dr vivek baliga writes about prediabetes to diabetes

Prevent Progression Of Prediabetes To Diabetes

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Have you been diagnosed with prediabetes and are worried what it might be? Are you concerned that you might develop diabetes in the future? This article should clear your doubts about prediabetes and it’s progression to diabetes.

Type 2 diabetes is a rapidly rising problem across the world, and India is no exception.

It is expected that over 160 million people will be affected globally in the next decade. India is slowly becoming the diabetes capital of the world.

In practice, I have encountered many individuals who undergo routine blood investigations and are diagnosed to have slightly elevated blood sugar levels. These blood sugar levels are not normal, and do not fall under the definition of diabetes either.

This is a condition called prediabetes.

The Center for Disease Control and Prevention (CDC) reports that 90% of people who have prediabetes don’t really know that they have it!

Prediabetes is the precursor of diabetes. In other words, it is a warning sign that diabetes is likely to develop in some time.

Some believe this term to be a misnomer. The World Health Organisation calls it ‘Intermediate Hyperglycemia’, while the American Diabetes Association calls it ‘High Risk for Diabetes’.

Studies have consistently shown that regular exercise and following a healthy diet can lower the risk of development of diabetes.

But before we look into how prediabetes can evolve into full blown diabetes, it is important for us to understand the basics of prediabetes.

Prediabetes Is Not A Diagnosis – Its A Disease

We have discussed prediabetes in a great deal of detail here. However, it is important to review certain important facts about this disease before we proceed further.

Firstly, prediabetes is accompanied by changes in the small and large blood vessels. These changes increase the risk of development of heart disease, kidney disease and stroke.

One marker that is important in determining whether diabetes is affecting the kidney is the presence of microalbuminuria.

This is a state of microscopic quantities of protein leak through the kidneys into the urine.

Normally, there should be no protein present in the urine whatsoever. However, in early diabetes related kidney disease, small amounts of protein might begin to leak out.

This is an early indicator of kidney damage in diabetes and must be addresses soon.

In one clinical survey, it is found that 17.7% of people with prediabetes had some form of kidney disease compared to just 10.6% of those without the condition.

Other clinical trials have found that prediabetes can affect the nerve fibers and lead to a condition called ‘polyneuropathy’ twice as more often compared to those who do not have diabetes or prediabetes.

Eye changes – retinopathy – has also been seen in prediabetes patients.

In short, it appears that prediabetes seems to have similar effects on the vital organs as compared to full-blown diabetes. This means that it is important to take certain steps that can prevent the progression of prediabetes to diabetes.

What Are The Risk Factors That Promote Conversion Of Prediabetes To Diabetes?

There are a multitude of factors that are responsible for this change.

It is usually a combination of lifestyle, behavior, increasing age, environmental risk factors and level of education that contribute to the shift from prediabetes to diabetes.

Below is a table that lists some of the conditions that can increase the risk of progression to diabetes.


  1. Family history of diabetes
  2. The presence of heart disease
  3. Obesity or being overweight
  4. Lack of exercise, sedentary lifestyle
  5. Asian ethnicity
  6. History of gestational diabetes (diabetes during pregnancy)
  7. Polycystic ovarian syndrome
  8. Certain medication such as anti-depressants and anti-psychotics
  9. High blood pressure (hypertension)
  10. High triglyceride and low HDL levels

Low birth weight may have an influence on the development of prediabetes.

If born underweight, our body tries to catch up to reach the actual weight all of us should be at that particular age.

In an attempt to do so, there is fat accumulation in the body This fat is resistant to the glucose lowering effects of insulin.

Obesity in combination with insulin resistance can lead to diabetes in adults.

Preventing Progression Of Prediabetes To Diabetes

So what can you do to prevent prediabetes from turning into diabetes? What are the treatment options available for prediabetes?

Before I start explaining this, you might be wondering why prediabetes needs to be treated in the first place.

Well, given what I have explained so far, it is evident that treating this condition can help prevent progression to diabetes, lower complication risk from diabetes and protect the heart and other vital organs.

Lifestyle change seems to be the main treatment strategy. Intensive lifestyle changes has led to an almost 58% risk reduction in the development of complications. In the DaQing Diabetes Prevention Study, individuals who followed lifestyle changes sincerely had a 43% risk reduction int eh development of diabetes.

Change Your Diet

Indian diets have now become quite westernized, and this has led to dietary patterns and exercise routines that are quite opposite to what was seen 30 to 40 years ago.

Busy work schedules leave little time to exercise, and eating out often is becoming fashionable given the number of restaurant deals and offers that keep being advertised all the time.

Snacking late in the night is a problem as well.

prediabete to diabetes

High intake of saturated fats, trans fats, salt and sugar can all contribute to the development of obesity, type 2 diabetes and heart disease.

Fortunately, the solution is simple. Just cut out these bad elements from your diet and follow a healthy balanced diet.

In the Finnish diabetes study, changing to a diet that was low in fat and high in fiber significantly reduced the chances of converting prediabetes to diabetes. This was particularly seen when combined with increased physical activity.

Crash diets may work in the short term, but are terribly difficult to continue following in the long term. Furthermore, cutting down carbohydrates and certain kinds of fat only has short term benefits on health.

Follow a healthy, balanced diet. Eat the recommended quantity of fruits and vegetable, eat unrefined grains with high fiber content, use oils like olive oil or rice bran oil and consume fish for protein.

A high fiber diet has been shown to lower cholesterol levels and reduce spikes in blood sugar levels after meals. Achieving this can be hard, though supplements are now available that can help.

Exercise Regularly

There is clear evidence that regular exercise has a many benefits on overall health, and can control blood sugar increases and prevent prediabetes turning into type 2 diabetes.

how to prevent prediabetes dr vivek baliga

Combine a cardio routine with a strength training routine. In other words, brisk walk and light weight training can help. Any activity of moderate intensity can help. Yoga can help but only when combined with a strict aerobic exercise routine.

The recommended exercise duration is 150 minutes per week. However, if you are serious about your health, crank it up to 60 minutes a day. It works better.

Lifestyle Change

Mix and match your daily exercise routine. Try and walk every day for at least 45 to 60 minutes a day.

If that is difficult to do, walk at least 10,000 steps a day by using a pedometer or a cool gadget like a Fitbit. There is sufficient evidence that exercising at moderate intensity can help prevent progression of prediabetes to diabetes .

In the Finnish diabetes study, it was found that regular diet and exercise reduced the risk of progression of prediabetes to diabetes by 58%.

In another study that looked at the use of single drug medical therapy against lifestyle modifications in patients with prediabetes, the chances of developing diabetes was significantly lower in the lifestyle modification group as compared to those who had been prescribed medication.

One primary reason why lifestyle changes help in prediabetes is the weight loss that it leads to. Even the slightest weight loss has great benefit, so make sure you do everything you can to reduce your body weight.


Medicines such as metformin and acarbose are useful in preventing progression of prediabetes to diabetes. We have not gone into details regarding this here, but there are a many medicines that can help.

Weight Loss Surgery

Bariatric surgery, also called weight loss surgery, has a many benefits, and has been proven to reverse diabetes. While the benefit seems to be mostly in people with diabetes, it is likely the same benefits extend to those with prediabetes.

Weight loss surgery can lower the chances of developing diabetes by 87% in those with prediabetes. However, it is only recommended for those individuals with extremely high body weight.

Closing Remarks

Prediabetes carries a similar risk to diabetes when it comes to complications. Simple measures can help reduce the chances of progression of prediabetes to diabetes.

Dr Vivek Baliga B
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