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Treatments and drugs
By Mayo Clinic staffIf you have prediabetes, healthy lifestyle choices can help you bring your blood sugar level back to normal or at least keep it from rising toward the levels seen in type 2 diabetes. Guidelines from the American College of Endocrinology suggest the following to treat prediabetes:
- Eat healthy foods. Choose foods low in fat and calories and high in fiber. Focus on fruits, vegetables and whole grains. Strive for variety to help you achieve your goals without compromising taste or nutrition.
- Get more physical activity. Aim for 30 to 60 minutes of moderate physical activity at least five days a week. Take a brisk daily walk. Ride your bike. Swim laps. If you can't fit in a long workout, break it up into smaller sessions spread throughout the day.
- Lose excess pounds. If you're overweight, losing just 5 to 10 percent of your body weight — only 10 to 20 pounds (4.5 to 9 kilograms) if you weigh 200 pounds (91 kilograms) — can reduce the risk of developing type 2 diabetes. To keep your weight in a healthy range, focus on permanent changes to your eating and exercise habits. Motivate yourself by remembering the benefits of losing weight, such as a healthier heart, more energy and improved self-esteem.
- Take medications as needed. Sometimes medications — such as the oral diabetes drugs metformin (Glucophage) and acarbose (Precose) — also are an option if you're at high risk of diabetes. This includes if your prediabetes is worsening or you have cardiovascular disease, fatty liver disease or polycystic ovary syndrome. Some studies have indicated that pioglitazone (Actos) and similar drugs, which improve insulin sensitivity, might help reduce the risk of converting from prediabetes to diabetes, but were associated with weight gain and water retention (edema).
In other cases, medications to control cholesterol — statins, in particular — and medications to control high blood pressure are needed. Healthy lifestyle choices remain essential, however.
Because the findings from several recent studies suggest that regularly getting a good night of sleep may reduce insulin resistance, try to get at least six hours or more of sleep each night.
References
- Prediabetes FAQs. American Diabetes Association. http://www.diabetes.org/diabetes-basics/prevention/pre-diabetes/pre-diabetes-faqs.html. Accessed Oct. 4, 2011.
- Insulin resistance and pre-diabetes. National Institute of Diabetes and Digestive and Kidney Diseases. http://diabetes.niddk.nih.gov/DM/pubs/insulinresistance/. Accessed Oct. 4, 2011.
- Standards of medical care in diabetes — 2011. Diabetes Care. 2011;34:S11.
- Diabetes mellitus (DM). The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/endocrine_and_metabolic_disorders/diabetes_mellitus_and_disorders_of_carbohydrate_metabolism/diabetes_mellitus_dm.html?qt=diabetes%20mellitus&alt=sh. Accessed Oct. 7, 2011.
- Chaput JP, et al. Sleep duration as a risk factor for the development of type 2 diabetes or impaired glucose tolerance: Analyses of the Quebec Family Study. Sleep Medicine. 2010;10:919.
- Glucose. Lab Tests Online. http://labtestsonline.org/understanding/analytes/glucose/tab/test#. Accessed Oct. 7, 2011.
- Karam JG, et al. Update on the prevention of type 2 diabetes. Current Diabetes Reports. 2011;11:56.
- DeFronzo RA, et al. Pioglitazone for diabetes prevention in impaired glucose tolerance. New England Journal of Medicine. 2011;364:1104.
- Natural medicines in the clinical management of diabetes. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Oct. 4, 2011.
- Ratner RE, et al. Treatment recommendations for prediabetes. Medical Clinics of North America. 2011;95:385.
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