In a study published in 2002 by the Diabetes Prevention Program Research Group, people with prediabetes slashed their risk of diabetes by more than half if they lowered the fat and calories in their diet, boosted exercise, and lost weight.
Kathy Lawrence, who is 61 and lives in Austin, developed some worrying symptoms in her late 50s. She had cat scratches on her feet that refused to heal. Slow-healing wounds are a sign of diabetes, so she visited her doctor and had her blood sugar tested.
Lawrence had a fasting blood glucose of 119 mg/dL, just short of the level that signifies diabetes (over 126 mg/dL). Although she technically had prediabetes, not diabetes, her doctor told her: "We're going to count you as having it."
She started by making some changes in her diet. "You ate your way into this disease, and you can eat your way out of it," her gynecologist once told her. That's not entirely true; she had some type 2 diabetes risk factors she couldn't changeher age, a family history of the disease and gestational diabetes during pregnancy.
However, she did have some risk factors she could change, including her weight (she knew she could lose a few pounds in her midsection) and her activity level.
She first looked at the types of carbohydrates she was eating. Carbohydrates are a key part of the human diet, but some raise blood sugar more than others.
She focused on getting carbohydrates from fruits, vegetables, and whole-grain foods, which are rich in nutrients and fiber, and fewer from snacks loaded with sugar and white flour, which cause blood sugar to zoom up faster.
Lawrence still enjoys treats. For example, she had a small piece of tiramisu at her daughter's birthday party. But that phrase "You can eat your way out of it" pops up in her head whenever she's tempted to have a more radical splurge, such as "eat a chocolate cake or engage in several days of bad activity," she says.
Try the plate method
If you have prediabetes, a quick way to ensure that your food choices will help you avoid diabetes is to do "the plate method," recommends Darci Cook, RD, formerly a dietitian and diabetes educator at Clarian Diabetes Centers in Indianapolis, Ind.
At lunch and dinner, put vegetables on half your plate. Divide the remaining half of the plate in two, and cover one of those sections with a whole-grain carbohydrate. Cover the remaining portion with low-fat meat, such as fish or poultry, Cook recommends. This is a normal or small plate, by the way; your portion sizes still need to be reasonable.
If you have prediabetes, you need to also be extra-concerned about cholesterol as prediabetes boosts the risk of heart attack and stroke. A diet high in trans fat or saturated fat promotes bad cholesterol.
Lawrence lost 15 pounds and started exercising 45 minutes five days a week. She's motivated by her desired to avoid needing insulin. And she wants many healthy years to enjoy her 17-year-old daughter and her future grandchildren.
"I decided that at my age, if I want to be able to be a grandmother and enjoy my retirement years one of these days without a lot of complications and other kinds of health risks, I need to take it seriously," she said.
She keeps her walking clothes stacked neatly in her office, which serve as a reminder to go for her daily lunchtime walk.
"Learning to live a healthy lifestyle isn't a hard thing to do," Lawrence says. "At first it's not so easy, but once you make the changes, the healthier habits are not that difficult to maintain."