Not everyone with prediabetes inevitably develops into type 2 diabetes. What you can actively do to bring your blood sugar levels back into the normal range.
Type 2 diabetes has long been considered a disease that cannot be reversed. However, we now know that it is possible, at least in the early stages of the disease, to bring the derailed sugar metabolism back into a healthy balance.
The role that nutrition plays in this was the topic of the autumn conference of the German Diabetes Society (DDG) 2023 in Leipzig, which took place this year in cooperation with the German Society for Nutritional Medicine.
Prediabetes is a precursor to type 2 diabetes. Three parameters are crucial for the diagnosis: If fasting blood sugar is measured, values between 100 and 126 mg/dl are considered prediabetes. If the sugar level is recorded two hours after drinking a sugar solution, values between 140 and 200 mg/dl are considered prediabetes. When measuring long-term blood sugar and recording the HbA1c value, values between 5.7 and 6.4 percent are considered a harbinger of diabetes.
The DDG points out that the ultimate goal in the treatment of prediabetes and early type 2 diabetes is remission, i.e. the regression of the disease. Since being overweight is by far the biggest risk factor for the development of the metabolic disease, it should be avoided. In addition to a balanced, healthy diet, experts recommend integrating plenty of exercise and sporting activities into everyday life.
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“These measures not only have a preventative effect, but are also important when the blood sugar level has already changed noticeably,” says Professor Diana Rubin, conference president of the German Diabetes Society (DDG) and chief physician at the Center for Nutritional Medicine and Diabetology at the Vivantes Humboldt Clinic Spandau Clinic in Berlin.
The likelihood that blood sugar levels will return to normal increases the more body weight is reduced.
Exercise has both short-term and long-term effects on blood sugar levels. In the short term it lowers it, but in the long term it ensures that the body’s cells react more sensitively to insulin. This means that less insulin is needed to keep blood sugar levels within normal limits.
Experts recommend 2.5 to 6 hours of exercise per week to prevent diabetes. There is no need to achieve top sporting performance. Everyday exercise such as shopping by bike, gardening or climbing stairs are also alternatives that have a positive effect on your metabolism.
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It is important that the healthy lifestyle is practiced permanently. Instead of following special diets, those affected should find a diet that they enjoy and that suits them and incorporate the type of exercise that they enjoy into their daily routine.
Even if type 2 diabetes is manifest in the early stages, a consistent change in diet can still lead to improvement. Studies prove this. When blood sugar levels return to normal, the risk of serious complications such as heart attacks, strokes, kidney and eye diseases also decreases.
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A current study by the German Center for Diabetes Research (DZD) shows that reducing abdominal fat is crucial for the success of therapy. This fatty tissue that lines the internal organs can promote inflammation and reduce the effect of the blood sugar-lowering hormone insulin in the body. Therefore, reducing waist circumference is particularly important when losing weight.
The accumulation of fat in the abdominal area is particularly dangerous, which increases the risk of diabetes mellitus. (Source: Eternalcreative/Getty Images images)
In order to achieve these goals, those affected need intensive nutritional support. “This should be in the hands of nutrition professionals such as dietitians, nutritionists, nutritionists or specially trained ecotrophologists,” says Rubin.
A change in diet does not work according to the “one size fits all” principle, but must be planned individually. It is only possible to achieve the required weight reduction of 10 to 15 percent and maintain it in the long term by taking into account people’s living conditions – such as daily rhythms determined by work or family and culture.
Different nutritional rules apply for older patients
However, there are also people with diabetes for whom completely different therapy goals apply. “In older people, for example, whose muscle mass has already been significantly reduced, additional weight loss is no longer sought,” explains Rubin.
The focus of nutritional therapy is on a sufficient supply of protein, which, together with exercise, strengthens the muscles, but also improves blood sugar levels through this intervention.
