Prediabetes doesn't have to lead to type 2 diabetes
The differences between type 1 diabetes, type 2 diabetes and prediabetes can be confusing, especially when it comes to understanding what a diagnosis means for a person’s health and whether the condition can be reversed or cured.
While a prediabetes diagnosis may feel like an inevitable path to developing type 2 diabetes, a Parkland Health expert says progression is not a guarantee, and that early intervention can help reduce the risk of developing the disease.
“There’s always hope, and there are lots of actions you can take to address it early,” said Uma Gunasekaran, MD, endocrinologist and Executive Medical Director of the Global Diabetes Program at Parkland and Associate Professor of Internal Medicine at UT Southwestern Medical Center. “You’re actually at that fork in the road where you can back up.”
Diabetes is a condition that affects the body’s ability to regulate blood sugar through insulin produced by the pancreas.
In type 1 diabetes, the body’s immune system attacks the cells in the pancreas that produce insulin, leaving the body unable to make enough of the hormone. In type 2 diabetes, the body becomes resistant to insulin, forcing the pancreas to work harder to regulate blood sugar.
“When you have type 2 diabetes, your body becomes less efficient at using insulin, so your pancreas has to work harder to produce more of it,” Dr. Gunasekaran said. “It’s like putting your pancreas on a treadmill. It’s constantly working, constantly churning out extra insulin to keep your blood sugar under control. Over time, the cells in the pancreas that produce insulin can become exhausted and begin to lose their ability to keep up with that demand.”
Prediabetes occurs when blood sugar levels are higher than normal but have not yet reached the threshold for a type 2 diabetes diagnosis. A person with prediabetes often has no symptoms.
Medical providers use an A1C test to measure the average blood sugar levels over the past three months. An A1C below 5.7% is considered normal. An A1C between 5.7% and 6.4% indicates prediabetes. A higher percentage is considered diabetes.
Dr. Gunasekaran stressed that prediabetes can be reversed through lifestyle changes and represents a critical window to address and improve blood sugar levels before diabetes develops. She recommends starting with diet and lifestyle changes such as:
- Eating balanced meals: Build meals around vegetables, lean protein, fiber-rich foods and moderate portions of carbohydrates to help keep blood sugar levels steady.
- Adding more fiber: Eating vegetables, beans, lentils, fruits and whole grains can slow the absorption of sugar and help prevent sharp blood sugar spikes.
- Moderating carbohydrates: Foods such as bread, rice, pasta and potatoes contain carbohydrates that raise blood sugar. Be mindful of portion sizes.
- Moving more throughout the day: Walking, climbing stairs, doing household chores or finding other ways to stay active helps the body use insulin more efficiently and burn glucose for energy.
- Making physical activity a daily habit: Start with manageable activities and build movement into your routine, especially if you spend much of the day sitting.
There is no definitive cure for type 1 diabetes. Although lifestyle changes and medications can also help people with type 2 diabetes manage their blood sugar, Dr. Gunasekaran cautioned against assuming the disease has been reversed or cured simply because blood sugar levels improve or medication is no longer needed.
“I tend to tell people, don’t take the label away,” she said. “You may have controlled diabetes, but ongoing monitoring is still essential, including regular screenings for complications affecting the eyes, kidneys and feet.”
People who want to make changes but are unsure where to begin can talk with their primary care provider about their options.
For information about Parkland’s diabetes services, resources and education, visit www.parklanddiabetes.com.
For information about services available at Parkland, visit www.parklandhealth.org.
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