What you need to know about treating pre-diabetes

Diabetes — a condition where your body has difficulty converting glucose into energy, leading to high levels of sugar in the blood — is something most of us have heard of [1]. What you might not have heard of, however, is pre-diabetes. 

While not quite at the same level as diabetes, pre-diabetes is something that should be taken very seriously, as it means you are at an increased risk of developing type 2 diabetes. 

In fact, 10-20 times more likely than the average person [1]. However, with the right lifestyle changes and medical support, it is possible to lower some of your risk factors and reduce your chances of developing type 2 diabetes. Here's what you need to know.

What is pre-diabetes?

Pre-diabetes describes a condition where your blood glucose levels are higher than normal but not high enough to be diagnosed with type 2 diabetes [2]. If you have pre-diabetes, it means the cells in your body are not responding normally to insulin [3]. 

It may be known as Impaired Glucose Tolerance (IGT) — meaning the blood glucose level is above normal but not high enough to be called diabetes — or Impaired Fasting Glucose (IFG), where the fasting blood glucose level is above normal, and can be diagnosed through an oral glucose tolerance test [4]. 

An oral glucose tolerance test is taken after fasting blood glucose levels are high, and involves fasting for 8 hours and then drinking a sugary drink [1]. 

Blood tests are then taken after 1 hour, and 2 hours, to measure blood glucose levels. Those who have pre-diabetes are often at higher risk of developing both cardiovascular disease and type 2 diabetes [4].

What is insulin?

Insulin is a hormone that your pancreas makes, which helps the glucose in your blood (which comes from the food you eat) to make its way into cells in your muscle, fat and liver so it can be used for energy [5]. 

Your blood glucose level or blood sugar level rises after you eat, causing your pancreas to release insulin into your blood, which lowers your glucose to keep it in the normal range [5].

What is insulin resistance?

For most of us, our body is able to regulate its blood sugar levels and blood glucose without any issues. 

However, some people experience an issue called insulin resistance, where the body's cells stop responding to the insulin being pumped out by the pancreas [6]. 

If you have insulin resistance, your muscles, fat and liver struggle to take up glucose from your blood [5]. 

Your pancreas then attempts to make more insulin, but eventually, it cannot keep up, and your blood sugar continues to rise [6].

What are the symptoms of pre-diabetes?

One of the challenging aspects of pre-diabetes is the fact that many people do not display symptoms. Due to the lack of clear signs, pre-diabetes can go undiagnosed for a long time if you do not get your blood glucose level checked. 

While there are no technical symptoms of pre-diabetes, factors such as having high blood pressure or high cholesterol, having a family history of type 2 diabetes, experiencing gestational diabetes during pregnancy, having polycystic ovarian syndrome or being overweight can all be signs that you may be more likely to develop pre-diabetes [1]. 

If your pre-diabetes has escalated to type 2 diabetes, you might experience symptoms including more frequent urination, blurred vision, feeling more tired, and being more thirsty [1].

How common is pre-diabetes?

According to Diabetes UK, 7 million people in the UK have pre-diabetes, which means they have a higher risk of developing type 2 diabetes [2]. It is more common amongst certain demographics (more on that below). 

Having pre-diabetes means those 7 million people are 15 times more likely to develop type 2 diabetes than the rest of the population [2]. 

However, being diagnosed with pre-diabetes does not necessarily mean you are sure to develop type 2 diabetes — with the right lifestyle changes under the guidance of a medical professional, you can reduce some of your risk factors while also improving your health.

Who is at risk of pre-diabetes?

When it comes to demographics, there are certain groups within society who are at high risk of pre-diabetes. 

Medical factors such as a family history of type 2 diabetes, polycystic ovarian syndrome, having gestational diabetes during pregnancy, or giving birth to a large baby can play a role. 

Those who have Pacific Island, Asian, Arabic or north African heritage and are over 25 years old also have a higher chance of developing pre-diabetes [2]. 

Other risk factors include being overweight or having a large waist size (more than 31.5 inches or over for women; 37 inches or over for men, but 35 inches or over for South Asian men according to Diabetes UK), smoking, not being physically active and having high triglycerides (blood fats) and low HDL-C (good cholesterol), or high total and LDL cholesterol [2].

Can pre-diabetes go away?

Depending on when you are diagnosed, it can be reversed before going on to develop into type 2 diabetes. It also depends on your specific risk factors, and whether or not they can be managed or controlled. 

For example, if you are at risk due to family history or other medical conditions, these are unfortunately not something you are able to change [2]. 

For those whose risk factors include things like being overweight, having high blood pressure and cholesterol, or doing little to no physical activity, these can potentially be targeted through lifestyle changes or medication [2].

How to treat pre-diabetes

Disease control is not simple or straightforward, but with the right medical support and lifestyle changes, it is possible to manage pre-diabetes and not progress into type 2 diabetes [7]. Treatment for pre-diabetes generally involves similar changes advised for people who have type 2 diabetes [1]. 

Regular physical activity has multiple benefits in the treatment of pre-diabetes — it makes your insulin work better and can help lower blood pressure, blood glucose and cholesterol levels, and aids in weight management [4]. 

If you are a smoker, this could also be contributing to insulin resistance [4]. 

Healthy eating, including fewer saturated fats and more healthy fats, plus plenty of fruits, vegetables, and whole grains is also advised and can aid in losing weight if necessary.

Another way to approach weight loss is through Juniper's Weight Reset Programme — this holistic programme was created to help you achieve long-term weight loss with a mixture of breakthrough medication, which regulates digestion, reduces your appetite and lowers your set point, and behavioural changes guided by our health coaches and doctors.

We prescribe Wegovy, a GLP-1 medication that contains the active ingredient, semaglutide.

Semaglutide is clinically proven to reduce your appetite and make you feel fuller for longer, while also reducing cravings by targeting the rewards centre in the brain. 

For long-term success, changing your eating and movement habits is also crucial, which is why we offer a comprehensive programme that includes 3 core pillars of lifestyle change with the assistance of our UK clinicians.

We can help you break habits that might be impacting your weight and help you hit your weight loss goals sooner.

By making the right changes, you can reduce not only your chance of developing type 2 diabetes but also your likelihood of developing other conditions such as heart disease. 

If you suspect you may have insulin resistance or pre-diabetes, make sure to speak to a medical professional to assess your risk factors, organise a glucose tolerance test and discuss embarking on a lifestyle change programme.