How to Stop the Progression of Prediabetes to Diabetes

Friday, August 24, 2012

ROCHESTER, Minn. — The progression from insulin resistance and prediabetes to diabetes likely can be stopped with changes in diet and lifestyle, according to the August issue of Mayo Clinic Health Letter.

In people with insulin resistance, cells do not respond normally to insulin, and the body's fuel, glucose. As a result, the body produces more insulin to overcome the resistance. Over time, cells become more resistant, and the body can't keep up with insulin production. Blood glucose levels rise and eventually, type 2 diabetes develops.

But the progression from prediabetes to type 2 diabetes often can be stopped. One large study, the Diabetes Prevention Program, found that modest lifestyle changes reduced the risk of progression by 71 percent in adults age 60 and older. Participants who reduced their risk the most:

• Consumed fewer calories and cut back on fat.
• Exercised the equivalent of brisk walking 30 minutes a day, five days a week.
• Lost a little weight. The goal was 7 percent of body weight; for example, 14 pounds for a person weighing 200 pounds.

Insulin resistance appears to be caused by a combination of genetic and lifestyle factors. A sedentary lifestyle and a family history of diabetes are risk factors. So is being black, Native American, Asian-American, Hispanic or a Pacific Islander. Being overweight, especially with excess fat around the abdomen, is the greatest modifiable risk factor for progressing to type 2 diabetes among those who already have insulin resistance.

Several medications have been shown to reduce the risk of type 2 diabetes. The best appears to be metformin (Glucophage), but studies show many limitations. This medication is least effective in adults over 45 and not recommended for those over 60. Even for younger adults, metformin isn't as effective as losing weight and exercising.

Mayo Clinic Health Letter is an eight-page monthly newsletter of reliable, accurate and practical information on today's health and medical news. To subscribe, please call 800-333-9037 (toll-free), extension 9771, or visit Mayo Clinic Health Letter Online.

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