved

With simple lifestyle correction, diet, weight loss and exercise, it is possible for those with prediabetes to get back to normal glucose levels. (Source: Getty/Thinkstock/Pixabay images)

Type 2 diabetes is a disorder which is usually life-long. It is caused by genetic factors or lifestyle-induced triggers like obesity, excess carbohydrates, stress, lack of sleep and exercise. That’s why it is important not to ignore the stage leading up to the development of diabetes, or prediabetes, which gives us a long period during which both corrective and preventive measures can be taken. Although there are reports of remission of diabetes, these cases are few and far between, may be in five to 10 per cent of people.

For a long time, managing prediabetes was not the focus of diabetes management protocols. But recently we did a study with diabetologist Prof Andreas Birkenfeld from the University of Tübingen, Germany and found that it is much easier to not only reverse prediabetes but prevent the onset of diabetes in one’s lifetime. Why is this significant? That’s because the conversion of prediabetes to diabetes among Indians is faster than any population and about 136 million Indians or 15.3 per cent of the population is already in the prediabetes stage. If steps are not taken, then that number of patients will become 200 million in the years to come.

How do you know you have prediabetes?

When your fasting blood glucose is below 100 mg/dL, you are normal. If your fasting blood glucose levels are between 101 and 125 mg/dL, it means you have prediabetes. When your fasting blood glucose level is above 126 mg/dL, it means you have progressed to diabetes. Unfortunately, there are no symptoms of prediabetes at all. In fact, most symptoms like feeling thirsty and frequent urination show up in advanced forms of diabetes, not before.

Why is prediabetes easier to manage?

At the stage of prediabetes, the pancreatic beta cell function (which regulates insulin secretion) is much better preserved than in the later stages. So the insulin resistance is not as high as in diabetes.

Those with full-blown diabetes have difficulty reversing their condition but can keep it under control and lead a long life if they keep their ABC levels under control. This means you should keep your A or haemoglobin A1c levels (average blood sugar count of three months) below 6.4 per cent, B or blood pressure in normal range and C or cholesterol levels under control.

All you need is a simple lifestyle correction

With simple lifestyle correction, diet, weight loss and exercise, it is possible for those with prediabetes to get back to normal glucose levels. What many do not know is that you need to lose weight by only 3 kg to 5 kg to get your HbA1c levels to 5.6 per cent or below without medication. This kind of weight loss can be achieved by stepping up on normal aerobic exercises like brisk walking, swimming and jogging and resistance training using smaller weights. You would have to lose more weight if you have overt diabetes with more difficult routines.

Our studies have shown that even a 10 per cent reduction in carbohydrate intake (rice, wheat, bread and chapati) can help achieve remission of prediabetes with a compensatory 10 per cent increase in the protein intake. The proteins should, however, be vegetable proteins like grams, legumes, beans in addition to paneer or milk. This, too, is easier to control and manage in everyday life.

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Such steps are doable and achievable. So test your sugar levels today.