Reversing prediabetes naturally: A GP’s guide 

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This blog is for educational purposes only and does not replace professional medical advice or diagnosis. If you have health concerns, consult an AHPRA-registered telehealth doctor or request a medical certificate online if clinically appropriate. Please note: Hola Health does not currently offer Mental Health Care Plans.

What is pre-diabetes?

Pre-diabetes is a metabolic condition in which blood glucose (sugar) levels are higher than normal but not high enough to be diagnosed with type 2 diabetes. Often, the condition is picked up by chance on a blood test because pre-diabetes does not have any symptoms. People with pre-diabetes have a higher risk of developing type 2 diabetes, one of the leading causes of death in Australia.  

How long does it take to reverse pre-diabetes?

Around 16% of adults have pre-diabetes. 5-10% of these will progress to type 2 diabetes each year, and a similar proportion revert to normal in this time frame. Of those with pre-diabetes, around one-third will progress to diabetes within a decade. The good news is that some important lifestyle changes can be made to reverse pre-diabetes and help prevent it in the first place. 

Who is at risk of pre-diabetes?

The risk factors for pre-diabetes are the same as those for type 2 diabetes. This includes, but is not limited to, having a family history of pre-diabetes or type 2 diabetes, overweight or obesity, an inactive lifestyle, high blood pressure, reduced quantity and quality of sleep, and gestational diabetes during pregnancy.  

How is pre-diabetes diagnosed?

A variety of blood tests can be used to diagnose pre-diabetes and type 2 diabetes. These are easy to undertake and usually performed as a fasted blood sample (nothing to eat or drink for 8 hours before the test). Your doctor can refer you for a test if you have concerns about your health. For those with risk factors, periodic blood tests will help to pick up early any signs of pre-diabetes or, for those with the condition, progression towards type 2 diabetes. This is important given that around 500,000 adult Australians are living with silent, undiagnosed type 2 diabetes. Early diagnosis means effective treatment can be started which reduces the risk of developing diabetes-associated conditions, such as kidney disease and eye disease. Sometimes, clinical terms such as impaired fasting glucose or impaired glucose tolerance, are used to describe the condition of pre-diabetes, depending on the type of test used. 

Conditions associated with pre-diabetes

Pre-diabetes may exist as part of a wider collection of conditions associated with impaired cardio-metabolic health, such as high blood pressure, obesity and abnormalities in lipids (e.g., cholesterol). This is known as metabolic syndrome and people with this condition are at higher risk of cardiovascular disease and diabetes. 

When should I see a doctor?

Given pre-diabetes has no symptoms, it is important to check in with your doctor if you have any of the risk factors for it. This is particularly important for people aged 40 years and over given most people with pre-diabetes develop the condition in middle age. Your doctor will be able to determine your risk of developing the condition and advise on approaches to reduce your risk and frequency of monitoring. Telehealth doctor will help in diagnosing your condition and issue instant medical scripts (if clinically appropriate), telehealth medical certificates if needed. 

How is pre-diabetes managed?

Pre-diabetes is managed by lifestyle changes supporting healthy eating, regular physical activity, and weight loss. The goal of management is to reduce the risk of diabetes and nits associated complications. Structured intensive lifestyle treatments offer the best chance of success, particularly when weight loss is needed. It’s important to not lose sight of the health gains that accompany even small amounts of weight loss. Just 5% weight loss in a person with obesity and pre-diabetes can improve blood sugar levels. It is estimated that for every kilogram of weight lost the risk of diabetes decreases 16%.  

How is pre-diabetes prevented and treated?

Weight goals focused on long-term sustainable weight management, as opposed to short-term weight loss targets, offer the best chances of maintaining health-positive behaviour changes. These are best achieved by setting smart goals focused on health gains around behaviour changes that promote health. For example, a goal to ‘eat more vegetables and less refined carbohydrate this week’ is more specific and achievable than ‘lose 5 kg of weight’. This helps to maintain focus on healthy practices that matter, rather than just kilograms of weight loss and supports longer-term motivation to maintain these positive behaviour changes.  

Physical activity is important for pre-diabetes management, cardiovascular health and weight loss. Most guidelines recommend at least 150 minutes of moderate intensity physical activity per week or around 30 minutes on most days of the week. Exercise does not mean having to join a gym or buy expensive equipment. In fact, exercise is more likely to be sustained long-term if its affordable, achievable and enjoyable. 

What support is out there to help prevent or manage pre-diabetes?

An accredited dietician can help make recommendations on a personalised approach to your nutrition considering your energy needs and health goals. Digital weight management programs are also gaining popularity. These are delivered via an app on your smart phone, such as MyFitnessPal. These can help with engagement and sustainability for those that enjoy this technology. The Australian Health Eating Guidelines also provide more information on healthy eating practices such as portion control and balanced nutrition. An exercise physiologist can provide a bespoke exercise plan to support your physical activity goals that considers potential barriers to exercise such as time constraints, pre-existing health conditions (e.g., knee osteoarthritis) and cost issues.