What is prediabetes?
Prediabetes is considered to be a stage in the development of type 2 diabetes and a risk factor for cardiovascular disease (heart disease and stroke). It means your blood glucose (sugar) levels are higher than normal (hyperglycaemia), but not high enough to be diagnosed as type 2 diabetes.
Some terms you might hear are impaired glucose tolerance, non-diabetic hyperglycaemia and impaired glucose regulation, which may all be referred to as prediabetes.
What is happening in my body?
When your blood sugar levels rise after you eat, your pancreas releases insulin into your blood. This important hormone helps glucose in your blood move into muscle, fat and liver cells where it’s used for energy. When these cells don’t respond well to insulin and can’t easily take up glucose, it remains in your blood. This can happen because you’re overweight or have eaten a bad diet for many years and is known as insulin resistance.
Will my prediabetes turn into type 2 diabetes?
Not necessarily. However, you’re at a high risk of developing type 2 diabetes if you don’t make substantial changes to your lifestyle. This includes improving (and changing) your diet, exercising more and losing any excess weight you might be carrying.
Each year around one in 10 people with prediabetes develop diabetes. If you’re diagnosed with the condition, your GP or nurse will give you lots of advice on how to manage your blood sugar levels to reduce your risk of developing type 2 diabetes.
Will I be given any medicine to reduce my chances of getting type 2 diabetes?
If you’re diagnosed with prediabetes, the first plan of action will be to try to manage and improve your blood sugar levels through positive changes to your diet and an exercise regime. If after six months of making consistent lifestyle changes your glucose levels are still high, you may be prescribed metformin to help reduce your risk for, or delay the onset of, type 2 diabetes. But your GP or diabetes nurse will assess your need for this.
Let’s talk diet!
If you have prediabetes, you’ll need to make some changes to your diet to help keep your blood sugar levels in check. It’ll also have a positive knock-on effect – you’ll most likely lose some weight in the process, further reducing your risk of developing type 2 diabetes. It’s a win-win!
As a dietitian, if I see a patient with prediabetes, I’ll advise them to work on these five areas. I’ll go into more detail below.
- Eat more wholegrains, vegetables and other foods that are high in dietary fibre.
- Eat less fat, especially foods high in saturated fat.
- Consider the glycaemic index of foods, and choose options that have a lower GI.
- Avoid added sugars as much as possible.
- Stick to appropriate portion sizes of carbohydrate foods.
Up the fibre
Include more foods in your diet that are high in fibre. These include:
- wholegrain breakfast cereals, such as bran flakes
- wholewheat and granary bread
- wholewheat pasta
- oats and barley
- fruit and vegetables
- peas, beans and pulses
- nuts and seeds
- jacket potatoes with the skin on
Find out where and when your local markets are held – fruit and veg can often be cheaper. Simple swaps, such as buying wholewheat pasta or bread instead of white pasta or sliced white bread, can make a big difference to your fibre intake.
Cut the fat
Go for low-fat options when you can, such as low-fat yoghurt, cheese and hummus. Swap foods high in saturated fat (such as butter, ghee or coconut oil) for versions made with vegetable oil. Also, choose skimmed or semi-skimmed milk instead of full-fat milk. It’s important to read the product labels though, as sometimes low fat can mean high sugar.
Mayonnaise, chips, crisps, pastries, poppadoms and samosas are all tasty, but unfortunately all high in fat. Sorry to say it, but cut these types of from your diet as much as you can. A treat now and then won’t hurt, but keep it to special occasions.
Lean meat, such as chicken and fish, are much lower in fat than processed meats, such as sausages and burgers. Or why not try Quorn as a substitute to meat? Need some inspiration? This blog is packed out with 50 healthy food swap ideas.
Plan your snacks
We’re all guilty of grabbing unhealthy, convenient snacks when our tummies rumbles or we’re in need of a sugar pick up. But snacks such as crisps, Bombay mix, cake, chocolate and biscuits won’t do your blood sugar levels any good.
Choose fruit, hummus and carrot sticks, unsalted nuts or low-fat yoghurt as snacks instead. Plan and pack them in advance, so you don’t suddenly crave something to eat when only the vending machine at work is in reach!
Go low GI
The infographic below shows what foods have a low glycaemic index (GI). Following a low GI diet is a great way to manage your blood sugar levels. You may not necessarily have to go low GI all the time, but it’s good to be aware of what foods can affect your blood sugar levels more. Your GP or dietitian will be able to advise what’s best for you.
Click to open a PDF version of Bupa's Glycaemic index (0.6MB)
Cut added sugars
Sugar comes in many different forms and has many different names – table sugar, honey, syrup, molasses, glucose syrup and fructose syrup are just some. These ‘simple’ sugars have the quickest and largest impact on your blood sugar levels, while offering very little nutritional benefit. Try to avoid these added sugars as much as possible by checking food labels and looking at the ingredients list. The higher up the list, the greater the quantity in the food.
Check your carbohydrate portion sizes
Carbohydrates often get a bad reputation, but actually, they should make up a large part of your diet. The same is true for those with prediabetes. As well as considering the type of carbohydrate foods you eat (see our GI infographic above), it’s also important to consider the portion size. Even low GI foods can cause your blood sugars levels to rise too high if you eat too much in one sitting. Take bread as an example, a sensible portion size at any one time is two slices. Spacing out carbohydrate foods evenly throughout the day will help to avoid large increases in your blood sugars.
Cook it right
It’s not just what you eat that can make a difference to your diet. It’s how you cook it. Grilling, baking, poaching and steaming your food are much healthier ways to cook, rather than frying or roasting.
Here are some simple ideas and swaps.
- Have a baked potato instead of deep fried chips.
- Steam your vegetables (for only a few minutes) to retain nutrients and a delightful crunch.
- Grill any fatty meats to allow the fat to drain off.
- Poach or oven-bake fish instead of frying.
Not keen in the kitchen? Don’t worry – read our blog, Healthy eating if you don’t like cooking for some inspiration and quick wins.
Supporting your health
Making changes to your lifestyle is ultimately your responsibility. But you’re not alone in your journey. If you’re at high risk of developing diabetes, you’ll be invited back to your GP to be assessed every year and have regular blood tests to monitor your blood sugar levels. You’ll also be offered lots of dietary and fitness advice to get you started if it’s all very new to you.
If you’ve been diagnosed with prediabetes, talk to your family and close friends for support. Encourage your partner, children or another family member to join you with your lifestyle changes, or to at least offer support where they can.
Your eating habits at home can often be dictated by what the rest of the household eat. So, take the time to explain what changes you need to make and why. If it’s for the long-term benefit of your health, it’s likely that your family and friends will want to support you every way they can.