With prediabetes, blood sugar levels are higher than normal but not high enough for a type 2 diabetes diagnosis.¹   The good news is that making healthy changes lowers your risk for all these problems. Up to 50% of cases of type 2 diabetes can be prevented or delayed if people with prediabetes use combined lifestyle interventions – including diet, physical activity and sustained weight loss – to reduce their risk.²

The food we eat is broken down by the body into glucose, a simple sugar, which circulates in our bloodstream. The hormone insulin, secreted by the pancreas, allows glucose (sugar) in the blood to enter the cells for use as energy.^1,3   If the cells in your body don’t respond normally to insulin, however – as can happen after years of poor diet and inactive lifestyle – your pancreas reacts by producing yet more insulin, but eventually can’t keep up and blood sugar will rise. This leads to prediabetes, and, in time, to type 2 diabetes.^1,3

Anyone can develop prediabetes, but the chances are higher if you:^1,4  

• Are overweight.
• Are aged 45 years or more.
• Have a parent or sibling with type 2 diabetes.
• Aren’t sufficiently physically active i.e. you exercise less than 3 times a week.
• Are a woman who’s had gestational diabetes (diabetes during pregnancy), or who’s given birth to a baby weighing over 4kg.
• Are a woman with polycystic ovary syndrome.
• Ethnicity can also be a risk factor. For example, in South Africa the Indian population is at highest risk for developing prediabetes and diabetes.

You can have prediabetes for years without any obvious symptoms, so the condition often goes undetected until serious health problems such as type 2 diabetes and associated complications develop.¹   This is why it’s important to have a simple blood sugar test if you have any risk factors for prediabetes. You can do this at your doctor’s office; many pharmacies also offer blood sugar testing.¹   The most common blood sugar test is the HbA1c test which gives your average blood glucose (sugar) levels for the last two to three months. If your HbA1c level is:

• Below 5.7% – your blood sugar level is normal
• 7% to 6.4% – you have prediabetes
• 5% or higher – you have diabetes.^2,5

If you have prediabetes, you can lower your risk for developing type 2 diabetes by:   Losing weight if you are overweight. Losing even 5-7% (5-7kg if a person weighs 100kg, for example) of your body weight can significantly reduce your risk. Research has shown that for every 1kg of weight lost, there is a 16% decrease in the risk of developing Type 2 diabetes.^1,4   Eating a healthy, balanced diet. Include more of these foods:¹

• Fruits and vegetables (especially green leafy vegetables like kale, blueberries, grapes and apples)
• wholegrains
• lean proteins
• Fat-free or low-fat yogurt and cheese
• unsweetened tea and coffee

Reduce intake of these foods:

• sugar-sweetened drinks
• red and processed meats (e.g. beef, lamb, pork, ham, sausages)
• refined carbohydrates (e.g. sugary snacks, white bread, sugary cereals)
• potatoes (especially French fries).

  Getting regular exercise. Being sedentary, which involves spending too much time sitting and lying down and generally being inactive, is linked with an increased risk of type 2 diabetes.¹   The recommendation is to build up to at least 150 minutes a week (30 minutes a day, 5 days a week) of moderate intensity aerobic (cardiovascular) exercise e.g. brisk walking, playing doubles tennis.²   It’s best to also include strength or resistance training (e.g. lifting weights, doing pressups and squats) as this has been shown to improve insulin use by the body and, consequently, also to improve blood sugar levels.⁴   Every bit of physical activity you can add to your daily life helps reduce your risk of developing type 2 diabetes. Think about making small changes such as taking phone calls standing up, using stairs instead of the lift, going for a walk on your lunch break, and playing with kids or pets.²