Walking it Back: Reversing Prediabetes

You probably know someone who has prediabetes and doesn’t know it. More than a quarter of Americans have it, and many are undiagnosed, according to the Centers for Disease Control and Prevention. And that’s bad news. Prediabetes – high blood sugar that isn't quite Type 2 diabetes – leaves you at greater risk of developing diabetes and also having a heart attack or stroke.

“Prediabetes carries significant cardiovascular risks, and it’s a sign of oncoming added risks of Type 2 diabetes,” says Dr. Tom Rifai.

Worse, a significant portion of the population has risk factors. Are you over 45? Overweight? African-American, Hispanic/Latino, Native American or Pacific Islander? You’re at higher risk. But Dr. Rifai thinks we’re all at risk. “Living in America is a risk factor, as far as I’m concerned,” he says. “It comes along with our lifestyle -- sedentary behavior and a highly processed diet.”

Now, the good news: prediabetes can be reversible. Your habits can tip you into the prediabetic range, but they also can nudge you back out of it. “There’s no magic wand,” Dr. Rifai warns. But making certain lifestyle changes can both reduce your risk of future problems and improve your quality of life. That’s because those changes can also help with other issues that often accompany prediabetes such as high blood pressure, high cholesterol, acid reflux, chronic joint pain and even asthma.

Here’s how to get prediabetes – and your general health – under control:

Number 1Get screened. People who have prediabetes generally don’t know they have it because it’s asymptomatic. “People should be screened, even if their only risk factors are being overweight and over 40,” Dr. Rifai says, “although I would argue you shouldn’t wait till you’re 40 if you also have a family history of type 2 diabetes.” Screening tests include the HbA1c, fasting plasma glucose and two-hour oral glucose challenge. Talk to your doctor to see if any are recommended for you.

Number 2Get moving. A gym membership can be great, but think beyond exercise classes. Take longer walks with the dog. Use the stairs in your office building. Park at the farthest edge of the parking lot. It all adds up. Visit the get moving section of the blog for more ideas.

Number 3Eat wisely. A diet high in processed, high-sugar, high-calorie foods is associated with prediabetes and a host of other medical issues. Look for high-fiber fruits and vegetables, and skip the sodas and fries. If you need a little inspiration, check out these quick and easy healthy recipes. This leads us to the last, most important recommendation...

Number 4Lose weight. (You knew this was coming.) “Nothing has more clear evidence for reversing prediabetes than achieving a healthy weight reduction,” Dr. Rifai says. He knows it’s not easy; he’s been there himself. “I’m 45 pounds lighter than my peak,” he explains. By the end of his internal medicine residency, he had prediabetes. “I couldn’t believe it – many residents live on processed, caloric-dense junk food, and I was no exception.” So it’s no surprise he went into lifestyle medicine. “This is as much therapy for myself as to help patients,” he admits. “I let them know they’re not alone.”

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Finally, beginning April 2018, Medicare Advantage members who have prediabetes can talk to their doctor about a referral into the Diabetes Prevention Program. This yearlong program will teach members how to live a healthier life through eating, exercise and stress management techniques targeting the risks related to prediabetes. Check with your doctor about how to enroll in the program.


MDPP services will be covered for eligible Medicare beneficiaries under our Medicare health plans.  MDPP is a structured health behavior change intervention that provides practical training in long-term dietary change, increased physical activity, and problem-solving strategies for overcoming challenges to sustaining weight loss and a healthy lifestyle.

Please refer to Chapter 4 in your 2018 EOC under the benefit “Medicare Diabetes Prevention Program (MDPP)” which describes your medical benefits and the cost as a member of our plans.

Categories: Get Healthy

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